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Measurements in The Normal Child

Measurements in The Normal Child. Alun Scourfield. Parameters of normality. Exclude: Birth weight Measurements of physical development(Ht,Wt,HC) Milestones Measurements in the context of looking at the well child and feverish child. Temperature. Measure

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Measurements in The Normal Child

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  1. Measurements inThe Normal Child Alun Scourfield

  2. Parameters of normality • Exclude: • Birth weight • Measurements of physical development(Ht,Wt,HC) • Milestones • Measurements in the context of looking at the well child and feverish child.

  3. Temperature • Measure • oral ,rectal,axillary(digital thermometer) • Advise against oral or rectal under age 5yrs • Generally,37.2°C axilla,37.5°C oral,38°C rectal---normal threshold • Recommend digital,chemical dot and tympanic(forehead strips not recommended) • Tympanic thermometers • May measure as much as 0.74below--1.34but instructions give a range of values suggesting they are close to core temp. • Recommended by Delphi panel(to NICE)

  4. Pulse rate • Varies with temp----(1°C  =20 beats/min ) • 130 beats/min at birth • 110 beats/min at 1yr • 100 beats/min at 3yrs • 80 beats/min at 8yrs

  5. Respiratory rate • 40 breaths /min at birth • 2nd year 25/min • 5th year 20/min • 1:3 or 4 ratio with pulse in health.

  6. Blood pressure • Rarely measured !--cuff size ? • 80/50 in the newborn • 85/60 at 4yrs • 95/65 at 8yrs • 110/70 at 10yrs • 110/75 at 13yrs

  7. Reference grid

  8. Capillary refill time • How reliable ?---less than two seconds . • Measure of what ? • Effect of ambient temperature /fever? • Observer error(even with stop watch)

  9. Hydration • Significant dehydration defined as 5% or more loss in weight---clinical signs apparent • Urine output an indicator • 2 of four of the following: capillary refill time >2 secs absent tears dry mucous membranes ill looking Ref:PEDIATRICS Vol. 99 No. 5 May 1997

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