Templates do not just facilitate documentation but also can guide bedside observations. The person taking a history who uses OLD-CARTS might be reminded to ask a dimension of a symptom that otherwise would not have been elicited.
What does it mean to say a child is “well-appearing” or “ill-appearing?” I find the GCS (Glasgow Coma Scale) categories to be helpful:
Eyes – is the child attentive with the eyes
Motor – is the child appropriately active/reactive
Verbal – is the level of social interaction appropriate for age (eg comforted by the arms of the mother).
Using GCS can stimulate a more detailed description of what we mean when we describe an ill-appearing child.
TAKE HOME POINTS
-Use the categories of GCS to detail what it means for a child to be “ill-appearing.”