General Inspection

Sick-Appearing Infant? → ABC
- A: Appearance → tone, gaze, alertness, symmetrical movement
- B: Work of Breathing → inter-costal indrawing
- C: Circulation to the skin → Cynosis, mottled, Jaundice, Pallor

Vitals

Pre-to-postductal SpO2 (Δ <3%, > 95%)
Pediatric Vitals For a newborn:

Heart Rate (beats/min) Blood Pressure (mm Hg) Respiratory Rate (breaths/min) Urinary Output (mL/kg/hr) Wet Diaper Stool

<160 >60 <60 2.0 1-2 (for 1-2 days) ‣
Pediatric Growth Assessment for a newborn:

Weight Height Head Circumference

2.5 - 4.5 kg 50 cm +/- 2 > 32 cm
- Birth Weight (2.5 - 4.5)
  - Large = GDM - Gestational Diabetes
  - Small = IUGR/FGR
- Head circumference (32 in NB)
  - Abnormal = Head Trauma in Newborn, Hydrocephalus
Consider detailed Pediatric Volume Status if abnormal

Heart Rate (beats/min)	Blood Pressure (mm Hg)	Respiratory Rate (breaths/min)	Urinary Output (mL/kg/hr)	Wet Diaper	Stool
<160	>60	<60	2.0	1-2 (for 1-2 days)	‣

Weight	Height	Head Circumference
2.5 - 4.5 kg	50 cm +/- 2	> 32 cm

Dysmorphic features → Chromosomal disorder, e.g. Trisomy 21 - Down Syndrome
- Position and shape of the ear
  - Outer canthus of the eye should cut the ears so that 1/3 is above, and 2/3 is below
- Upper philtrum is not smoth