General inspection

alert/ conscious

comment on size [need to plot on growth chart]

commenting on respiratory rate [RR=20, other vital signs normal]

clubbing of fingernails

checking throat/or nose (polyps)/ or asking for ear exam

noisy breathing/ stridor, wheezing

signs of distress;

grunting

flaring of alae nasi

cyanosis

use of accessory muscles (retractions; suprasternal, intercostal, subcostal)

chest inspection

shape of chest or symmetry /antero-posterior diameter

breathing pattern (thoraco-abdominal)

scars

chest deformities

palpation ⇒

wash hands/ use hand sanitizer

ask for permission to examine/ interact with child