Warning - Do Not Read This If You're Easily Offended

Paediatric Physical Exams Are Better Left to Real Doctors!

"Children, Of Course, Have Very Different Needs to Adults, Especially When it Comes to Health Care"

 

Dr Neil Davies at NIP Academy and Kiro KidsTruth is, I say, let the best trained people do their jobs and anyone who fluffs around the edges should stay out of potential trouble! Now I’ve ruffled some feathers, let me explain myself. Chiropractors do a great job of treating kids … well most of the time …. but the standard of examination often leaves something to be desired. I know some will say they don’t diagnose – let’s see what the law would say about that!

I don’t know where you live and work but my country has very straight forward legislation. It says you’re responsible for anything taught  at under-graduate level and to maintain your continuing professional development to an acceptable level. It goes on to say that you should practice to the level that any other reasonable practicing colleague might agree they should adhere to.

Bottom line – before you claim expertise caring for children, it might not be a bad idea to bring yourself up to speed with current, acceptable guidelines for a paediatric physical examination. No reason for you not to perform a top notch exam on your paediatric patients – maybe better than your local neighbourhood doctor! Now that wasn’t so hard to say and if you’re still upset, read on…

Kiro Kids teaches post-graduate chiropractic clinical educationMy name is Dr Neil Davies and it is my heartfelt belief that the simple but subtle skills of physical examination and history taking are essential if one is to be a chiropractor to children. Paediatric health care has its own challenges, quite different from caring for adults who can answer for themselves and respond to an instruction. If you’re a chiropractor who wishes to see more children, offer safe and responsible care and demonstrate competency in front of parents, you’re in the right place!

Kiro Kids has educated chiropractic students and practitioners over many years in the art and science of clinical paediatrics. It takes a fine ear, patience, subtlety and practice – in short it’s not something you conquer overnight! But a very worthwhile skillset that you’ll keep improving on with practice.

In our own Kiro Kids clinics in Western Victoria, our history and examination follow a strict protocol and to deviate from this can have dire consequences.  Years of experience with literally thousands of young patients have shown us that shortcuts, missed steps and a cavalier attitude don’t serve our patients or our profession well, certainly not the community you wish to position yourself in as a primary wellness practitioner.

 

Our Mission and Passion

 

Examining the Child by Kiro Kids is the adapation of NIP the paediatric patientWe aim to empower every chiropractor to attract families in their community, provide the highest levels of proficiency of examination and help those chiropractors to position themselves in their local community with the unique skills learned in this program.

After many years, it is true to say that the enjoyment of witnessing that empowerment take place, the growth of confidence in young chiropractors and sharing the remarkable results seen in those changing practices is the greatest reward of all!

Any chiropractor who is patient and diligent enough to study and practice these examination skills can attain prominence and respect in their local community for being respectful enough to listen, take their time and give the due time for childrens’ health care that they deserve…referrals and reputation are earned by hard work.”
Dr Neil J. Davies D.C.

Examining the Child – A Sneek Peek

 

Dr Neil Davies published Chiropractic Paediatrics A Clinical Handbook in 2000Kiro Kids has taught Certificate and Masters courses in Clinical Paediatrics since 2003.  Dr Neil Davies published Clinical Paediatrics A Clinical Handbook in 2000 and 2010 positioning him as a leading chiropractic educator and author. The text has received acclaim globally and in many chiropractic colleges.

It has formed the basis of Kiro Kids post-graduate courses and is a comprehensive reference for any chiropractor with an interest in caring for children. Multimedia products were developed by Kiro Kids to assist study of key areas of the text, particularly regional examination. This has undoubtedly been the main area in which chiropractors have lowered their standards of practice and the evidence is all too frequently seen in courtroom records of initial and subsequent exams, for both adults and children.

Recognising that not every chiropractor wishes to pursue post-graduate studies, there has always been a need for weekend refresher courses and a condensed method to review clinical examination of children enabling a return to the office on Monday morning with a fresh set of skills, an easy way to take better histories, perform better, more meaningful exams and demonstrate to parents that you have a diligence and passion for caring for their children’s health.

Read on for a glimpse of the modules we cover, the approach taken and why joining NIP Academy with Kiro Kids could be just the ticket to refresh, revive and recharge your clinical skills.

History Taking in the Paediatric Patient

Develop your listening skills when taking a history“The most important attribute of any good doctor is to be a good listener” – Denis Gill & Niall O’Brien, Paediatric Clinical Examination, 1997.

A good history is the cornerstone of paediatric problem solving and where it all starts. We often say the ‘history leads where the exam goes’. More important information is gathered during a good history than from the physical exam and some lab and imaging tests. We cover the many facets of a good history for all levels of childhood, including the infant who can’t speak up but always has plenty to tell you.

Mothers are the best witnesses and we teach you “they are always right, until proved otherwise”. There is a lot going on during the history, some verbal and some not. Often lots of activity and interesting body language – we cover it all. Learn how to be competent with prenatal and postnatal histories, learn to ask relevant questions and not an endless barrage of non-leading questions. Learn how the terminology can be highly confusing and learn to check exactly what mothers are really telling you.

