Peds Se1 Notes PDF

**PEDS SE1 Notes** **[M1]** +-----------------------------------------------------------------------+ | AAP vs CDC pediatric age | | | | **AAP Bright Futures**...

**PEDS SE1 Notes** **[M1]** +-----------------------------------------------------------------------+ | AAP vs CDC pediatric age | | | | **AAP Bright Futures** | | | | - Infant 0-2 | | | | - Child 2-12 | | | | - Adolescent 12-21 | | | | - Adolescence | | | | - Early 11-14 | | | | - Middle 15-17 | | | | - Late 18-21 | | | | **CDC** | | | | - Infant 0-1 (0-28 DAYS NEONATE) | | | | - Toddle 1- 3 | | | | - Preschooler 3-5 | | | | - Child 6-11 | | | | - Adolescent 12-17 | | | | **[\ | | How is pediatrics different than adult medicine?]** | | | | - **Histories** | | | | - Parent as historian: differences between parent & child | | histories | | | | - Prenatal & birth histories | | | | - Maternal/Family histories | | | | - Social history | | | | - Immunization history | | | | - **PE** | | | | - Age & condition specific | | | | - General vs focused | | | | - Newborn | | | | - Infant | | | | - Toddler/child | | | | - Physical milestones | | | | - **Physiologic** | | | | - **Proportion**: BSA \> in adults | | | | - Thinner skin | | | | - Immature BBB: more susceptible to CNS effects of medications | | | | - **Respiratory & HR** are faster | | | | - Infants & young children are **obligate nose breathers** | | | | - **Airways are shorter & narrower** | | | | - Lungs are more **prone to collapse** | | | | - **Metabolism & absorption** are higher: lower | | doses/frequencies | | | | - Higher proportion of **rapidly growing tissue** | | | | - More prone to **dehydration** | | | | - Poor temperature control | | | | - Immature/weaker immune system | | | | - Require more H2O & calories than adults: | | | | - Immature **organ systems** affect medication & metabolism | | | | - **Developmental** | | | | - Varies tremendously by age | | | | - Mental & emotional capabilities start egocentric and | | concreate thinking with limited resilience | | | | - Depend on sensory experiences | | | | - Limited concentration span "windows of development" | | | | - Have a longer life expectancy | | | | - CNS development continues throughout adolescence | | | | - **Prevention & safety** | | | | - Co-dependent (adult assistance needed for their safety) | | | | - Unique environmental exposure (placental & BF; outdoors; on | | ground) | | | | - Vax ! | | | | - Media exposure | | | | - **Dz & injury** | | | | - More likely to get sick or severely injured | | | | - some diseases are considered child specific | | | | - younger age at disease onset may mean increase in severity | | | | - Head and neck injuries are common | | | | - fractures require more force and have bigger impact infants | | and children metabolize medications differently | | | | - Few medication clinical trials done with children | | | | - common acute illnesses | | | | - "Cold" (viral URI) | | | | - RSV | | | | - Ear infxn | | | | - Roseola | | | | - Common childhood chronic Dz | | | | - Dental caries | | | | - Asthma | | | | - CF | | | | - DM | | | | - Obesity | | | | - Malnutrition | | | | - Developmental delays | | | | - CP | | | | - Legal/Ethical | | | | **[Pediatric History ]** | | | | - Parent as historian: differences between parent & child histories | | | | - Prenatal & birth histories | | | | - Maternal/Family histories | | | | - Social history | | | | - Immunization history | | | | **[Examples of Medication Pharmacokinetics in Pediatric Pt | | ]** | | | | **[Medications]** | | | | - smaller doses -- not proportional to weight differences | | | | commonly use weight-based dosing for infants and smaller children | | | | limited clincal trial info | | | | **[Vital Statistics ]** | | | | - Continue data on births and deaths | | | | - Local\>states\>National Center for Health Stats | | | | - Maternal & infant mortality: 2 essential indicators of national | | health | | | | - Helps guide PH/policy | +-----------------------------------------------------------------------+ **[M2]** +-----------------------------------------------------------------------+ | **[The components of Neonatal Eval ]** | | | | - APGAR | | | | - Vitals | | | | - Age, Length & weight | | | | - Sex | | | | - PE | | | | **APGAR** | | | | - Purpose: to assess newborns health status | | | | - When: 1 minute and every 5 minutes following until baby scores | | 8-10 | | | | - 5 components | | | | - **Appearance** (blue/body pink/extremities blue, pink) | | | | - **Pulse** (none/\100) | | | | - **Grimace** (None/grimace/cry) | | | | - **Activity** (none/some/active) | | | | - **Respiration** (absent /slow or irregular/strong cry) | | | | - Score in need of respiration is 4 or less | | | |  | | | | A few signs with text AI-generated content may be incorrect. | | | | **[Newborn Vital Signs]** | | | | - **HR** | | | | - 100-165 bpm (awake) | | | | - 90-160 (sleeping) | | | | - Up to 180 bpm (crying) | | | | - **RR** | | | | - 40-60 breaths/min | | | | - **BP** | | | | - 67-84/35-53 mmHg | | | | - **Temp** | | | | - 36.5-37 C (97.7-98.6F) | | | |  | | | | **[Pearls]**: | | | | - Infants double their bw by 4 months of age and triple their bw by | | 1 year | | | | - Full-term avg 3.5-6 kg (7lbs 9oz-13lbs) | | | | - Drops to 5-10% of bw in the first week | | | | - Should be regained in 7-10 days | | | | - Avg length at (term) birth 51 cm or 20 inches | | | | - 10" during the 1^st^ year | | | | - 2"/year between 4 yo and puberty | | | | - Brain weight doubles by 4-6 months and triples by 1 year | | | | - Head circumference | | | | - Avg @ birth is 35cm | | | | - Increases \~1cm/month during year 1 | | | | - Head circumference is usually about 1-2 cm larger than chest | | circumference at birth | | | | **[Classification by GA and weight ]** | | | | **Preterm** \42 weeks | | | | **ELBW** \ yrs (homeless youth. Or parent of a | | child): unemancipated minor can consent to medically | | necessary health care | | | | - Clinical, rehab physical, mental | | | | - Must be living apart from parents/guardians | | | | - **Emancipated Minor (16 years or older)** | | | | - Valid marriage | | | | - Active duty | | | | - Deceleration of emancipation | | | | - **Medical Emancipation** | | | | - **Mature Minor Doctrine** | | | | **[Adolescent Well Visit -- Bright Future Pocket Guide has you | | covered ! ]** | | | | - **HEADSS**: adolescent Psychosocial History | | | | - **11-YEAR-OLD** **VISIT**: | | | | - History | | | | - Vitals | | | | - Hearing | | | | - Developmental surveillance | | | | - HEADSS | | | | - PE (includes **SMR**) | | | | - VAX: Covid/Flu, TDAP, HPV, Meningococcal | | | | - **Fasting Lipid Panel**\* | | | | - Anticipatory Guidelines | | | | - **Transition to Adult Care** | | | | - Steps | | | | - Transition policy (12-14) | | | | - Transition tracking & monitoring (14-18) | | | | - Transition Readiness | | | | - Transition Planning | | | | - Transfer and/or integration into adult centered care | | (18-21) | | | | - Transition completion & ongoing care w adult clinician | | (18-26) | | | | - Challenges | | | | - Fear of a new health care system | | | | - Inadequate planning | | | | - System difficulties | | | | - **Pre-participation Sports Physical:** | | | | - **maximizing SAFE participation** | | | | - Identify **medical problems** w risks of | | **life-threatening complications** during participation | | (hypertrophic, cardiomyopathy) | | | | - Identify **conditions that require a treatment plan** | | before or during participation | | | | - Identify and **rehabilitate** old MSK injuries | | | | - Identify & treat **conditions that interfere w | | performance** (exercise-induced bronchospasms) | | | | - **Remove unnecessary restrictions** on participation | | | | - **FOCUS: cardiovascular & musculoskeletal health** | | | | - **Medical & family history** | | | | - **Menstrual history** in females | | | | - **Cardiovascular risk factors**, previous injuries or | | surgeries | | | | - General **PE** | | | | - **Heart, lungs, vision & hearing** | | | | - Murmurs, wheezing, visual or hearing deficits | | | | - Focused **musculoskeletal** exam | | | | - Weakness, limited ROM, previous injuries | +-----------------------------------------------------------------------+ **[M5 -- Child Abuse]** +-----------------------------------------------------------------------+ | Reporting in NM: | | | | - CYFD central intake child abuse hotline | | | | - Dept of trical social services | | | | - LE | | | |  | | | |  | | | | Sentinel injuries: medially minor superficial injures that occur in | | young & developmentally immature infants who cannot hurt. Themselves | | and are often poorly explained | | | | - Cutaneous injuries such as bruising | | | | - Subconjunctival hemorrhages | | | | - Intra-oral injuries | | | | - Highly concerning for abuse | | | |  | +-----------------------------------------------------------------------+ M5 -- Sexual Abuse A diagram of a diagram of a person AI-generated content may be incorrect. A close-up of a white background AI-generated content may be incorrect. A close-up of a message AI-generated content may be incorrect.