Brief introduction of pediatric consultation

Directory 1 Introduction to Pinyin 2 3 questions about cold and heat 4 questions about sweat and heat 5 questions about spirit 6 questions about head and body 4 questions about five questions about two stools, eight questions about six tastes and nine questions about chest and abdomen 10 eight questions about sleep 16 nine questions about etiology 12 ten questions about personal history 1 pinyin é ré k ē wè n.

2 Introduction Asking questions is an important way to understand the medical history and illness. The main target of pediatric consultation is parents or nurses. The etiology of children, in addition to congenital factors such as fetal weakness and acquired factors such as exogenous and internal injuries, must be described by their parents or caregivers. Ask about the onset time, etiology and symptoms, and take pains to trace the main links to find out the root cause of the disease. The procedure and content of consultation can be carried out according to "Ten Questions".

3 When asked about hot and cold, children's fever can be perceived through contact, such as hand, foot and heart fever, head and forehead fever, and oral fever when sucking milk. Children's aversion to cold can be measured by the change of posture, such as snuggling in their mother's arms and lying down curled up. The key to asking questions about cold and hot is to distinguish between exterior and interior; Such as fever, gratifying hug, shrinking, reluctance to show up, facial bleeding, no thirst, self-adjustment, breast not hot, or nasal congestion and runny nose, or sneezing, all over the body is anxious, which belongs to exterior heat; When you have a fever, you like to show your face, lie on your back, raise your hand, take off your clothes and quilt, be thirsty to drink water, have a hot mouth when sucking milk, have yellow urine and constipation, which is internal heat. After a serious illness, or warm, or hot flashes, or thirsty or not thirsty, defecation as usual, for deficiency heat; Fever, dry lips, dry nostrils, catching a cold when you are happy, or lying on your back, exposing your hands and feet, undressing and quilt, endless thirst, constipation and constipation are all excess heat.

Children's fever at night is night fever, and those with abdominal heat and yellow face are night fever. According to different syndrome types, we should pay attention to the differentiation of milk accumulation, food accumulation, gas accumulation, shock accumulation, deficiency accumulation, excess accumulation and mass accumulation. For example, if you also see vomited milk tablets, those with abnormal acidity and smell are milk stasis and night heat; Sleeping, vomiting and diarrhea, abdominal distension, food accumulation and night heat; At the same time, abdominal pain and frequent crying, such as crabs and Bohai Sea, are qi accumulation and night heat; Seeing diarrhea and green juice at the same time, sometimes people who are surprised and crying are frightened and accumulate at night; Those with edema on the surface and hands and feet are asthenic accumulation of night heat; At the same time, excessive heat leads to drinking, and people who are good at eating shit are actually accumulating night heat; At the same time, phlegm and blood stasis are intertwined and there is a lump in the abdomen. If it is hard, it will accumulate at night. If the night fever persists, the whole body is emaciated, the skull is big and the abdomen is abnormal, it is malnutrition. Warm-up at night, emaciation, cough and hemoptysis, vexation, impatience and crying are all fever, or tuberculosis due to yin deficiency.

4 The second question is that children's skin is weak, and it is easier to sweat than adults, which is generally not pathological. If you sweat during the day or when you wake up, this is spontaneous sweating, which belongs to qi deficiency or yang deficiency; If you sweat at night or sleep, it's night sweats, mostly due to yin deficiency. Sweating like rain, dripping profusely, is the collapse of Yang.

5 Three Questions: Children with normal mental health have good personality and are lively and active. Those who are mentally normal are slightly ill, and those who are mentally depressed are seriously ill, mostly due to deficiency. Most restless people are heat syndrome and positive syndrome.

It is a headache for the four problem children about the head and body to cry and shake their heads or hold their heads with their hands. Headaches with fever and chills are exogenous headaches; Headache is accompanied by excess heat, sweating, convulsion and polydipsia, which is caused by hyperactivity of Yangming heat and internal movement of liver wind. If the limbs are restless, most of them are painful. Fever and limb pain are often manifestations of exogenous diseases or rheumatism.

7 five questions and two stools are difficult, and too dry is constipation. Constipation is a new disease, which belongs to excess heat of large intestine; Constipation due to chronic illness is dryness of body fluid. Frequent defecation and thin feces are diarrhea, which belongs to spleen deficiency. Diarrhea is sparse, and breast lumps are injured; Dysentery and purulent blood belong to excess heat of large intestine; Diarrhea is like water, believing that water is wet; Short urine, yellow and red heat, is hot; Urine is clear, large and long, and it is cold.

It is normal for children to eat on time without vomiting and diarrhea. If you don't breast-feed or eat less, it is spleen and stomach weakness. Longing for cold drinks is a heat syndrome; The thirst for hot drinks is cold syndrome. Frequent drinking is a loss of body fluid and insufficient stomach yin. Abdominal distension without thinking about diet is the stagnation of breastfeeding; Don't think about breastfeeding for diarrhea, because the spleen is unhealthy. In addition, most of the vomiting caused by neonatal breastfeeding is galactorrhea.

9 Seven Questions: The chest and abdomen are full and cough, which is the wind and evil; Chest tightness and asthma, phlegm blocking lung orifices; Chest pain, fever, asthma and cough are the evils of warming the lungs; Chest tightness, palpitation, blue face and shortness of breath are blood stasis and qi stagnation, and heart yang deficiency is weak; Abdominal fullness is mostly caused by food stagnation; Abdominal pain and diarrhea, mostly spleen deficiency; Abdominal pain is weak and located around the navel, which is more common in ascariasis.

10 Eight questions Normal sleeping children sleep quietly. The younger they are, the longer they sleep. Restless sleep, irritability, belonging to the same heat of heart and stomach; Sleep is not deep, easy to wake up, for lack of heart; Bite your teeth when you sleep because there are insects and hot air in your stomach; Shock and crying during sleep are mostly shock; Sleeping at night is restless and itchy, mostly pinworm disease. Sleepiness and drowsiness in fever are mostly caused by pathogenic factors entering pericardium or phlegm.

1 1 Nine questions about the cause ask about the direct cause and related factors. Such as whether you were frightened before you got sick, whether you ate unclean food or had contact with infectious diseases (such as measles, diphtheria, dysentery, etc.). ), and whether your parents and other family members have a history of tuberculosis.

12 ten questions about personal history ask about the history of production, breeding and growth. The production history includes parity, parity, term, natural delivery or dystocia, delivery mode, delivery situation, nutritional status and health status during pregnancy. This is especially important for newborns and babies. Feeding history includes feeding methods and complementary food addition. Older children should also ask about eating habits, current recipes and appetite. Developmental history includes physical and intellectual development, time of sitting, standing and walking, language, etc. If you have entered the school, you should also know about your study to infer your intellectual development.