[6-25-2017: Using the 3-minute Toolkit Basic Child Assessment is the best way to avoid pediatric diagnostic errors.]
What follows is the 3-Minute Toolkit Checklist (from the video–Purpose of The 3-Minute Toolkit) at the site Spotting the Sick Child. This site is an outstanding review course of basic pediatrics and all childrens’ doctors can benefit from this structured course. To access the content, you need to register which is free.
Be sure to watch the entire Basic Child Assessment set of videos of 3-Minute Toolkit.
The Checklist:
A Airway
- Secretions
- Stridor
- Foreign Body
B Breathing
- Respiratory Rate
- Retractions/Accessory Muscle Use
- Oxygen Saturation
- Auscultation
C Circulation
- Color (eg, pale or mottled)
- Heart Rate
- Capillary Refill
- Temperature of the Hands and Feet
D Disability
- Pupils
- Limb Tone & Movement
- AVPU Score/CGS
- Glucose
ENT Ear, Nose & Throat Examination
T Temperature
T Tummy
If Drowsy or Very Unwell, Include:
DEFG– And Don’t Ever Forget Glucose
as part of C.
The authors state:
“Diagnosing acutely ill children can be scary, but this section will teach you a checklist which will help you. Children’s symptoms are often vague and tend to be quite non-specific, such as vomiting or a temperature, whatever the cause of the illness, so physical examination often plays a greater part in diagnosis than it does in adults. You will often only make a diagnosis through examining a child, such as finding the focus of infection. Assessing the child’s physiological status will help you assess the severity of illness, such as bronchiolitis or asthma or dehydration. Although a general impression is important, children who are starting to decompensate can look deceptively well, but the clues will be there if you make a thorough examination. Face to face consultation is therefore important. A physiological examination is also important to pick up serious but tricky diagnoses such as meningococcal septicaemia, diabetic ketoacidosis or myocarditis, where features such as tachycardia or tachypnoea are sometimes the only clues for a disease which is hard to diagnose. You will pick these up using the 3 minute toolkit.
“The three minute tool-kit is a quick top to toe assessment tool for examining a child to pick up common physical sigs and make a rapid physiological check.”