General Pediatrics

Overview

Pediatrics (sometimes called paediatrics or paediatrics) is the area of medicine concerned with the medical care of babies, children, adolescents, and young adults. The American Academy of Pediatrics recommends people seek pediatric care until the age of 21, but some pediatric subspecialists continue to care for adults up to the age of 25. Worldwide age limits of pediatrics have been trending upward year after year. Pediatrics and its cognates are derived from the phrase "child healer." 

two Greek words: (pais, meaning "child") and (iatros "doctor, healer"). Pediatricians work at clinics, research facilities, universities, general hospitals, and children's hospitals, as well as those who specialize in pediatrics (e.g. neonatology requires resources available in a NICU).

Good health, especially throughout childhood, leads to a healthy existence later in life. It also provides a positive atmosphere for children to grow and acquire important life lessons. As a result, it's critical to treat and manage any ailment that affects your child. This is to guarantee that he or she lives a long and healthy life.

Pediatrics is thus specifically designed to assist all children from birth to the age of 18. It is concerned with the diagnosis, treatment, and management of a wide variety of pediatric illnesses. It also strives to provide every kid with an equal opportunity to thrive and live a fulfilling life.

 

How Does Pediatrics Differ from Adult Medicine?

In more ways than one, pediatrics differs from adult medicine. The smaller body of a baby, neonate, or kid differs significantly physiologically from that of an adult. Treating children is not the same as treating a little adult.

Pediatricians are more concerned with congenital flaws, genetic variation, and developmental concerns than adults. Furthermore, there are various legal difficulties in pediatrics. Children are minors and, in most jurisdictions, are unable to make their own decisions. Every pediatric operation should take guardianship, privacy, legal responsibility, and informed consent into account.

 

Training

A paediatrician is first and foremost a medical school graduate. As a primary care paediatrician, he or she subsequently completes three years of training in a recognized pediatric residency program. During this time, they learn about caring for infants, children, adolescents, and young adults.

Following the completion of a rigorous written test, the pediatrician is eligible for board certification by the American Board of Paediatrics. Every seven years, recertification is necessary.

 

Objectives of Pediatrics

Pediatrics is a medical specialty that focuses on the care and treatment of newborns, young children, and adolescents. A pediatrician, on the other hand, is the child's medical professional who specializes in this specialty.

Pediatricians are in charge of treating for severely and chronically ill children as well as providing preventative care to healthy minors. They also assist in the management and monitoring of the children's mental, emotional, and physical well-being at each developmental stage. This is true whether they are well or ill.

In general, pediatrics strives to reduce baby and child mortality rates in a variety of methods, including: 

• Promoting healthy lifestyles to ensure that they live a life free of disease and frequent infections. 
• Controlling the spread of certain infectious diseases 
• Closely working with the children and adolescents to help them ease health problems associated with certain chronic diseases

Furthermore, pediatrics addresses a wide spectrum of health issues impacting children. Infections, trauma, genetic abnormalities, congenital impairments, organ illness and dysfunction, and cancer are all examples.

Furthermore, it monitors the long-term effects of specific conditions on the children's quality of life, survival, and functioning. As a result, pediatricians are concerned with the early detection, care, and prevention of illnesses such as;

• Behavioral issues
• Social stress and challenges 
• Development disorders and delays 
• Functional disabilities 
• Mental problems such as anxiety and depression 

 

Pediatrics Subspecialties

Pediatric is typically concerned with all problems and health concerns that affect every child. As such, pediatrics comprises several subspecialties where each is concerned with the children's health and well-being. 

The main types of pediatrics subspecialties include the following; 

Pediatric Cardiology

Pediatric cardiology is concerned with congenital heart defects )e.g. VSD)and other heart-related diseases that occur in newborns and children. Thus, pediatric cardiologists specialize in the diagnosis and treatment of different cardiac problems. Heart valve problems, heart murmurs, and cardiac rhythm irregularities are examples of these ailments.

 

Adolescent medicine

The diagnosis and treatment of any medical disease affecting teenagers is the focus of adolescent medicine. The primary purpose of adolescent pediatricians is to help with young people who are suffering health problems that are interfering with their daily life. Mental health illnesses, growth challenges, and alcohol or drug misuse are all examples of health concerns.

 

Critical care

Intensive care Pediatrics is the diagnosis and treatment of severely sick children. As a result, critical care pediatricians are well-versed in dealing with chronic diseases. Furthermore, they specialize in various therapeutic processes as well as high levels of monitoring the child's health. They treat severe situations such as respiratory failure, persistent physical injuries, and septic infections.

