224
224
MED
224
M1
Growth and development
OSCE
OSCE Team
Growth parameters
Disclaimer: No doctor have approved this file ,
and is made by students for the benefit of the
students.
Watch the video for the procedure
[Link]
remember WIPPPER
W - wash (sanitize) hands (before and
after)- wear gloves where appropriate.
I - introduce yourself
P - privacy and comfort of patient is
conserved
P - permission from patient
P - position patient correctly
E - expose the procedure part on the
patient by asking them to do so (where
appropriate)
R - right side of the bed
After finishing cover the patient
and thank them
Growth parameters
Growth parameters are measured routinely with each visit measured and plotted on growth charts for
evaluating the growth and nutritional status of child. All the charts are provided at the end
The question could
In case the child is able to understand you should do all the talking including WIPPPER directly to the chilld and
if they are not able to understand you can speak to the parents.
Length (in case the child is not able to stand or below the age 2)
Exposure : as appropriate (like remove foot or headwear)
Position : Supine with knees fully extended
Place a Head-board firmly above the Child’s head (in exam maybe you will use the
wall as the head-board).
Place a foot-board firmly against the child’s foot, make sure their knees are fully
extended.
Mark on the bed sheet the edges of both boards. (if there are no bed sheets and
pen directly use the the measuring tape to measure
Remove the boards and put the child aside or return them to their parent.
Using a measuring Tape, measure between the two marks you made on the sheet
and note it down.
Plot the measured Length on the growth chart, and finally report if normal or
abnormal. Make sure to use the correct chart for LENGTH and not mistakenly use
the one for height , also make sure its the correct gender and age chart
Height (in case the child is able to stand or above the age 2)
Exposure : as appropriate (like remove foot or headwear)
Position : standing with knees fully extended
Ask the child to firmly place their back, buttocks and scapulae against the wall
with straight posture.
Place a headboard firmly against the child’s head.
Mark the location of the board with a pen on the wall.
Ask the child (volunteer) to step away .
Measure the marked height with measuring tape and note it down.
Plot the measured Height on the growth chart, and finally report if normal or
abnormal. Make sure to use the correct chart for Height and not mistakenly use
the one for Length , also make sure its the correct gender and age chart
Expected Length/Height according to age (if told to estimate, no calculations)
At Birth: 50 cm 1 year: 75 cm
6 Months: 66cm 2 - 12 years: 6 (age in years) + 77
Weight (This part will be only Theoritical)
Exposure :
•< 2 years old: The child should be completely naked for accurate measurement. (sometimes if
the diaper is empty you can leave it on)
• 2–9 years old: The child should be dressed in minimal clothing to avoid unnecessary weight
from clothing.
Position :
• < 2 years old: Place the child in a supine position on a infant scale.
• 2–9 years old: Use a standing scale for measurement.
Plot the measured weight in Kg on the appropriate growth chart and report if
normal or abnormal, make sure to use the correct chart for the appropriate gender
and age
If you were only given the age of the child’s age and asked how to calculate the
expected weight of the child remember these (you will do no calculations) :
3-12 months = (age in months + 9) / 2
1-6 Years = 2 (age in years) + 8
7-12 Years = (7 x age in years - 5) / 2
Head Circumference
Exposure : as appropriate
Position : Sitting or supine
Place the measuring tape above the eyebrows (superior orbital ridge).
Wrap it around the widest part of the head, above the ears, passing over the occipital
protuberance.
Pull the tape snug but not tight.
Record to the nearest millimeter.
Measure three times and take the highest value.
Plot the result on the appropriate age- and gender-specific chart.
Report as normal or abnormal.
If abnormal, measure the parents to check for familial patterns.
Note : if the recorded measurement is greater or lesser than the normal , take the
measurement of the parents and see if they are also abnormal as it could be familial
If you were asked to estimate, as a seperate question, knowing only the age these are the
expected:
At birth - 35 cm
3 months - 41 cm
6 months - 44 cm
1 Year - 46 cm
Mid-upper arm circumference (MUAC)
To assess malnutrition in children, especially when weight measurement is
unreliable (e.g., cancer, edema, liver diseases).
Exposure: as appropriate
Position : supine or sitting down
Locate landmarks: Identify the acromion process of the shoulder and the
olecranon process of the elbow.
Mark the midpoint: Measure in cm the distance between these two points and
mark the midpoint on the arm.
Measure circumference: Wrap the measuring tape around the arm at the
marked midpoint.
Record the measurement to the nearest millimeter.
At birth MUAC is normally around 10 cm.
6 months to 5 years: Normal range is 16–17 cm.
Any measurements above 13.5 cm is considered normal.
MALNOURISHMENT ASSESSMENT
Green Zone (above 12.5 cm) = Well nourished child
Yellow Zone (11.5 - 12.5 cm) = At risk of malnourishment
Red Zone (0 - 11.5 cm) = Acutely malnourished
Note that
If you were required to use the growth chart it would be mentioned in the question,
otherwise you can mention the formulas to get the expected measurements
according to age
Examples of how the questions might come:
What is the range of MUAC of a child who is at risk of malnourishment? 11.5-12.5
What is the expected height/length of a child at birth, 6 months, 1 year?
What is the formula used to calculate the expected height?
A 3 year old boy came to the clinic....... what is the expected weight? mention the
formula
A 6 year old girl came to the clinic....... use the appropriate chart to assess if the
his weight and length/height is normal?
Make sure you use the right chart regarding age and gender, you should only
use centimeter (cm) and Kilogram (Kg)
Weight
Length Height
Head Circumference
Our team
Haidarah alghamri Bisher salame
Anees hussain Mohammed
Dalati
Mohammed alaidarous Walid Kastali
Sulaf Almesh Fayza Akil
Thank you