Pediatric drug handbook 2011

Who are primary caregivers? Parents work outside the home? How many other children? In a home vs. What does your child do for fun? How many siblings? Are they healthy? How does everyone get along? What do you argue about? On weekends? Who are your best friends? What do you do together? Frequency of use? How much? Why do you use X? Any police involvement? DO NOT assume heterosexuality!

Are you having sex? On a scale of ? Ability to concentrate? Bike helmets? Include amount, frequency, rate if applicable. Daily weights eg.

Make sure you sign the order sheet and write your name legibly and pager number. What has changed since the previous note. Does the patient have any new symptoms? Remember to ask about: behaviour, activity, sleep, appetite, in and outs. Awaiting culture and sensitivity Issue 2 eg.

Doubts about a colleague's treatment decisions should not be recorded in medical records. Better to talk to your colleague instead. Write only what YOU did or did not do. You cannot testify to the truth of the event if no personal knowledge. Again write no comments as to what others did, will do, or said, etc. Notes may be written elsewhere not in chart in the event of potential litigation, but these notes are not protected, NEVER change, tamper or add to a medical record.

Any subsequent additions or changes should be dated and signed at the time you make them, to avoid undermining the credibility of any changes. Poor charting may be perceived as reflecting less attention to detail, risking the conclusion that care provided was poor. Refer to separately dictated note for full history and physical examination of admission. Maintenance 2. Deficit Replacement 3.

Ongoing Losses Replacement 1. Any police involvement? D Dealing? DO NOT assume heterosexuality! Are you dating someone now? Are you having sex? How would would you describe your mood? On a scale of ? Any change in sleep pattern?

Ability to concentrate? Have you had any thoughts about hurting hurting yourself? Safety Do you regularly use: use: seatbelts? Bike helmets? Does anyone at home home own a gun? Include amount, frequency, rate if applicable. Daily weights eg. Make sure you sign the order sheet and write your name legibly and pager number.

What has changed since the previous note. Does the patient have any new symptoms? Remember to ask about: behaviour, activity, sleep, appetite, in and outs. Doubts about a colleague's treatment decisions should not be recorded in medical records. Better to talk to your colleague instead. Write only what YOU did did or did not do. You cannot testify to the truth of the event if no personal knowledge. Again write no comments as to what others did, will do, or said, etc.

Notes may be written elsewhere not in chart in the event of potential litigation, but these notes are not protected, NEVER change, tamper or add to a medical record. Do NOT later change an existing entry. Do NOT black-out or white-out words or areas. Do NOT insert entries between lines or along the margins of the chart as these may appear to have been added later, casting doubt on their reliability.

Poor charting may be perceived as reflecting less attention to detail, risking the conclusion that care provided was poor. Refer to separately dictated note for full history and physical examination of admission.

Maintenance 2. Deficit Replacement 3. Ongoing Losses Replacement 1. Or just the presence of bradycardia. Will be reported as self resolved or requiring stimulation. Common in preterm infants however must always rule out sepsis. May also be used in MAS meconium aspiration syndrome or severe pneumonia.

CPAP- Continuous positive airway pressure, non invasive form of ventilation v entilation providing continuous PEEP positive end expiratory pressure used to keep airways open and prevent airway collapse. Used in a multitude of settings. Gavage- form of feeding, by where an OG tube is inserted into the stomach placed clinically and a feed is given by gravity or over a period of time by pump.

Prior to the feed the nurse will ge generally nerally draw back to see if there is any residual feed in the stomach. Histogram- continuous monitoring of oxygen saturations over hrs, done in either prone or supine position. Reported as an average of the time period. Reported as greater than 90 over 90, first number represents the saturation the second the percentage of the time that they over that saturation. IDDM- infant of a diabetic mother can cause a multitude of neon neonatal atal complications, most commonly hypoglycemia.

NEC necrotizing enterocolitis - Gut infection, characterized by feeding intolerance, bilious residuals, abdominal distension, bloody stools, with other signs and symptoms of sepsis. TFI- Total fluid index volume of fluid that an infant receives per day, either enteral or parenteral. Prematurity 2. Apnea of prematurity 3. Unconjugated hyperbilirubinemia 4. A: Summarize active issues.

