The pediatric physical examination: General principles and standard measurements
- Jan E Drutz, MD
Jan E Drutz, MD
- Section Editor — General Pediatrics
- Professor of Pediatrics
- Baylor College of Medicine
Sophisticated technologic advances in medicine have proved to be remarkably beneficial in the diagnostic process, yet the well-performed history and the physical examination remain the clinician's most important tools. They are venerated elements of the art of medicine, the best series of diagnostic tests we have .
A relatively complete physical examination should be performed on each patient, regardless of the reason for the visit. Numerous medical anecdotes relate instances in which the examination revealed findings unrelated to and unexpected from the patient's chief complaint and major concerns. On occasion, a limited or inadequate examination may miss a significant condition, mass lesion, or potentially life-threatening condition.
The general principles, standard measurements, and overall approach to the pediatric patient are discussed here. Examination of specific organ systems is discussed separately. (See "The pediatric physical examination: HEENT" and "The pediatric physical examination: Chest and abdomen" and "The pediatric physical examination: Back, extremities, nervous system, skin, and lymph nodes" and "The pediatric physical examination: The perineum".)
The approach — After years of experience, seasoned examiners become aware of potential avoidable pitfalls often encountered upon entering a patient's room. Before entering the room, the clinician should review the patient's chart and confirm the identity of the patient and others in the room. Most clinicians have experienced the discomfort of walking into a room and greeting the patient, parent, or caregiver by the wrong name or of having the correct name but the wrong medical record.
To avoid a potentially embarrassing situation, the examiner should always knock on the door and await a response before entering. Small children standing on the other side can be injured easily by the door handle or by the door's impact as it is being opened.
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