Carrying out anthropometric measurements algorithm. IV. Additional Information. Chest circumference measurement

Anthropometry is the definition physical development person by measuring the body and its parts. Anthropometry includes determining the patient’s body weight, height, circumference chest and etc.

Determination of adult height

I. RATIONALE.

Measuring height is necessary to determine the patient’s physical development, diagnose certain metabolic diseases (pituitary gland, etc.), as well as to select appropriate clothing sizes.

II. EQUIPMENT.

A height meter, which consists of a platform, a vertical stand with centimeter divisions, and a horizontal tablet moving along the vertical stand.

III. PREPARATION.

1. Help the patient take off his shoes and stand correctly on the platform: heels, buttocks, shoulder blades and the back of the head touch the stadiometer stand; keep your head straight (so that the upper edge auricle and the outer corner of the eyes were on the same horizontal line).

2. Lower the stadiometer board onto the patient’s head and use the scale to determine the number of centimeters from baseline to the bottom edge of the tablet.

3. In some cases, patients have their height measured while sitting, then the distance from the bench to the floor is added to the resulting figures.

4. Tell the patient the measurement result.

5. Help the patient leave the site and record the result in the accepted documentation (in the “special notes” column).

Determining the patient's body weight

I. RATIONALE.

Determination of body weight is necessary to determine the physical development of a person, diagnose certain metabolic diseases (pituitary, digestive system, heart, kidneys, etc.), as well as for calculation medicines, nutrition calculations (especially for children) and monitoring the dynamics of edema.

II. EQUIPMENT.

Medical scales, properly positioned and well adjusted.

III. PREPARATION.

1. Explain the essence to the patient this study: done without outerwear and shoes, after visiting the toilet (to determine the dynamics of edema: in the morning, on an empty stomach, in normal clothes).

2. Check the adjustment of the scales: open the shutter located above the panel and adjust the scales with the screw: the level of the balance beam, at which all the weights are in the zero position, must coincide with the control point.

3. Close the shutter.

IV. ALGORITHM.

1. Help the patient remove his shoes and carefully stand in the center of the scale platform.

2. Open the shutter and move the weights on the rocker arms to the left until it is level with the control point.

3. Close the shutter.

4. Communicate the results to the patient. Help him get off the scale.

5. Record the result in the accepted documentation (in the “special notes” column, temperature sheet).

Chest circumference measurement

I. RATIONALE.

Measuring chest circumference plays a role in diagnosing lung diseases.

II. EQUIPMENT.

Tape measure.

III. ALGORITHM.

A measuring tape is placed around the chest, behind the lower corners of the scapula, and in front along the 4th rib. The patient's arms should be lowered, breathing should be calm; measurement is carried out at calm breathing, deep breath and exhalation (noted in temperature sheet).

IV. ADDITIONAL INFORMATION.

All surfaces that the patient has come into contact with are treated with a rag moistened with a 1% solution of bleach (chloramine, esan).

PROFESSIOGRAM No. 11

ENSURING SANITARY AND EPIDEMIOLOGICAL REGIME IN THE ADMISSION DEPARTMENT OF A HOSPITAL

I. RATIONALE.

Since the emergency department is one of the busiest departments in terms of the number of patients, the risk of nosocomial infection is the highest, therefore it is necessary to take certain measures to prevent the development of nosocomial infections.

II. EQUIPMENT.

Marked containers for wiping surfaces and washing floors for each department separately;

Disinfectant solutions:

1% chloramine solution 3% chlorine solution lime

3% chloramine solution 1% bleach solution

Rags for wiping surfaces and floors;

Labeled mops for each area of the reception area.

III. ALGORITHM.

1. Routine and final wet cleaning is carried out in each room of the reception department. Cleaning equipment for each room is labeled and stored in separate room. Routine wet cleaning is carried out 3 times a day with a 1% solution of bleach (1:10 Esan). Final cleaning is carried out once every 7 days with a 3% bleach solution. The frequency of cleaning depends on the number of patients passing through the emergency department (more than 40 people per day - wet cleaning every 2 hours, and the final one – after 3 days).

2. After examining each patient, all surfaces with which he came into contact are treated with a rag moistened with a 1% chloramine solution.