Insert post-delivery management. Insert Insert any complications: HFO, chest tubes, nitric oxide. Caffeine was discontinued on date. Describe current status of murmur. Repeat echocardiogram? Other cardiac anomalies? Hematology: Hematology: List any blood product transfusions.

A ultrasound. A follow-up eye appointment has been made at the eye clinic at McMaster for date and time. Immunizations: 1. Synagis eligibility and date received or required and reference. Pentacel date received or required , 3. Prevnar date received or required. Newborn Screen was completed on date. Hearing screen was performed on date date as as per Ministry of Health guidelines.

Follow-up The infant requires follow-up for retinopathy of prematurity and cranial ultrasounds as well as indicate any appointments, etc. Otherwise, precipitation of calcium and phosphorus may occur. Normal molar ratio of Ca:P is Use caution if unequal amounts of calcium and phosphorus added to TPN solution. Prescription amounts above are given as elemental iron check dosage on product used. Centers for Disease Control.

Revised guidelines for prevention of early onset group B streptococcal GBS disease. Pediatrics ; 4. Preventing group B streptococcal infections: New recommendations. Paediatr Child Health ; 5. Prevention of early onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. For women who are GBS culture positive, antibiotics should be reinitiated when labor that is likely to proceed to delivery occurs.

When signs of sepsis are present, a lumbar puncture, if feasible, should be performed. If lab results and clinical course do not indicate bacterial infection, duration may be as short as 48 hours. Applies only to penicillin, penicillin, ampicillin ampicillin or or cefazolin, cefazolin, assumes assumes recommended recommended dosing dosing regimens. It is recognized that these weights deviate from the CPS Guidelines of the 10th and 90th percentile cut-offs for birth weight at term.

Pediatrics and Child Health. Ongoing newborn assessment and timely interventions should not be limited by these guidelines. If at any point the newborn is symptomatic or otherwise unwell, notify the Family Physician or Midwife who may then choose to consult a Pediatrician.

If baby is unable to feed at any point in these guidelines, notify the Family Physician or Midwife. May start wean IV feeding 12 hours after stabletoBG is and established. May start to wean IV 12 hours after stable BG and feeding is established. It is recommended that a maximum maximum of 2 boluses of D10W be used.

When weaning glucose, slowly. If the next edition is published less than one year after your purchase, you will be entitled to online access for one year from your date of purchase.

Elsevier reserves the right to offer a suitable replacement product such as a downloadable or CD-ROM-based electronic version should online access to the web site be discontinued. Access the fully searchable text online at Expert Consult. Completely revised and updated to provide readers with the latest treatments, guidelines, procedures, and management recommendations all in the easy-to-use, quick-access format that's made it a bestseller.

The first medical reference book written "by residents, for residents" and reviewed by expert faculty at The Johns Hopkins Hospital, it continues to provide the gold standard in point-of-care clinical information for any health care professional treating pediatric patients.

Take advantage of the most dependable drug information available with thoroughly updated, one-of-a-kind Pediatric Formulary providing the standard of pediatric care from the leading pediatric hospital in the world. Trust thoroughly updated content that includes parameters for pediatric and neonatal septic shock; guidelines for acute management of severe traumatic brain injury; a convenient table detailing common genetic tests; a significantly extended collection of radiologic images; expanded mental health coverage; plus much more.

Access information easily and quickly with reformatted sections designed make the book easier to use via mobile device. Updated and expanded content, as well as increased online coverage, keeps you fully current with new guidelines, practice parameters, and more.

Easy to use, concise, and complete, this is the essential manual for all health care professionals who treat children. Trusted by generations of residents and practitioners, offering fast, accurate information on pediatric diagnosis and treatment.

Download Free PDF. A short summary of this paper. Download Download PDF. Translate PDF. This handbook was designed for the large number of residents from a variety of disciplines that rotate through pediatrics during their first year of training. It may also be helpful for clinical clerks during their time on the pediatric wards, as well as for pediatric residents and elective students.

