HealthCheck Training

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Post-Test

Overview

• EPSDT Benefits
• HealthCheck EPSDT
  • Goals
  • Participants/Providers
  • Support Services
  • Coordination

Health Supervision

• Introduction
  • Screens
  • Diagnosis/Treatment/Referral
• Health History
  • Initial History
  • Interval
  • Specific Visits
• Physical Examination
  • Unclothed Exam
  • Body Measurements
  • Specific Visits
• Screening Services
  • Nutrition
  • Vision
  • Speech/Language
  • Hearing
  • Development/Behavior
• Laboratory Tests
  • Metabolic
  • Sickle Cell
  • Lead
  • Anemia
  • Urinalysis
  • Cholesterol
  • Tuberculosis
  • STDs
• Immunizations
  • Schedule
  • Vaccines for Children Program
  • Documentation
  • Precautions/Exceptions/Contraindications
• Health Education
  • Tips for Working with Families
  • Tips for Working with Teens
  • Specific Visits

Special Health Issues

• Introduction
• Dental Health
  • History/Evaluation
  • Guidance/Referrals
  • Dental Services
  • Provider Resources
• Overweight and Obesity
  • Screening
  • Assessment
  • Treatment/Referrals
• HIV Guidelines
• Child Abuse & Neglect
• Language Barriers
  • Resources and HIPAA
  • Interpreter Tips
• Early Intervention

Documentation

• Guidelines
• Reporting
• EMRs and Required Data
• Billing Procedures
• Billing Codes

Go To Resources »

Health Supervision

Laboratory Tests: Cholesterol Screening

Risk assessment is a primary strategy in early identification of high cholesterol, a major factor in the development of coronary heart disease. All children and teens in the District need to be assessed at each preventive health visit from ages 3 to 21 years to determine their risk of developing high cholesterol.

Risk Assessment

Risk assessment to identify high cholesterol levels is based on:

• Comprehensive physical exam.
• Family history.*
• Other risk factors (e.g., obesity, diabetes, smoking).

Periodicity and Guidelines for Cholesterol Screening

HealthCheck recommends cholesterol screening as follows:

Childhood and Adolescence:

• Assess risk at each preventive health visit from 3 years to 21 years of age .
• If child or teen at high risk: Screen with a blood test if indicated.

Screening Methods

When the physical exam, family history, and/or other factors indicate that the child or teen is at high risk, screen with an initial blood test to measure total cholesterol (TC). If TC > 200 mg/dl, perform a fasting lipoprotein analysis to measure high-density cholesterol (HDL-C) and low-density cholesterol (LDL-C).

Evaluation and Management

The following table classifies TC and LDL-C levels:¹

The American Academy of Pediatrics' recommendations for cholesterol management include the following:

If LDL-C level is in the acceptable range:

• Provide health education on eating patterns and on other risk factors.
• Repeat test in 5 years.

If LDL-C level is borderline:

• Advise about risk factors for cardiovascular disease.
• Initiate the American Heart Association low-fat diet and other risk factor interventions.
• Repeat test again in 1 year.

If LDL-C level is high:

• Examine for secondary causes (thyroid, liver, and renal disorders) and familial disorders.
• Screen all family members.
• Initiate American Heart Association low-fat diet.

Resources

Green M, Palfrey JS, eds. Bright Futures: Guidelines for Infants, Children, and Adolescents (2nd ed., rev.). (Appendix H: Hyperlipidemia Screening.) 2002. Arlington, VA: National Center for Education in Maternal and Child Health. Available online at www.brightfutures.org.