3. After sanitizing the patient, the sanitary checkpoint must be treated with:

1) The bath is rinsed hot water with detergent, after which it is treated with a 3% chloramine solution for 15 minutes, then the solution is washed off using detergent, then running water;

2) All items that were used during sanitary treatment are processed and disinfected:

The scissors are washed under running water with a brush and soap and immersed in ethanol 70% for 30 min. and stored dry;

The comb and combs are washed under running water with a brush and soap, disinfected in a 3% solution of bleach with full immersion for 30 minutes;

The washcloths are washed under running water and boiled for 20 minutes;

After drying the patient’s skin, used towels are placed in an oilcloth bag marked “dirty linen” and then sent to the laundry.

3) All surfaces of the sanitary inspection room are treated with a 1% bleach solution. Cleaning equipment (mop, rags, bucket) is disinfected in a 1% solution of bleach for 30 minutes, then rinsed under running water, dried and stored here.

IV. ADDITIONAL INFORMATION.

Compliance with sanitary and epidemiological regulations in the reception department is carried out in accordance with Order No. 288.

PROFESSIOGRAM No. 12

TECHNIQUES FOR CARRYING OUT SANITARY TREATMENT OF THE PATIENT

I. RATIONALE.

Sanitation is carried out to prevent the spread of nosocomial infection.

II. INDICATIONS.

Strictly as prescribed by the doctor.

III. EQUIPMENT.

Containers marked “clean washcloths”, “used washcloths”, soap, shampoo, towel, scissors, combs, water thermometer, diapers, a set of clean clothes, treated shoes.

IV. PREPARATION.

- Nurse dressed in uniform, oilcloth apron;

- patient: in the examination room of the sanitary inspection room, the patient is undressed and an inventory of clothes is made in 3 copies (for the medical history, for the patient’s belongings, for the patient). Examine the skin and “hairy” areas of the body. If necessary, treatment is carried out using F-20;

- sanitary inspection station: exclude drafts, air temperature = 24-25 o C.

V. ALGORITHM.

Full sanitization

1. The nurse fills the bathtub halfway. cold water, and then hot so that there is no accumulation of vapors in the room.

2. The water temperature should not exceed 36-37 o C.

3. The patient is immersed in water, holding him in a “sitting” position so that the water covers 2/3 of the body. The heart area should be free of water.

4. If the patient’s condition allows, he can wash himself, but the nurse, while the patient is taking a hygienic bath, does not leave him alone, monitors him general condition and helps him wash himself.

5. Special attention you need to pay attention to areas of greater accumulation of sweat and dirt (armpits, under the mammary glands in women, fat folds, inguinal folds, interdigital spaces).

6. Bath duration – 15-20 minutes.

7. After the patient has washed, the nurse helps him get out of the bath. He stands on a wooden stand, which is covered with a clean, dry diaper.

8. Skin the patient is dried with a warm towel or a warm, clean sheet;

9. The patient puts on clean underwear, the nurse cuts the nails (if necessary) on the hands and feet, helps the patient comb his hair, and helps him put on his shoes.

10. A nurse accompanies a patient to the medical department.

ANTHROPOMETRIC STUDIES- measurement of height, body weight.

Standing height is determined using a stadiometer. The patient must be without shoes.
Women with high hairstyles should have their hair down when measuring their height.
The patient should stand without tension.

ALGORITHM of the nurse's action when measuring height (standing):

Place the patient on the stadiometer platform with his back to the stand with the scale so that he touches the stadiometer with three points (heels, buttocks and interscapular space);
Tilt your head slightly so that the upper edge of the outer ear canal and the lower edge of the eye socket are located on the same line, parallel to the floor;
The nurse should stand at the side of the patient;
Lower the tablet onto the patient's head;
Take the count along the bottom edge of the tablet;
Record the patient's height on the temperature sheet.

ALGORITHM of the nurse's actions when measuring height (sitting):

1. Place the patient on a bench, with his back to the stadiometer stand so that he

touched the stadiometer with the sacrum and interscapular space;

2. Tilt your head slightly so that the outer edge of the orbit and tragus

the ears were on the same horizontal plane;

3. The nurse should stand on the side of the patient;

4. Lower the tablet onto the patient's head;

5. Count along the bottom edge of the tablet;

6. Record the patient's height on the temperature sheet.

DETERMINATION OF BODY WEIGHT (WEIING).

