Secondary Diagnosis and Treatment
After you have progressed through the ABCDE method and have discovered a treatable cause, and the child or infant has not deteriorated to a more severe clinical (life-threatening) situation, move on to performing a more thorough survey. This includes a focused history and physical examination involving the individual, family, and any witnesses as relevant. In terms of history, you could follow the acronym SPAM: Signs and symptoms, Past medical history, Allergies, and Medications.
The focused examination will be guided by the answers to the focused history. For example, a report of difficult breathing will prompt a thorough airway and lung examination. It may also prompt a portable chest x-ray study in a hospital setting. Key point is that it is best to work from head to toe to complete a comprehensive survey. Make use of diagnostic tools when possible to augment the physical examination.
|S: Signs & Symptoms|
|• Evaluate recent events related to
-Preceding illness, dangerous activity
|• Examine patient from head to toe for
-Agitation, anxiety, depression
|P: Past Medical History|
|• Complicated birth history|
|• Any drug or environmental allergies|
|• Any exposure to allergens or toxins|
|• What medications is the child taking
(prescribed and OTC)?
|• Could child have taken any inappropriate
medication or substance?