This is intended only to act as a guideline for general pediatrics use, and some drugs, doses, indications and monitoring requirements may differ in individual situations.

Moyez Ladhani for editing and supporting the production of this handbook. We would very much appreciate any feedback, suggestions or contributions emailed to ladhanim mcmaster. The detailed monthly schedule for this can be found at www. It is therefore important to complete a succinct handover within the allotted 30 minutes. The two ward Attendings, the Senior Residents and Nurse Managers will attend and discuss potential discharges and bed management.

Patients that can go home will be identified at this time and discharges for these patients should occur promptly. Discharge planning should always be occurring and patients that could potentially go home should be discussed by the team the night before.

This would then be the time to ensure that if those patients are ready that the patients are discharged. See Patients: During this time the team will see their assigned patients. The chart and nursing notes should be reviewed to identify any issues that have arisen over night.

The patient should be seen and examined. All lab work and radiological procedures that are pending should be reviewed. The house staff should then come up with a plan for the day and be ready to present that patient during ward rounds.

It is not necessary that full notes be written at this time, as there will be time allotted for that later in the day. These are work rounds. All efforts should be made to go bedside to bedside to ensure that all patients are rounded on. All three teams are required to attend.

The residents on the team are responsible for this case based teaching. A Junior Resident should be assigned by the Senior Pediatric Resident in advance to present at the case based teaching.

The Junior Resident should present the case in an interactive manner to the rest of the teams. After which the Senior Resident should lead a discussion on that topic and the staff Pediatrician will play a supervisory role. The attending pediatricians are to attend these rounds to provide input. All work is to stop at hrs and all 3 teams are to meet at that time. If at all possible all pages to learners at this time should be avoided.

Please note: patient care does take priority; patients waiting for ER consults etc should not be delayed to attend these rounds. Nurses and other health care professionals are welcome to attend these rounds. These should begin promptly at hrs. The schedule for these sessions will be put out separately. The rest of the team, at this time, will continue with discharge rounds and seeing patients. The second Thursday of each month will be morbidity and mortality rounds and all learners should attend these.

They will finish charting on patients. This is also the time for them to get dictations done and to complete face sheets. Please refer to the CTU teaching schedule for locations — this will be posted online as well as on the wards. It is the goal during this time to get various specialties to come in and teach around patients that are on the ward. All three teams are to meet at hours on 3C. At this time the attendings will split the group up and do bedside teaching. The attendings will decide how to split the group up to get the maximum out of these sessions.

Although the Senior Pediatric Resident is expected to lead these sessions, the Team 1 and 2 attendings are expected to be there and provide input. This is mandatory for all new residents on the CTU service including pediatric residents who have not done wards yet. This would be the opportunity for the attending paediatricians to do at least one long case examination with the pediatric residents, if possible.

All efforts should be made to ensure that this does occur. However, depending on how busy the teams are there is not a mandatory expectation. At least one of the three attendings will meet with learners to discuss objectives and expectations. The Chief Pediatric Residents will run the orientation. This orientation session is mandatory for new learners on the CTU rotation.

Team 1 and 2 MDR will occur on Tuesdays. Hayward et al. Monthly publication by AAP. Call schedules are also posted here in a password-protected area. Online back to January in full text and pdf formats. Accessed through a McMaster e-Resources. Some of these are quite helpful in Level 2 Nursery and other newborn settings.

Also links to Canadian Immunization Guide General Henderson MUMC Chedoke Enter Report Type Consultation Discharge 3. Operative Report 4. Inpatient 2. Outpatient 3.

Hold 2. Fast Forward 44 to move to end 5. Disconnect 6. Prioritize 7. Rewind 77 rewind to beginning 8. Moyez Ladhani Deputy Chief Education ladhanim mcmaster. DIAL to access the central dictation system. PRESS the sign. PRESS 1. Who are primary caregivers? Parents work outside the home? How many other children? In a home vs. What does your child do for fun? How many siblings? Are they healthy? How does everyone get along? What do you argue about?

On weekends? Who are your best friends? What do you do together? Frequency of use? How much? Why do you use X?