The patient's body weight is determined on medical scales, which must be verified and adjusted before weighing.

The rules for weighing the patient should be followed: weigh on an empty stomach, in the same clothes, after bowel movement Bladder and intestines, without shoes.

ATTENTION! There are two weights on the scales: a large one - tens, a small one - within one tens of kilograms and grams.

ALGORITHM of the nurse's action when determining the patient's body weight:

Adjust the scales;
Place the patient in the middle of the scale;
Open the shutter of the scale;
Move the weights on the scales to the left until the level of the balance beam matches the reference level;
Close the shutter;
View and record the data on the temperature sheet;

Normal body weight on average is determined by the formula: HEIGHT - 100.

FOR EXAMPLE: The person's height is 163 cm, so normal weight it should be 63kg.

MEASUREMENT OF CHEST CIRCUMSTANCE.

Required accessories:

Measuring tape, 0.5% chloramine solution.

Algorithm of actions m/s:

Ask the patient to spread his arms out to the sides.
Place a measuring tape at the back under the lower angle of the scapula, at the front - in men and children along the lower edge of the nipple circles, in women - under the mammary glands at the place where the 4th ribs are attached to the sternum.
After applying the tape, lower the patient's arms.
The measurement is carried out in three positions:

a) at rest

b) with a full inhalation;

c) with maximum exhalation.

Record these measurements in your medical history. The difference between inhalation and exhalation is called chest excursion
Disinfect the measuring tape.

ALGORITHM FOR COUNTING RESPIRATORY MOVEMENTS.

Take the patient's hand in the same way as for the Ps study on the radial artery, thereby diverting his attention).
Place your other hand on the chest (for chest breathing) or on epigastric region(at abdominal type breathing).
Count the number of breaths in 1 minute.

Number breathing movements(frequency) is recorded graphically on the temperature sheet.

DETERMINATION OF ARTERIAL PULSE.

Pulse (Ps) is the vibration of the arterial wall caused by the release of blood into the arterial system.

The nature of the pulse depends on:

the size and speed of blood ejection from the heart;
condition of the artery wall (elasticity).

The arterial pulse is USUALLY determined at the radial artery.

ALGORITHM FOR DETERMINING PULSE ON THE RADIAL ARTERY.

Use the fingers of your right hand to grasp the patient’s hand in the area of the wrist joint.
Place your first finger on back side forearms.
II - IY fingers, feel the pulsating radial artery and press it to the radial bone.
Define characteristics pulse waves within 1 minute.
It is necessary to determine the pulse simultaneously in the right and left radial arteries, comparing their characteristics, which normally should be the same.
Data obtained from examining the pulse on the radial artery are recorded in the medical history or outpatient card, are noted daily with a red pencil on the temperature sheet. Column “P” (pulse) shows heart rate values from 50 to 160 per minute.

BP MEASUREMENT ALGORITHM:

Blood pressure is usually measured 2-3 times at intervals of 5 minutes, and the air from the cuff must be completely released each time.

Place the blood pressure cuff on the patient's bare shoulder 2 - 3 cm above the elbow. Clothing should not compress the shoulder above the cuff.

Fasten the cuff so tightly that only one finger fits between it and your shoulder.

Place the patient's arm correctly in an extended position, palm up, muscles relaxed.
Connect the pressure gauge to the cuff. The pressure gauge needles should be at the zero scale mark.
Feel the pulse on the brachial artery in the area of the ulnar fossa and place a phonendoscope in this place.
Close the valve on the bulb and pump air into the cuff. Inflate air until the pressure in the cuff, according to the readings of the monometer, does not exceed approximately 30 mm Hg. the level at which the pulsation of the radial artery ceases to be detected.
Open the valve and slowly, at a speed of no more than 20 mm Hg. per second, deflate the cuff. At the same time, use a phonendoscope to listen to the sounds on the brachial artery and monitor the readings on the pressure gauge scale.
When the first sounds appear above the brachial artery, note the level of systolic pressure.
Note the value of diastolic pressure, which corresponds to the moment of complete disappearance of sounds in the brachial artery.
Write down the blood pressure measurement data as a fraction (in the numerator - systolic pressure, and the denominator is diastolic).

We emphasize again! Blood pressure should be measured 3 times a day. For a reliable result, take the average result, since the reaction of blood vessels to compression is taken into account (there may be a spasm, in which case the blood pressure is higher).

