Pediatric Assessment PDF

PEDIATRIC ASSESSMENT Nutrition Screening Nutrition risk Score (Paris tool) Subjective global assessment Strongkids tool STAMP PYMS Anthropometry Head circumference – Under 2 years Weight – Ideally naked or dry nappy – Using a digital calibrated scale – More frequently for sic...

PEDIATRIC ASSESSMENT Nutrition Screening Nutrition risk Score (Paris tool) Subjective global assessment Strongkids tool STAMP PYMS Anthropometry Head circumference – Under 2 years Weight – Ideally naked or dry nappy – Using a digital calibrated scale – More frequently for sick infants Height – Supine under 2 years vs standing – Sick infants every month WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction.  Measurement of Length Recumbent Length, until age of 24 months, up to 36 months if child is unable to stand Should use a Perspex measuring boards or length board WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. Measurement of Length Remove shoes, socks, braids, hair ornaments… Perform measurement with mother, best if she holds the head Eye socket should be perpendicular to the board Shoulders and buttocks touching the board Legs straight, gentle pressure on knees (attention to newborns) Measure to nearest 0.1cm WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction.  Measurement of Height Used when a child is 2 yrs or older and able to stand In general height is about 0.7cm less than recumbent length –If a child is less than 2yrs old and will not lie down, add 0.7cm to convert to length –If a child is 2yrs old or older and cannot stand, subtract 0.7cm to convert to height WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction.  Feet slightly apart  Touching spots: Head, shoulders, buttocks, heels…as many spots as comfortable in the case of an obese child WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction.  Read to the nearest 0.1cm WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. Proxy measurements Measurements of lower leg length or knee-heel length have been used and are a useful proxy for growth Formulas for calculating stature in children are available MUAC is useful to monitor the health of sick children WC is useful in assessing the presence of dyslipidemia, insulin resistance in overweight children SFT (skinfold thickness can be used). It might be unpleasant for some children Bioelectrical impedance is useful in normal children but not for sure in those who are sick  Head Circumference Relevant up till age of 36 months (now till 24mnths) Usually growth is rapid up till 12 months and slows down till 36 months Just above the eyebrows, above (not over) the ears, around the back of the head Measures maximum circumference Measurement should be taken to the nearest 0.1cm abnormal head circumference is due to a disease rather than malnutrition WHO (2008). Training Course on Child Growth Assessment. WHO Child Growth Standards. Module A, Introduction. Head Circumference Growth charts Measurements should be regularly plotted on a relevant growth chart Thrive lines’ have also been developed to aid interpretation of infants with either slow or rapid weight gain. The 5% thrive lines define the slowest rate of normal weight velocity in healthy infants: - If an infant is growing at a rate parallel to or slower than a 5% thrive line weight gain is abnormally slow. The 95% thrive lines define the most rapid rate of normal weight gain in healthy infants and weight gain that parallels or is faster than the 95% thrive line is abnormally rapid BMI Body mass index A BMI measurement can be calculated from weight and height measurements: BMI = weight (kg)/height (m2). There are limitations, however, to the use of BMI in children: 1. It is not recommended in children