Antibiotic selection can be complicated. In this episode, we discuss how you should approach choosing the appropriate antibiotic for your pediatric patient. There are multiple considerations, including: What organisms do you want to treat? What does anatomy have to do with antibiotic selection? You also have to think about individual circumstances, such as immunzation status, chronic disease, drug allergies, and environmental exposures.

Resources/Links:

Up to date: uptodate.com  

American Academy of Pediatrics Red Book: https://publications.aap.org/redbook?autologincheck=redirected 

Sanford Guide to Antimicrobial therapy: https://www.sanfordguide.com/products/print-guides/?gad=1&gclid=CjwKCAjwtuOlBhBREiwA7agf1oWtsyBrx0OFaHxpG2ZpDTXYukd1JGs5R_ZpRWrECT_v0bqhboN15hoCijIQAvD_BwE

American Academy of Pediatrics clinical practice guideline: The Diagnosis and Management of Acute Otitis Media. 2013. https://publications.aap.org/pediatrics/article/131/3/e964/30912/The-Diagnosis-and-Management-of-Acute-Otitis-Media

Prescribing medicines in pediatrics is different than prescribing medicines for adults. In this episode, we discuss what you need to know before prescribing medications for the pediatric population, including calculating dose for the child’s weight, choosing IV vs PO medications, and other considerations.

1)    References to look up pediatric drug doses and frequencies.

2)    Calculating weight-based doses

3)    Maximum daily doses

4)    Different formulations of medications

5)    Prescribing oral medicines

6)    What if the medicine is not available in liquid form

7)    Options if oral medications are not easily available in liquid form.

8)    Medicine dosing frequency – use the least frequent option

9)    Acetaminophen and Ibuprofen

Resources/Links:

Up to date: uptodate.com  

Harriet Lane Handbook: https://evolve.elsevier.com/cs/product/9780323876988?role=student

Lexi-Comp: https://apps.apple.com/ca/app/lexicomp/id313401238

Many of our patients and their families are not proficient in English, and it's important to be able to communicate effectively with them.  In this episode, you’ll learn about how to work with an interpreter during encounters with patients who are not proficient in English. We’ll discuss dos and don’ts, common challenges, and tips for interacting with interpreters and families.

III.           Who should not serve as an interpreter?

VII.         At the end of the encounter

VIII.        After the visit

Resources:

–         “Addressing Low Health Literacy and Limited English Proficiency,” American Academy of Pediatrics: https://www.aap.org/en/practice-management/providing-patient--and-family-centered-care/addressing-low-health-literacy-and-limited-english-proficiency/

–         “Guidelines for Use of Medical Interpreter Services,” Association of American Medical Colleges: https://www.aamc.org/media/24801/download

–         “Appropriate Use of Medical Interpreters,” American Academy of Family Physicians: https://www.aafp.org/pubs/afp/issues/2014/1001/p476.html

–         “Working effectively with an interpreter,” U.S. Department of Health and Human Services Office of Minority Health: https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/working-effectively-with-interpreter.pdf

Following safe sleep guidelines is the best way to protect a baby from dying suddenly and unexpectedly from sudden infant death syndrome (SIDS), accidental suffocation or strangulation, and deaths with unknown cause. Today we’re going to talk about what you need to know before you talk to a family about what safe sleep looks like for their infant. We’re going to talk about the importance of safe sleep habits, the AAP safe sleep recommendations, guidelines for infant sleep products, and tummy time.

Safe sleep recommendations:

 References:

The sexual history is an important part of the adolescent visit. In this episode, we will discuss the importance of the sexual history and how to handle patient confidentiality. We will introduce the 5Ps framework for the sexual history. We will also brieflyy discuss screening for sexually transmitted infections (STIs), including human immunodeficiency virus (HIV).

References:

5 Ps Framework: 

STI Screening and Treatment: 

HIV screening algorithm:

Today, we will be reviewing what you need to know to examine your pediatric patients. Examining children is a bit of an art form and is often unfamiliar to clerkship students who may have a varied degree of experience being around children, may never have worked with children and may not have been exposed to pediatric patients in the pre-clinical years. In this episode, we discuss tips and tricks to get the exam you need on your pediatric patient with as little crying as possible.

Resources/Links:

Bates' Guide to Physical Examination and History Taking by Lynn Bickley (your pediatric clinics will generally have a copy)

https://batesvisualguide.com

Providing vaccines is one of the most important health promotion activities that we do. However, it involves much more than just putting in the orders for the various vaccines. In this podcast episode, we will briefly review how vaccines work, the types of vaccines, what you need to do before the visit, what you should review with families before ordering the vaccines (including precautions and contraindications), and anticipatory guidance about vaccines. We will also talk a little bit about how to handle vaccine hesitancy.

REFERENCES/LINKS:

www.cdc.gov/vaccines

AAP Child and Adolescent Immunization Schedule by Age: https://publications.aap.org/redbook/pages/Immunization-Schedules?autologincheck=redirected

O’Shea P, John J, et al. Reframing the Conversation about Child and Adolescent Vaccines, January 2023, Frameworks Institute. https://www.frameworksinstitute.org/wp-content/uploads/2023/01/reframing-the-conversation-about-child-and-adolescent-vaccinations_Jan272023.pdf

In this episode, we discuss how to best prepare for your time on the inpatient wards, including how to prepare before the rotation, how to pre-round, how to present a patient, and how to be an effective team member.

The goal of the adolescent well visit is to empower the adolescent in starting to take ownership of their health with the support of their parent/caregiver and their health provider. There are thus specific ways in which the adolescent well visit differs from well visits for younger children. We will discuss how you can approach these visits, how to handle patient confidentiality, and how to ask those sensitive questions.

Before visit:

During visit:

Physical exam

Preparation for oral presentation 

This episode describes how to prepare for a newborn’s first outpatient visit after they have been discharged from the birth hospital, including the information that you need to obtain from the medical record before the visit, the topics you need to discuss during the visit, and how to approach the physical examination in a newborn.

Introduction

Socio-emotional state of parents

Before the visit, you should review

Newborn visit

Normal newborn vital signs

Infant growth parameters and weight trajectory

Physical exam

Anticipatory guidance

Next follow up appointment depends on weight, bilirubin level

Resources/Links:

https://peditools.org/bili2022/ - resource for management of hyperbilirubinemia