ALGORITHM FOR MEASURING BODY TEMPERATURE FOR A PATIENT:

Make sure the thermometer is intact.
Shake the thermometer until the mercury is below 35 degrees.
Examine the armpit for inflammatory phenomena and skin damage.
Wipe your skin armpit dry towel.
Place the thermometer so that the reservoir of mercury is completely surrounded by folds of skin.
Measure your body temperature for 10 minutes.

Anthropometry is the main method of anthropological research, which consists of measuring human body and its parts in order to establish gender, race, age and other characteristics of the physical structure, which make it possible to give quantitative characteristics of their variability.

Life is a continuous process of development, including the stages of maturation, maturity and aging. Development and growth are two interdependent and interconnected aspects of one process. Development is characterized by qualitative changes, differentiation of organs and tissues and their functional improvement. And growth is quantitative changes associated with an increase in cell size, tissue and organ mass, and the entire organism as a whole.

Physical development is one of the main indicators of human health and age standards improvement. The practical ability to correctly evaluate it contributes to raising a healthy generation. In this article we'll talk o algorithm for measuring height and weight.

Factors influencing anthropometric indicators

Energy exchange and metabolism processes continuously occur in the human body, and they determine its developmental characteristics. Mass, height, consistency in the increase in various parts of the body, proportions - all this is programmed by hereditary mechanisms. The sequence of development may be disrupted under the influence of certain external and internal factors. The first include social conditions, sedentary lifestyle life, unfavorable intrauterine development, poor nutrition, wrong mode work and rest, bad habits, ecology.

Internal factors include heredity and the presence of various diseases.

Knowing the algorithm for measuring height and weight, you can clearly assess physical development.

Conditions for conducting the study

Anthropometry requires the use of carefully adjusted and tested instruments: stadiometer, scales, dynamometer, measuring tape, etc. Measurements are recommended to be taken in the first half of the day on an empty stomach or two to three hours after a meal. The clothes the person is wearing should be light, knitted. If measurements are planned to be taken in the afternoon, you should take a horizontal position for ten to fifteen minutes beforehand.

For further assessment to be effective, an algorithm for measuring the patient's height must be followed. It should be remembered that the analysis of anthropometric indicators is the most important element in the study of how physical development corresponds to age standards. Detected abnormalities may be a sign of a specific disease or a risk factor.

Measuring height while standing

Since in the evening a person becomes one or two centimeters shorter, which is due to natural fatigue, flattening of the arch of the foot and intervertebral cartilaginous discs, and a decrease in muscle tone, it is advisable to measure height in the first half of the day. The algorithm includes three stages: preparation for the procedure, measurement and completion of the procedure. Let's talk about each of them.

Preparation

In accordance with the instructions, prepare the stadiometer for use.
Introduce yourself to the patient, tell him about the upcoming procedure and obtain his consent.
Clean hands hygienically and dry them.
Place a napkin on the stadiometer platform (under the patient’s feet).
Ask the subject to remove his hat and shoes.
Raise the bar of the stadiometer above the expected height of the subject.

Performing a measurement

The patient should stand on the stadiometer platform so that the back of the head, interscapular area, buttocks and heels touch the vertical stand.
The stadiometer bar must be lowered onto the patient’s head without pressing down.
Ask the subject to leave the site and, if necessary, help him do so.
Determine your height using the bottom edge of the bar on the scale.

End of the procedure

Measuring height while sitting

The algorithm for measuring the patient's height in a sitting position is somewhat different from that described above.

It is necessary to ask the subject to sit down on the folding seat of the stadiometer, previously covered with oilcloth.
The patient should sit so as to touch three points - the shoulder blades, the back of the head and the buttocks - to the vertical bar with the scale.
The subject's head should be positioned so that the earlobe and the tip of the nose are on the same horizontal line.
The measuring bar must be lowered onto the patient's crown, pressed against the scale and asked to stand up.
You need to take readings on the left side of the scale, then lower the bar.
Similarly to the above, record the results and inform the patient about them.

