Pediatric emergency medicine trisk 0649 0649
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Physical
examination
General
HEENT
Diagnosis to consider
Alertness, responsiveness
Work of breathing, color,
feeding activity
Eyelid swelling, erythema,
tenderness
Conjunctival erythema, +/−
discharge +/− rhinorrhea
(i.e., +/− URI)
Periorbital, orbital
cellulitis
Conjunctivitis, viral
syndrome, Kawasaki
disease (if limbic
sparing)
Otitis media
Tympanic membrane
erythema, bulging,
decreased mobility, loss
of landmarks/light reflex,
air–fluid level behind, or
purulent drainage from a
perforation
Rhinorrhea, nasal
Viral upper respiratory
congestion
infection (URI)
URI symptoms persisting
Acute bacterial sinusitis
≥10 days OR severe onset
of fever >39°C and
purulent nasal discharge
≥3 days
Stridor, excessive drooling, Epiglottitis, a bacterial
and tripod positioning
tracheitis, a diphtheria
(rare) a ; retropharyngeal
abscess
Barky cough, +/− URI
Croup
findings, stridor
Oropharyngeal erythema,
Acute pharyngitis (viral or
exudate, tonsillar
streptococcal), tonsillitis,
hypertrophy, peritonsillar
peritonsillar abscess
swelling
