Communicating with Children in Healthcare Beware the quiet child - a child who is screaming or making a lot of noise, you know their airway is good, you know their breathing is good, and their circulation is ok if they've got the strength to scream for any length of time then you know they're not that bad. You know they don't have serious injuries, they don't have major head injuries, they don't have major respiratory problems because if they did it would hurt too much to cry. Also, abdominal trauma or major abdominal problems, because if they do it hurts to cry because children use their diaphragm to breathe. Children have the benefit of coming with somebody 99% of the time, so use that person to get that information from them. Listen to the parents - they know their children best and they can recognise when they are sick or deteriorating. But sometimes you need to tell the parents you want to work with them. We want them to work with us and tell us if they think their child is changing. Encourage parents to be involved in their child's care. So if you are putting in drips or nasogastric tubes, or doing dressings or things like that, but it's ok if they don't want to. Sometimes if they don't like the sight of blood or don't like needles it's worse for the child to have the parent their than not. So make them feel ok to go and get a cup of coffee or sit outside, as soon as it's over we'll come and get you and then you can be the nice person and we will be the baddies with the child at the moment.