Measuring the height of a pregnant woman: algorithm

First, you need to explain to the pregnant woman the goals and progress of the procedure. The growth measurement algorithm is as follows:

Stand to the side of the stadiometer and raise the bar above the expected height level of the subject.
Ask the pregnant woman to stand on the stadiometer platform so that her buttocks, heels and shoulder blades touch the stand of the device, and her head is in such a position that the outer corner of the eye and the tragus of the ear are on the same horizontal line.
The stadiometer bar should be lowered to the crown of the pregnant woman and the number of centimeters from lower level planks.
Enter the received data into individual card patients.
The height gauge should be cleaned with a cloth soaked in a solution (05%) of calcium hypochlorite.
Wash your hands thoroughly.

Body weight measurement

To conduct anthropometric studies, it is not enough to know only the algorithm for measuring height; you also need to be able to determine a person’s weight. Body weight is measured using floor scales. The patient must stand still on the platform so that the weighing error does not exceed +/-50 grams. Unlike height, weight is an unstable indicator and can change under the influence of many factors. Thus, daily fluctuations in body weight can reach one to two kilograms.

Knowing how height is measured, the algorithm for determining weight will be extremely easy to remember. The procedure consists of three stages.

Preparing to measure your weight

First, in accordance with the instructions, you should check the accuracy and serviceability of the medical scales.
It is necessary to establish the balance of the device; if mechanical structures are used, close the shutter.
You need to place a napkin on the scale platform for one-time use.
The person performing the procedure must explain to the patient the sequence of future actions.

Executing the procedure

The subject should be asked to undress to his underwear and also take off his shoes. Ask him to carefully stand on the scale platform in the middle.
When standing on the scale measuring panel, the subject must be held by the hand; during the measurement process, it is important to monitor his balance.
If a mechanical design is used, the scale shutter must be opened.
Following the instructions for use of the device, it is necessary to determine the body weight of the subject.

End of the procedure

The patient should be informed of the weight measurement results and helped to get off the measuring panel, holding his hand if necessary.
You need to remove the napkin from the scale platform and place it in a container intended for waste.
Hands should be sanitized and dried.
The results must be recorded in appropriate documentation.

Algorithm for measuring height in children of different ages

The most stable indicator of physical development in children is height. It reflects the development process of the child’s body. Usually, significant violations growth are accompanied by pathologies of other systems and organs. Thus, in the case of slowing skeletal growth, differentiation and growth of the brain, myocardium, and skeletal muscles most often slow down to a lesser or greater extent.

How is a newborn's height measured? The algorithm requires a stadiometer in the form of a board 40 centimeters wide and 80 centimeters long. On the left side of the device there should be a centimeter scale with a fixed transverse bar at the beginning and a movable, easily moved along the scale with a transverse bar at the end.

Baby height measurement technique

The baby must be placed on his back so that his head touches the stationary transverse bar of the stadiometer. It should be positioned so that the upper edge of the ear tragus and the lower edge of the orbit are in the same horizontal plane.
The baby's mother or an assistant measuring should firmly fix the baby's head.
The child's legs should be straightened by easy press on your knees with the palm of one hand, and with the other hand you need to bring the movable bar of the stadiometer tightly to your toes, while your feet need to be bent to your shins to a right angle. The distance from the fixed to the movable bar will be the height of the child. It is necessary to mark the length to the nearest millimeter.

How to Measure Height in Older Children

The algorithm for measuring the growth of a child under one year old was presented above, but what technique of performing the procedure is suitable for older children? In this case, you need a stadiometer in the form of a wooden block eight to ten centimeters wide, about two meters long and five to seven centimeters thick. The front vertical surface of the bar should contain two division scales in centimeters: on the left - for measuring height while sitting, on the right - while standing. There should also be a movable twenty-centimeter bar. A bench is attached to a vertical bar at a level of forty centimeters from the wooden platform to measure height while sitting.

The algorithm for measuring height in children aged one year and older is similar to that used for adults.

Child's body weight

Compared to height, a baby’s weight is a more labile indicator, which reflects the degree of development of muscle and skeletal systems, subcutaneous fatty tissue, internal organs, and depends not only on constitutional features, but also on factors external environment such as mental and physical exercise, food, etc.

Typically, the weight measurement algorithm (as well as the height measurement algorithm) does not cause difficulties. Children under three years old weighing up to twenty kilograms are weighed on a cup scale consisting of a rocker arm and a tray with lower (in kg) and upper (in g) division scales. Children aged three years and older are weighed on lever scales.

