Monday, October 1, 2012

A baby with fitting episode

Approaching
Hi, I'm medical student, how are you? What you name Madame?
The baby name? How old is he?
What can I know why you coming here?
" my child has fit"
Is it first time? How long the fit episode? Duration? What the baby do during that time? What are your action?
The fit resolve spontaneously? What happen to the baby, any abnormal movement? Any Other symptom
: uprooting eyes, drooling of salivation, urinary incontinence
Post ictal: how is the baby? Drowsy, weakness, crying, any loss of consciousness
Any repeated episodes of fit?
How long you take to being to hospital

Exclude Differential diagnosis
Meningitis, hypoglycaemic! URTI, UTI, AGE 

The baby having fever? Duration? What day the fit develop? Pattern of fever? High grade, rigor,resolve with antipyretic? Sought treatment? What given by the clinic, any blood investigation done? How the result? After taking medication fever resolve or not?Antibiotic?
Last meal taken before fit episode? Any loss of appetite since illness, reduce oral intake?
Rhinorrhea, color of discharge?
Cough? Phlegm, nature? Taking medication, resolve? On day what it develop? Any rapid breathing, chest in drawing noted, wheezing, 
Inconsolable crying, activity daily, oral intake ? Any reduction. Irritability, skin rashes, bowel open, how the stool? Changes? Color? Frequency?blood stained, mucus,
Urination, color? Smelly, blood, pus,increase in frequency, crying during urination.vomiting episode?
Who taking care of him,N   baby sitter? Other child had fever  or same symptoms, any family member ? Contact with tb patient?
Pmhx
Admission to the ward before? Underlying disease
Prenatal. Infection during pregnancy
Intapartum, asphyxia, resuscitation? Method of delivery 
Post. Jaundice, what day develop? Nice admission, treatment, blood taking daily
Fhx
Sibling? Having fit? Parent? Mr? Congenital ds,
Development . Delay? What he can do know
Immunization? Skipped? What currently, next ? Cx?


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