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Pediatrics

Contents (below)
  • Links
  • Abdominal pain
  • Bronchiolitis/RSV
  • Croup
  • Development
  • Developmental Dysplasia of the Hip (DDH)
  • Diarrhea, Pede
  • Factlets
  • Fever w/o Source
  • Fifth Disease, (PV B19)
  • Fluoride
  • GI foreign body
  • H/A & Brain Tumor
  • HSP
  • HHV 6,  (Roseola)
  • Intoeing
  • Iron def anemia (infant)
  • Kawasaki
  • Misc
  • Neonatal Jaundice
  • Neonatal resuscitation
  • Pubertal and Growth Disorders
  • Rhinitis
  • Sedation
  • Sudden cardiac death
  • Tachypnea and pneumonia
  • Topical Anesthesia
  • UTI
  • Vaccination

  • Links

    Abdominal pain

    Red Flags

    1. pain not central, peri-umbilical
    2. noctural pain that awakens child **
    3. onset related to meals
    4. child not a “high achiever”, no school absenteeism
    5. emesis, or hematemesis
    6. diarrhea, with or without blood
    7. no stressful life events
    8. loss of weight, or failure to gain
    9. anal tags, perianal disease, anemia, fever, etc.
    10. keeps eyes open during abdominal exam (attention not internalized)

    See also: Distinguishing. Features (FPH).

    Bronchiolitis/RSV

    RSV bronchiolitis/pneumonia

    Therapy

    Croup

    FPH: Stridor and Dyspnea

    Steroid Therapy

    Developmental Dysplasia of the Hip (DDH)

    Development

    Red Flags - should have

    Diarrhea, Pede

    Child

    Pepto-Bismol??: 100mg/kg/day in 4 doses. (liquid is 262mg/15ml, max strength is 525 mg/15ml, also available 262mg chewable tabs. Dark tongue and stool) (ref: #1230)

    Diarrhea, Infant

    Factlets

    Fever w/o Source

    The history and physical assessments of the febrile infant. Bonadio WA - Pediatr Clin North Am - 1998 Feb; 45(1): 65-77 (MD Consult)

    Evaluation

    1. confirm with a rectal temp
    2. urine culture for boys < 6 mo, girls < 2 y (no prior UTI)
    3. UTIs may have little or no findings
    4. antipyretics don't improve affect much with meningitis, but can improve with less serious conditons.
    5. good signs (esp > 2 w old, doesn't help with UTI)

    Management

    Fifth Disease, erythema infectiosum, Parvovirus B19

    Fluoride

    1. limit dosing, start at age 6 months. Not needed if > .6 ppm in water.

    Age <0.3ppm 0.3-0.6 ppm >0.6
    6mo - 3 yr 0.25 mg 0 0
    3 yr - 6 yr 0.50 mg 0.25 mg 0
    6 yr - 16 yr 1.00 mg 0.50 mg 0

    2. beware fluoridated toothpaste (pea-sized only). Avoid Beech Nut’s ‘Spring Water with Fluoride’

    GI foreign bodies (coin/battery swallowing)

    coin (AP chest)

    button battery

    Headache & Brain Tumor

    see imaging indications

    Onset of Neurologic Findings

    Henoch-Schonlein Purpura (HSP)

    Human Herpesvirus 6, Exanthum Subitum, Roseola Infantum, Sixth disease

    Intoeing

    Dietz FR. Intoeing -- fact, fiction, and opinion. Am Fam Physician 1994 Nov 1;50(6):1249-1264. #1771

    metatarsus adductus

    internal tibial torsion

    excessive femoral anteversion

    Iron deficiency anemia (infant)

    1. Hematocrit [mean (-2SD)]

    2. Evaluation

    3. Therapy: elemental iron 3 mg/kg/day

    Kawasaki

    Misc

    Neonatal Jaundice

    Neonatal resuscitation

    Suction Catheter

    Orogastric catheter

    Useful Numbers

    Drugs (old)

      prep dose typical
    (3.5 kg infant)
    Epinephrine 1:10,000. 1 ml ampule. 0.2 ml/kg ET, IV (IM, SQ not as good) 1/2 to 1 amp
    Sodium Bicarbonate 4.2 %. 10 ml syringe, 0.5 mEq/ml 2 mEq/kg IV 15 ml
    Albumin 5% as 40 ml syringe 10 ml/kg IV 1 syringe
    Narcan 0.4 mg/ml. 1 ml ampule 0.1 mg/kg IV, ET (IM, SQ not as good) 1 ampule

    Pubertal and Growth Disorders

    Disorders of body proportion

    Rhinitis

    Allergic rhinitis

    Sedation

    Under 1 year

    Chloral hydrate soln 250gm/5 ml and 500 mg/5 ml

    Sudden cardiac death

    Tachypnea and pneumonia

    Auscultation in infants and children is rarely useful. High negative predictive values of respiratory rate (measured for 1 min with scope) less than:

    Topical Anesthesia

    UTI

    Vaccination

    The live virus attenuated vaccines are:


    Author: John G. Faughnan.  The views and opinions expressed in this page are strictly those of the page author. Pages are updated on an irregular schedule; suggestions/fixes are welcome but they may take weeks to years to be incorporated. Anyone may freely link to anything on this site and print any page; no permission is needed for citing, linking,  printing, or distributing printed copies.