What is the best approach to the general and regional inspection?

  1. First stand back (at the end of the bed) and have a good look at the whole child (general inspection):
    • Does the child appear well or ill, distressed, toxic or shocked?
    • Does the child look strange, with an appearance suggesting a syndrome (dysmorphic)?
    • Is the child fully conscious and co-operative?
    • Does the child look thin or fat? What is the nutritional status? Is the child wasted?
    • Is the child afraid, tearful, angry or embarrassed?
    • Is the child pale, jaundiced or cyanosed?
    • Does the child have a rash?
    • Does the child appear well cared for?
    • Does the child appear dehydrated?
  2. Secondly, inspect each part of the body (region) starting with the head and ending with legs (regional inspection):
    • Head – size, appearance, hair, fontanelle
    • Ears – appearance, exudate
    • Eyes – appearance, conjunctivitis, jaundice, squint
    • Nose – discharge, flaring
    • Mouth – appearance, stomatitis, thrush, pallor or cyanosis, cleft palate
    • Neck – enlarged thyroid or lymph nodes
    • Arms – lymph nodes, rickets, palmar creases, clubbing, pallor or cyanosis
    • Chest and abdomen – appearance, dehydration, rash, scars, hernias
    • Spine – scoliosis
    • Genitalia – appearance, undescended testes, hernias
    • Legs – lymph nodes, rickets, oedema, clubbed feet

Usually the general and regional inspection is followed by an examination of the main body systems. The general and regional inspection often indicates what system needs special attention during the systematic examination.

Always look carefully first before touching the child.

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