Second Assessment: Diagnose & Treat

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 (Table 8).

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.