Children are not small adults
The fact that children are not simply small adults affects patient evaluation, even if the basic guidelines when evaluating a patient stays the same. Children can often only vaguely describe their complaints. Therefore, supplemental information obtained from caregivers plays a major role in caring for children. Nevertheless, the child should be taken seriously, and considered its own person. Lastly, children may present with very different symptoms than adults.
Signs of an altered state of consciousness in children include: Refusal to eat, irritability, shrill cries, apathy (possibly alternating with excited states), confusion, drowsiness, decreased bodily tonus, movement abnormalities, loss of consciousness and seizures.
Signs of respiratory difficulties/distress include: Nostril flaring (flaring of the nostrils after each breath), inspirations including the chest wall and neck, inverted breathing (the chest falls during inspiration and the belly curves; with opposite actions during expiration), nodding movements during respiration (chin raised during inspiration, chin down during expiration), coughing, hoarseness and breathing sounds such as whistling, grunting, moaning, crackling, gurgling, rattling, and wheezing, cyanosis (bluish coloration) of the lips, toe- and fingernails.
Signs of circulatory problems in children include: dizziness, paleness, cyanosis (bluish coloration) of the lips, toe- and fingernails, general malaise, marbling of the skin.
Signs of an injury include: whimpering, crying, screaming, protective postures.