 

Child abuse

Child abuse pediatricians specialize in assisting youngsters who have been neglected or abused sexually, physically, or emotionally. They can also help with the diagnosis and treatment of different health diseases related with child abuse and neglect, such as psychological issues and malnutrition.

 

Pediatrics Endocrinology

Pediatric endocrinology is concerned with endocrine gland disorders that affect children. Endocrinology pediatricians are also experts in the diagnosis and treatment of hormonal and metabolic abnormalities in children. This might involve physical growth and sexual development disorders, diabetes, childhood obesity, aberrant pituitary gland function, and hormonal growth issues.

 

Pediatric hematology-oncology

Pediatric hematology and oncology involve diagnosing, treating, managing blood diseases (hematology) and cancers (oncology) in children. Some of these conditions include brain tumors, leukemia, neutropenia, hemophilia, and blood cell disorders. 

 

Pediatric gastroenterology

Pediatric gastroenterology is concerned with the diagnosis, treatment, and care of children who have digestive or gastrointestinal (GI) tract diseases. Irritable bowel syndrome, gastric ulcers, pancreatitis, colitis, celiac disease, constipation, abdominal discomfort, and liver illnesses are among these ailments.

 

Pediatric pulmonology

This field specializes in diagnosing, treating, and managing conditions affecting children’s respiratory system. These conditions include pneumonia, asthma, cystic fibrosis, respiratory infections, chronic cough, and lung conditions. 

 

Pediatric neonatology

Pediatric neonatology is the care of preterm and critically ill newborn newborns. Certain health issues can be diagnosed while the kid is still in the mother's womb. Neonatal pediatricians can occasionally assist in the birth of newborns, particularly those who are at a greater risk. They also provide extensive medical treatment to them right after delivery.

 

Pediatric rheumatology

This is a pediatric subspecialty that is concerned with children suffering from disorders of the joints and bones. It also diagnoses, treats, and manages children with lupus, vasculitis, and rheumatoid arthritis. 

 

Differences Between Adult & Pediatric Drugs

Body size variations are mirrored by maturation changes. An infant's or neonate's tiny body differs significantly physiologically from that of an adult. Pediatricians are frequently more concerned than adult physicians with congenital malformations, genetic variation, and developmental difficulties. Children, contrary to popular belief, are not merely "small grownups." When examining symptoms, giving drugs, and diagnosing diseases, the doctor must remember the newborn or child's undeveloped physiology.

The pharmacokinetic qualities of medications that enter the body are directly influenced by pediatric physiology. Medication absorption, distribution, metabolism, and excretion varies between developing children and adults. Despite completed studies and evaluations, further study is needed to better understand how these characteristics should influence healthcare practitioners' judgments when prescription and providing drugs to children.

 

Absorption

Many variations in medication absorption between pediatric and adult populations concentrate around the stomach. Because of lower acid output, neonates and early babies have higher stomach pH, generating a more basic environment for medicines taken orally. Acid is required for the breakdown of certain oral medicines prior to systemic absorption. As a result of lower breakdown and enhanced preservation in a less acidic stomach region, children absorb more of these medications than adults.

Children also have a slower rate of stomach emptying, which delays medication absorption.

Specific enzymes that come into touch with the oral medicine as it passes through the body also have a role in drug absorption. As children grow their gastrointestinal system, their supply of these enzymes increases. Pediatric patients' proteins are undeveloped, resulting in reduced metabolism and higher blood concentrations of particular medications. Prodrugs, on the other hand, have the opposite effect since enzymes are required for their active form to reach systemic circulation.

 

Distribution

Both the percentage of total body water and extracellular fluid volume decrease as children grow and develop. As a result, pediatric patients have a higher volume of distribution than adults, which has a direct impact on the dose of hydrophilic medications such beta-lactam antibiotics like ampicillin. To account for this important change in body composition, many medications are delivered at higher weight-based dosages or with altered dosing intervals in youngsters.

Infants and newborns have less plasma proteins as well. As a result, highly protein-bound medicines have fewer protein binding chances, resulting in enhanced distribution.

 

Metabolism

Drug metabolism is largely carried out by enzymes in the liver and might differ depending on which individual enzymes are damaged at a certain stage of development. The maturation and development rates of Phase I and Phase II enzymes varies based on their individual mode of action (i.e. oxidation, hydrolysis, acetylation, methylation, etc.). Enzyme capacity, clearance, and half-life are all involved in the changes in metabolism between children and adults. Even within the pediatric population, drug metabolism might change, differentiating neonates and babies from young children. 