 

The Cardiovascular Exam

Kiro Kids teaches cardiovascular assessment of the paediatric patient to chiropractorsClicks, snaps, hums, thrills, murmurs, crackles, stridor …how are you at palpating and auscultating the paediatric chest? Do you know what to observe, what and where to palpate, what and where to listen for, how the sounds alter and why?

Let’s simplify it and give you the basics you really have to know and use. Chiropractors should be able to competently assess the paediatric chest – it’s vital to pick up the salient signs of illness and know when children are needing help you can’t give them.

 

The Head & Neck Exam

Learn to measure key anthropometric areasSadly, chiropractors have a poor record in demonstrating proficiency of examination in the area of neurology they claim to be experts in. File notes of head and neck exams often hint at the lack of detail by their empty space. It’s always easier assessing adults who can smile, frown and comply with your requests.

What to do when faced with non-compliant children, infants and those who cannot easily follow an instruction? Welcome to the world of using our eyes and ears, observing body language and behaviour, social skills and determining if the nervous system is maturing at its many levels for the appropriate age.

We cover the ‘must do’ tests, how to chart growth and development, assessment of the senses and practical easy to do tests that turn your clinic into playtime for kids! Essential topics like hypotonia, headache, developmental history, learning difficulties and environmental factors are all included.

 

The Abdominal Exam

Dr Neil Davies instructs paediatric abdominal examination in Examining the ChildIt is a fact that children present to chiropractors with abdominal and pelvic discomfort, alteration of bowel and urinary habits, circulatory and other issues. It is vital to perform the rudiments of an abdominal exam.

You’ll learn how to check for size and contour of organs, shifting dullness, fluid waves, bowel sounds and how to examine the child in different age groups.

A child need not have abdominal symptoms to warrant examination. Find how to correlate the history with your exam. Learn about the more urgent disorders that might present in younger children and why your highly developed palpation skills are so needed for this exam.

 

 

The Neurological Exam

NIP assists the central nervous system in removing dysafferent patterningThe complexity of the nervous system means that the truth is rarely revealed at first glance. A step by step approach to assessment is the only way to avoid missing those salient signs that otherwise go unnoticed.

We go through the steps of assessing mental status, age appropriate development, growth and development, motor and sensory grading, muscle stretch reflexes, coordination and proprioception. We show you how to assess the infant where they are unable to understand or answer you and use the power of observation.

 

The Orthopaedic Exam

Orthopaedic exam of the childAt different ages of development, there are more prevalent conditions of particular joints and a differential diagnosis of the more common possibilities must always be at hand. The infant hip, the young child with knee pain, thoracic pain in the teenager, unexplained groin pain …the list goes on.

Chiropractors must learn to be diligent in performing key orthopaedic tests and referring for imaging in some cases when the history and exam findings dictate it. We live and breathe by a dictum…if you’re not looking for it, you sure won’t find it!

 

How Up To Date Are Your Clinical Skills?

  • Gain confidence in seeing more children in practice

  • Demonstrate proficiency in performing diligent physical exams

  • Learn how to perform better wellness exams taking the time and detail

  • Develop competency in performing concise regional exams

  • Acquire the skills to recognize the salient signs of illness

  • Improve your competency with infant exams

 

NIP Academy – What is It?

NIP Academy ScreenshotNow we’ve whetted your appetite with the video above, we’re going to offer you something particularly special.

If you’re keen to get the utmost out of caring for kids, we’re super keen to give you a fast track in learning and put the turbochargers behind you to put you in pole position for 2014 in your practice!

You may know that we’ve been teaching this material for years – in fact we’ve produced some terrific multimedia materials to really reinforce and fine tune this field of knowledge and many have acclaimed our study tools.

You might have seen our interactive CDs on regional examination or DVDs of clinical paediatric seminars – or you may be new to Kiro Kids altogether.

 

Nevertheless, you’re to be about be offered an opportunity right here to ‘attend’ our previous related seminars and be able to bone up with the multimedia tools others have bought in past years.

NIP Academy is where we planned, plotted, schemed, connived and placed a heap of learning media for an up-to-date, one place online learning centre! It’s free to join right now at the bottom of this page. Simply sign up for free and become an NIP Academy Bronze member.

Now to be fair, you won’t get any free materials inside that’ll help you prepare for this seminar. However, there is an opportunity to upgrade to our Platinum level once inside…welcome to Aladdin’s Cave my friend!

Kiro Kids presents multimedia clinical education for chiropractors at NIP Academy

 

You can study interactive programs on head and neck exams, the paediatric chest exam, the paediatric neurological exam, growth and development, examining the child seminar videos with Consultant Paediatrician Mr Maurice Easton, neurological assessment of the child with Dr Neil Davies … I almost guarantee you that you can’t find the time to watch it all and learn it. But if you made an effort and caught some advantage, now that’s a commitment and a well deserved edge!

Just an opportunity, only my suggestion and we’ll hold your hand just the same without it. Jump in to NIP Academy and make a real commitment to your professional development. It costs a small monthly fee to remain a member and new materials are added each month. (Don’t hold me to it but you might record informal study hours for your continuing education committments!).

And here’s the kicker! Our clinical podcasts are filmed and added to the NIP Academy Platinum level content so you can catch them over and again in the future! Along with the seminars already included, you access a learning resource that grows with time and is always at your desktop.

NIP Academy Bronze Membership Join for Free!