This section covers top 10 sickness that parents call for pediatric care . This acts as a generic information that describes the cause, symptoms and its severity. The evaluation and treatment depends up on the child‘s age and his/her health conditions such as diabetes, etc.
Please communicate the following to the medical assistant during telephone triage or while making appointment so that they can evaluate the severity and urgency!
1. Vomiting
Q. What is the cause?
A. Stomach infection (gastritis) from a stomach virus (eg. Rotavirus). If vomiting persists more than 24 hours without diarrhea, more serious causes may be considered such as poisoning, meningitis, etc. It usually comes with one or more symptoms like diarrhea, cough, fever, head ache, abdominal pain, etc
Q. What is the severity?
A. 1-4 times per day -- mild; 5-10 times per day moderate; vomits everything -- severe;
Q. What are the signs of dehydration?
A. Very dry mouth, no urine in > 4 hours, no tears;
Q. Does the color of the vomit give any clues?
A. Yes. bile (yellow or green); blood --red or coffee ground; etc
2. Colds
Q. What is the cause?
A. Colds are caused by viruses. Healthy children averages 6 colds a year.
Q. What are the symptoms?
A. Fever ; sore throat; ear ache; nasal discharge; sinus pain; cough. If the child has multiple symptoms, please talk to the office staff and physician for further evaluation and treatment.
Q. Can we use OTC (over-the-counter) cough and cold medicines for children less than 2 years?
A. NO. OTC cough and cold medicine should never be used for children less than 2 years because of potential serious side effects.
3. Cough
Q. What is the cause?
A. Most are part of a cold caused by viral infection. Other common causes are croup, allergy, asthma, etc.
Q. What are the symptoms?
A. Yellow or green sputum. The lining of trachea was damaged by the viral infection and is being coughed up as new mucosa replaces it.
Q. Can we use OTC (over-the-counter) cough and cough medicines for children less than 2 years?
A. NO. OTC cough and cold medicine should never be used for children less than 2 years because of potential serious side effects.
4. Croup
Q. What is the cause?
A. It is the viral infection of the voice box (larynx) and usually caused by para influenza virus.
Q. What are the symptoms?
A. The croupy cough is tight, low pitched and barky. The voice or cry is hoarse.
Q. What is Stridor?
A. Stridor is a harsh, raspy sound heard with breathing in.
5. Diarrhea
Q. What is the cause?
A. Usually it is the viral infection of the stomach and intestine. Occasionally bacteria such as salmonella and parasite such as giardia may cause the illness.
Q. What are the symptoms?
A. It is the sudden increase in the frequency and looseness of the bowel movements.
Q. What is the severity?
A. mild diarrhea is the passage of a few loose bowel movements where as sever diarrhea is the passage of many watery bowel movements.
Q. What are the signs of dehydration?
A. mucous membranes normal to dry inside of mouth,
urine production decreasd to absent ,
Tears normal to absent.
6. Fever
Q. What is the cause?
A. Colds and other viral infections.
Q. What are the symptoms?
A. Fever may be the only symptom for the first 24 hours. The other symptoms such as runny nose, cough, diarrhea are often delayed.
Q. What is the normal variation of temperature?
A. Rectal: A reading of 98.6 degree F is the average temperature but it varies from morning to afternoon.
Oral: A reading of 97.6 degree F is the average temperature .
Q. What is the definition of lethargic child?
A. Lethargic children need to be seen immediately.
Some of the signs of true lethargy are:
Not alert when awake;
Does not follow simple commands;
Decreased spontaneous talking or babbling; etc.
7. Sore Throat
Q. What is the cause?
A. Colds . The organisms include rhinoviruses, influenza and parainfluenza.
Group A streptococcus is the most common bacterial cause.
Q. What are the symptoms?
A. Pain, discomfort or raw feeling of the throat, especially when swallowing.
Children less than 2 years do not know how to complain about sore throat but cries during fluid intake.
Q. What is the pain severity scale?
A. mild-does not interfere with normal activities;
moderate-does interfere with normal activities or awakens from sleep.
severe-excruciating pain, unable to do any normal activities.
8. Asthma Attack
Q. What are the causes (triggers)?
A. Viral respiratory infections; animal contact especially cats; tobacco smoke; pollens; air pollution, etc.
Q. What are the symptoms?
A. A wheeze or whistling sound on breathing out is the classic symptom. Coughing may be the first symptom.
Q. What is severity scale?
A. mild---shortness of breath at rest;
moderate -- audible wheezing;
severe -- loud wheezing; struggling to breathe.
9. Immunization Reactions
Local reaction:
Most local swelling, redness and pain at the injection begins within 24 hours of the shot. Occasionally, localized hives or itching occurs at the injection site.
Systemic reaction:
Fever with most vaccines begins within 24 hours. Headaches and poor appetite can also be seen. It usually last 1-3 days. With live vaccines such as MMR and chickenpox, fever and systemic reactions usually begin between 1 and 4 weeks later.
10. Breast feeding
Q. Frequency of Feedings
A. For the first month, expect your baby to feed every 1.5 to 3 hours. After one month of age, allow your baby to sleep longer. If your baby is gaining weight well, feed on demand.
Q. Length of Feedings
A. Offer both breasts with each feeding. Feed on one side first and if your baby shows signs of continued hunger, offer your second breast. Alternate which breast you can start on.
Q. Is your baby receiving enough milk?
A. Your baby should be relaxed and content (not hungry) after feedings. Your breast should feel full before feedings and softer after feedings. Also expect a steady increase in the number of wet diapers and stools. |