Terms of control using anthropometry

One of the main indicators of the health status of children is the level of physical development, which shows compliance or any deviation in their development and health.

Monitoring the physical development of a child using the method of planned anthropometry should be carried out systematically, in strict deadlines. Such control is usually carried out by a doctor or in children's preschool institutions. Anthropometric examination of a young child and preschool age includes full program examination procedures: measurement of body weight and height, head circumference (for a child of the first year of life) and chest, posture, degree of body fat and other indicators.

For a child under 1 year of age, anthropometry should be performed once a month, on his birthday (+/- 1-2 days); at the age of 1 year to 2 years - 1 time in 3 months (within the period corresponding to the date of birth: 1 year 3 months, 1 year 6 months, 1 year 9 months, 2 years; deviations within 5 are allowed in the date of examination days). A child aged 2 to 3 years undergoes an anthropometric examination once every 6 months; from 3 to 7 years - once a year (also within the period corresponding to the date of birth: at 4 years, 5, 6 and 7 years; with permissible deviations up to 7 days).

In addition to the above periods, monitoring of physical development, for example, the child’s weight, is carried out more often (from 2 to 6 months - once every 10 days; from 6 to 12 months - once every 15 days; from 1 year to 3 years - Once a month; from 3 years and older - once every 3 months). This frequency of measuring body weight makes it possible to detect the beginning of a possible lag in weight gain, the cause of which may be insufficient nutrition or an incorrect diet (especially in a young child), or, conversely, excessive weight gain due to excessive food consumption or an incorrectly selected diet.

Conducting an anthropometric examination physical condition children of early and preschool age must comply with a single unified measurement methodology, which is based on the following rules:

1. Measuring and weighing the child should be carried out in the morning, on an empty stomach, or after nap(also on an empty stomach) at the same time.

2. Before taking measurements, you need to make sure that all instruments are in working order and their indicators correspond to the true ones.

3. In order to measure a child’s height, it is recommended to use two types of stadiometers: a children’s wooden horizontal stadiometer(to measure the height of a child under 2 years of age), since in early age height is measured in horizontal position(measurement must be carried out by 2 people); And vertical height meter for measuring the height of a child over 2 years old with an attached or folding bench installed at a height of 25 cm from the level of the stadiometer platform. In this case, you need to ensure that when measuring the height of the child’s heels, buttocks and shoulder blades should touch the stadiometer (regardless of its position: horizontal or vertical), the arms are extended along the body, and the head is tilted back so that the tragus of the ear is on one horizontal line with the corner of the eye.

4. To measure body weight, the following types of scales are also used: cup scales (children’s) for weighing a child under 2 years of age (such scales allow recording fluctuations in body weight up to 10 g; the maximum load of such scales is up to 25 kg) and medical scales. It is recommended to weigh the child in the morning on an empty stomach. Before weighing, the child is undressed or left in shorts and a light vest.

5. Measuring the head circumference is carried out by applying a centimeter tape from behind at the level of the occipital protuberance, from the front - above the eyebrows. A child of the first year of life should be held in the arms of an assistant during the measurement.

6. The chest circumference is measured by placing a centimeter tape at the back under the lower angles of the shoulder blades, at the front - along the lower edge of the isola. For a child under 3 years of age, the chest circumference is measured in a horizontal position.

Chest circumference measurement

Principles for assessing a child’s physical development

An objective assessment or conclusion about the state of the child’s physical development is made by comparing data obtained by anthropometric measurements, with average indicators of physical development - centile series, local standards.

The evaluation tables contain average indicators of the main signs of physical development in children in accordance with their age (height, weight, head and chest circumference). In addition to the average indicators, the tables indicate the maximum permissible deviations (+/- sigma) upward or downward. When comparing permissible deviations with individual indicators, the level of physical development and individual deviations are determined. Note that general characteristics The physical development of a child is given only on the basis of a set of signs - it is impossible to objectively assess the level of physical development on the basis of only one sign (weight or height, head or chest circumference).

For objective assessment To ensure the harmonious development of a child, it is necessary to take into account indicators of weight, head and chest circumference with growth indicators.