 

Elimination

The liver and kidneys are the primary organs involved in drug clearance. The bigger relative size of the kidneys in newborns and young children leads to enhanced renal clearance of drugs excreted by urine. Because preterm neonates and babies' kidneys mature at a slower rate, they are unable to pass as much medication as fully formed kidneys. This can result in undesired drug build-up, which is why lower dosages and longer dosing intervals are recommended for this group. Diseases that impair kidney function can have the same impact, necessitating comparable precautions.

 

When to See Doctors?

A few key symptoms can be your guide as you decide whether to grab your phone and call your pediatrician.

 

Fever

The age of your child determines how to treat a fever. A rectal fever of 100.4 F or greater in a newborn under 2 months old is considered an emergency.

Sometimes, a fever is the sole clue that a baby has a dangerous illness. The hospital will do a comprehensive workup, including blood and urine tests and, in certain cases, a spinal tap.

The number on the thermometer is less revealing in older children than other cues. What matters most is how the child is reacting to the fever and how long they've had it. If a child has a 101 [degree] temperature but is really irritable, won't eat, isn't acting like themselves, or won't stop weeping, that concerns me. This guideline applies to vaccinated children; most fevers in unvaccinated newborns should be checked by a doctor straight away.

She claims that three days is the ideal number for viral fevers. Any fever that lasts longer than 48 hours should be reported to your doctor. It may have developed into a bacterial illness, such as pneumonia.

 

Vomiting and Diarrhea

These symptoms usually signal a viral infection. On their own, they're nothing to worry about. But when they're too intense, they can be a problem.

If the child is crying, I want to see tears. If you don't see tears, they're headed toward getting dehydrated. 

Other signs of dehydration include:

• Less pee than usual -- fewer than 6 wet diapers per day in infants
• Dark urine
• Dry, cracked lips and mouth
• Sunken eyes
• Crankiness
• Sunken soft spot on top of the head (in babies younger than 18 months)

many stomach infections that cause vomiting or diarrhea endure 24 hours or less. If these symptoms persist or your kid has a fever, contact your physician. These are more likely symptoms of a bacterial infection that need treatment.

A red or black color in the diarrhea or vomit, or specks that appear like coffee grounds, is another major red flag. These might be drops of blood. That is a medical emergency.

 

Colds and Other Respiratory Infections

Upper respiratory infections, such as colds, are common in children, who receive up to eight of them each year. They are usually viral and last approximately 10 days.

For the first three days, children may have a fever. The fever will then subside, and the clear nasal discharge will thicken, become green, and yellow. That simply signifies that those infection-fighting cells have been activated. It doesn't always imply a bacterial illness.

A fever that lasts longer than three days or symptoms that intensify need a trip to the doctor. Your child might have an ear infection or another type of bacterial infection.

Call the doctor right away if your kid needs to fight harder to breathe. With each breath, you'll observe your child's nose flare or their ribs suck in. When they try to breathe, they may produce a weird noise or wheeze.

A blue tint around the lips or nails indicates that your child is not getting enough oxygen. Call emergency right away.

 

Rash

This is one of the most difficult symptoms to diagnose. Rashes can take many different shapes and have a variety of reasons.

A rash that does not disturb your child is typically not cause for concern. But if it doesn't go away in a few days, you should call your doctor. Rashes along with a fever are more concerning since they may indicate an infection.

Other possible symptoms to tell your doctor about are:

• A rash that oozes or weeps
• A blistery or bubbly rash
• A rash that looks like a bull’s-eye or target
• Swollen bumps on the skin, along with trouble breathing or swelling of the face
• A rash on a child who looks sick or isn’t acting like themselves

 

Other Symptoms

These symptoms also call for a call to your pediatrician right away:

• Trouble waking your child
• Sharp or constant belly pain
• Burning when your child pees, or blood in their urine
• A constant need to pee
• Seizures

 

Conclusion 

Pediatricians are doctors who specialize in the physical, emotional, and social health of children from birth through young adulthood. Pediatric care includes a wide range of health services, from preventative care to the diagnosis and treatment of acute and chronic disorders. Pediatricians are aware of the numerous elements that influence children's growth and development. They recognize that children are more than just miniature adults. Children change quickly, and they must be handled with an understanding of their physical and mental growth stages.