May 2017 Default Cover Image
Office preparedness for childhood emergenciesStudies highlight a need for pediatrician offices to be ready to handle emergencies, available data also demonstrate that many practices, including those that have already needed to treat a critically ill child, are not adequately prepared because they lack the relevant protocols, training, and tools.
Allergy questionnaire helps determine true penicillin allergy in childrenAlthough penicillin allergy is the most commonly reported medication allergy in children, the true incidence of this allergy in children is low with data suggesting that the large numbers of adverse drug reactions reported by parents as signs of an allergic reaction, such as rash or diarrhea associated with antibiotics, may not be consistent with a true allergic reaction.
Be ready for an in-office 911Focusing on emergencies became our platform to address the far more important goals of situational awareness, team integration, and effective communication. As we build increasingly matrixed systems of care that surround our littlest of patients, having addressed these goals inspires us with confidence that we can do so with the child’s safety at top of mind.
Emergency airway managementSecuring a child’s airway in an emergency setting can be challenging, and success here is dictated by a mosaic of factors such as clinician experience, appropriate instrumentation, and, importantly, the many anatomical and physiological considerations that differ significantly from the adult population.
Toilet training kids with ASD: Part 2Like typical children, children with intellectual disabilities or autism will toilet train at different rates and with different strategies. For some families, this can be a frustrating and depressing time. Discussing the use of positive rewards and avoiding punishment will help these parents slowly make progress. Here is a detailed program to help patients achieve continence.
Functional constipation: A guideline reviewFunctional constipation in children is no news to pediatricians. What may be news is that recommendations on how to diagnose and treat this common malady keep evolving as more evidence becomes available.
Erythema and ecchymosis after newborn’s phototherapyA 2660-g male infant was born via cesarean delivery to a G3P1011 32-year-old mother at 38 weeks 5 days. The mother’s blood type was A-negative with known anti-D (big D) and anti-C (big C) antibodies. She had not received adequate prenatal care and did not get antenatal RhoGAM (Rho [D] immune globulin human). Furthermore, she had known hepatitis C with a high viral load and was a polysubstance abuser. Notably, the infant had a normal middle cerebral artery (MCA) Doppler 18 days prior to delivery. Delivery was remarkable for yellow amniotic fluid and a jaundiced infant. His Apgar scores were 9 and 9 at 1 and 5 minutes. Cord pH was 7.337, and the infant’s blood type showed direct antiglobulin test (DAT)-positive and O-positive. Per protocol, the patient was started on intensive phototherapy and the bilirubin peaked at 17.0 mg/dL at 7 hours of age.
Upgrade office triage to expedite careThis article describes how a mobile application, a “web widget,” and an office triage support tool can expedite and improve your existing office triage capabilities.
Consumers buy fewer cigarettes after CVS stops selling themAfter CVS, the large retail pharmacy chain, stopped selling cigarettes in its stores, many consumers who used to buy their smokes at CVS simply bought fewer cigarettes and presumably smoked less.
Poor housing is associated with asthma morbidityA new study found that the well-documented racial/ethnic disparities in asthma diagnosis and morbidity are diminished after accounting for material hardship.
ICS often does not follow asthma hospitalizationFewer than half of commercially insured children who have been hospitalized for asthma receive an inhaled corticosteroid (ICS), even though many of them make outpatient visits within 30 days of hospital discharge.
Newborn‘s rash is more than skin deepA healthy newborn girl returns for a follow-up visit at age 7 days, and she is exhibiting multiple disseminated red macules and papules of varying sizes. While in the nursery, several red blanching macules had been noted on her trunk at age 2 days.
Readers reactA reader writes in to discuss the management conditions specifically related to stress.