Determining Overall Health in Pediatric Patients
Core Assessment Components
- The American Academy of Pediatrics recommends plotting weight, length/height, and head circumference on CDC or WHO growth curves to identify percentiles and detect growth abnormalities 1, 2
- The Centers for Disease Control and Prevention suggests calculating and plotting Body Mass Index (BMI) on age- and sex-specific percentile curves, with the 85th percentile identifying mild-to-moderate overweight and the 95th percentile identifying significant overweight requiring further evaluation 3, 4
- For premature infants, the American Academy of Pediatrics recommends correcting for gestational age when assessing growth and development through at least 24 months 1, 2
- The American Academy of Pediatrics emphasizes the importance of documenting all five vital signs: heart rate, respiratory rate, blood pressure, room air oxygen saturation, and temperature 1
- The American Academy of Pediatrics recommends that vital signs provide objective markers of physiologic stability and are fundamental to distinguishing well from ill children 5
Laboratory Testing: A Targeted Approach
- The American Heart Association recommends obtaining blood pressure measurement, lipoprotein analysis, and fasting insulin and glucose determination for children with BMI >95th percentile 3, 4
- The American Academy of Child and Adolescent Psychiatry suggests targeted medical testing, such as height and weight for stimulants, and height, weight, and lipid testing for antipsychotics, before initiating psychotropic medications 6
Critical Documentation Elements
- The American Academy of Pediatrics recommends documenting allergies, previous adverse drug reactions, current medications, relevant diseases, physical abnormalities, and neurological impairment 6, 5
- The American Academy of Pediatrics suggests documenting immunization history 1