If the ratio of height and body weight in a child is greater than the established norm, disharmony in physical development can be suspected. Detection of disharmony in the physical development of a child helps to timely diagnose more serious violations in health conditions (for example, disorders endocrine system which lead to metabolic disorders: obesity (enzymopathy), which leads to metabolic disorders digestive function, or malnutrition of varying degrees).

In preschool institutions, mandatory anthropometric measurements are carried out medical staff. The final assessment of the state of the child’s physical development is carried out only by a doctor, who compares the examination data obtained and makes an appropriate conclusion.

infancy and early childhood

1. The weight of children under 3 years of age is determined on special children's scales with a maximum permissible load of 25 kg. and measurement accuracy up to 10 g. First, weigh the diaper, and then, with the yoke closed, place a completely undressed child on the scales so that his head and shoulder girdle were on the wide part of the tray. Children over 6 months of age can be placed on a scale. Nurse or doctor right hand move the weights of the scales, and with the left hand they insure the child from falling. The lower weight moves only into special slots. Readings are taken on the left (inner) side of the weight. After weighing, the weights are set to “0”, the yoke is closed and the child is removed from the scales. To determine the baby's body weight, subtract the weight of the diaper from the scale readings.

2. The body length of children in the first 2 years of life is measured in a supine position using a special horizontal stadiometer 80 cm long, 40 cm wide with a centimeter scale and two transverse bars - movable and fixed. The child is placed on his back so that the top of his head tightly touches the stationary transverse bar of the stadiometer. An assistant fixes the child's head in a position in which the lower edge of the orbit and the upper edge of the external auditory canal are in the same vertical plane. The child's legs are straightened with light pressure on the knees. The movable bar of the stadiometer is pressed tightly against the heels and readings are taken from the centimeter scale along its inner surface.

3. The head circumference is determined by applying a centimeter tape, passing it from behind along the occipital protuberance (occipital point), and from the front along the superciliary arches.

4. The chest circumference is measured while the child is breathing quietly. A measuring tape is applied at the back under the lower angles of the shoulder blades with the arms extended to the side. Then the hands are lowered and the tape is passed at the level of the nipples (at the mid-sternal point).

5. Shoulder circumference is determined with the arm freely lowered at the level of greatest development of the biceps muscle (at the border of the upper and middle third of the shoulder).

Methodology for anthropometric measurements of childrenpreschool and school age

1. Measurement of the weight of children aged 3 years and older is carried out in the morning on an empty stomach on special medical scales with an accuracy of 50 g. Before weighing, the child is undressed down to his underpants. The lower weight of the rocker is placed exactly in special sockets. Readings are taken on the left (inner) surface of the weight.

2. The height of an older child is measured using a vertical stadiometer with a folding stool. There are 2 scales on the vertical board of the stadiometer: one for measuring standing height, the other for measuring the body (sitting height). The child is placed with his feet on the stadiometer platform with his back to the scale. His body should be straight, arms freely lowered, knees straightened, feet tightly together. The back of the head, interscapular area, sacrum and heels touch the vertical bar of the stadiometer. The position of the head is considered correct if the lower edge of the orbit and the upper edge of the ear canal are in the same horizontal plane. The movable bar of the stadiometer tightly touches the apex of the head, and scale readings are taken along its inner (lower) surface.

3. The head circumference is determined by applying a centimeter tape, passing it from behind along the occipital protuberance (occipital point), and from the front along the superciliary arches.

4. The chest circumference is measured three times: during quiet breathing, at the height of inspiration, at the height of exhalation. The child should be in a standing position with his arms down. A measuring tape is applied at the back under the lower angles of the shoulder blades, with the arms extended to the sides. Then the child’s hands are lowered and the tape is passed along the mid-sternal point (at nipple level). For girls in puberty the tape is placed over mammary glands at the junction of the skin from the chest to the gland.

5. Shoulder circumference is measured twice: with tense muscles (arm bent in elbow joint, fist clenched) and with relaxed (arm freely lowered) muscles. A tape measure is placed at the site of greatest thickening of the biceps muscle. When calculating the indices, the measurement data of the shoulder circumference in a relaxed state of the muscles is used. By the difference in measurements in a tense and relaxed state of the arms, the development of the shoulder muscles is judged.

6. Thigh circumference is determined by horizontally applying a measuring tape under the gluteal fold.

7. The calf circumference is determined at the site of maximum volume of the gastrocnemius muscle.