The Hospital for Sick Children Handbook of Pediatrics

Front Cover
Inside front cover
Front matter
The Hospital for Sick Children: Handbook of Pediatrics 12th Edition
Copyright
Notice
Dedication
Contents
Section I: Acute care pediatrics
Section II: Subspecialty pediatrics
Section III: Laboratory reference values and transfusion medicine
Section IV: Drug dosing guidelines
Foreword to the 12th edition
Preface
Acknowledgments
Chapter Authors
Section I: Acute care pediatrics
1: Resuscitation
2: Emergency medicine
3: Poisonings and toxicology
4: Pain and sedation
5: Procedures
Section II: Subspecialty pediatrics
6: Adolescent medicine
7: Allergy
8: Cardiology
9: Child maltreatment
10: Dentistry
11: Dermatology
12: Development
13: Diagnostic imaging
14: Endocrinology
15: Fluids, electrolytes, and acid–base
16: Gastroenterology and hepatology
17: General surgery
18: Genetics and teratology
19: Growth and nutrition
20: Gynecology
21: Hematology
22: Immunology
23: Immunoprophylaxis
24: Infectious diseases
25: Mental health
26: Metabolic disease
27: Neonatology
28: Nephrology and urology
29: Neurology and neurosurgery
30: Oncology
31: Ophthalmology
32: Orthopedics
33: Otolaryngology
34: Plastic surgery
35: Respirology
36: Rheumatology
37: Technology and medical complexity
38: Transplantation
Section III: Laboratory reference values and transfusion medicine
39: Laboratory reference values and transfusion medicine
Section IV: Drug dosing guidelines
40: Drug dosing guidelines
Common Abbreviations
Section I Acute Care Pediatrics
1 Resuscitation
Common abbreviations
Useful calculations
Team dynamics
Clinical assessment of the ill child
Respiratory support during resuscitation
Circulatory support during resuscitation
Advanced airway management
Pals algorithms
Post-resuscitation care
Further reading
2 Emergency medicine
Common abbreviations
Useful calculations and values
Circulatory emergencies
Shock
Sepsis
Hypertensive crisis
Respiratory emergencies
Acute asthma exacerbation
Foreign body aspiration
Croup, bacterial tracheitis, and epiglottitis
Anaphylaxis
Neurological emergencies
Acute stroke
Status epilepticus
Raised intracranial pressure
Coma and altered level of consciousness (ALOC)
Environmental emergencies
Drowning
Hypothermia
Hyperthermia
Brief resolved unexplained event (BRUE)
Acute psychosis
Burns
Approach to trauma
Specific injuries in pediatric trauma
Further reading and useful references
3 Poisonings and toxicology
Common abbreviations
Useful formulas
Approach to the poisoned child
Approach to detoxification
Selected poisonings
Environmental contaminants
Substances of abuse (recreational drugs)
Methemoglobinemia
Further reading
Useful websites
4 Pain and sedation
Common abbreviations
Pain assessment
General principles of pain management
Pharmacological methods of pain control
Management of patients taking opioids
Patient/nurse-controlled analgesia (PCA/NCA)
Local anesthetics
Sedation
Further reading
5 Procedures
Common abbreviations
Preparation before procedure
Vascular procedures
Peripheral intravenous catheterization
Intraosseous access
Internal jugular catheterization
Femoral vein catheterization
Umbilical vein and umbilical artery catheterization (UVC, UAC)
Peripheral arterial access
Cardiorespiratory procedures
Needle aspiration of pneumothorax
Chest tube insertion
Gastrointestinal procedures
Nasogastric tube insertion
Replacement of a gastrostomy tube with foley catheter
Genitourinary procedures
Bladder catheterization
Central nervous system procedures
Lumbar puncture
Musculoskeletal procedures
Arthrocentesis
Reduction of radial head subluxation (“pulled elbow”)
Splinting
Laceration repair
Gluing
Suturing
Abscess incision and drainage
Further reading
Section II Subspecialty Pediatrics
6 Adolescent medicine
Common abbreviations
Interviewing the adolescent
Age of consent
Eating disorders
Substance use
Contraception
Sexually transmitted infections
7 Allergy
Common abbreviations
Allergy investigations
Hypersensitivity immune responses
Anaphylaxis
Food allergic reactions
IgE-mediated food reactions
Non-IgE-mediated food reactions
Drug allergic reactions
Latex allergic reactions
Insect sting allergic reactions
Vaccine allergic reactions
Allergic rhinitis and conjunctivitis
Urticaria and angioedema
Further reading
8 Cardiology
Common abbreviations
Focused cardiology assessment
Cardiac approach to chest x-ray
Electrocardiogram
Electrocardiogram interpretation
Electrocardiogram changes in selected disorders
Arrhythmias
Tachycardias
Bradycardias
Ectopic beats
Arrhythmia syndromes
Congenital heart disease
Newborn presenting with cyanosis
Newborn or child presenting with cardiogenic shock
Newborn or child presenting with congestive heart failure
Other cardiac lesions
Cardiac surgical procedures
Infective endocarditis
Acute rheumatic fever
Myocarditis
Cardiomyopathy
Pulmonary hypertension
Syncope
Syndromes associated with cardiac disease
Cardiac screening guidelines
Newborn pulse oximetry screening
Cardiac screening before use of stimulant medications
Lipid screening
Preparticipation screening in athletes
Antiarrythmic medications
Heart transplantation
9 Child maltreatment
Common abbreviations
Reporting and documentation
Red flags
Physical abuse
Sexual abuse
Neglect and caregiver fabricated illness
10 Dentistry
Childhood dental care and caries
Teething, natal/neonatal teeth, and early tooth loss
Dental trauma
Odontogenic infections/dental abscess
Common dental problems
Conditions associated with dental anomalies and periodontal disease
Dental care of medically compromised patients
Useful websites
11 Dermatology
Common abbreviations
Morphology
Neonatal/infantile eruptions
Vesiculopustular eruptions
Subcutaneous fat necrosis of the newborn (SCFN)
Diaper dermatitis
Seborrheic dermatitis
Neonatal/infantile vascular lesions
Infantile hemangioma
Capillary malformations (CM)
Dermatitic eruptions
Atopic dermatitis (AD)
Allergic contact dermatitis
Papulosquamous eruptions
Psoriasis
Acne vulgaris
Cutaneous bacterial infections
Cutaneous viral infections
HSV mucocutaneous infections
Molluscum contagiosum
Verrucae (Warts)
Hand, foot, and mouth (HFM) disease
Childhood exanthems
Fungal eruptions
Infestations
Alopecia
Acute blistering reactions
Genodermatoses (Genetic skin conditions)
Epidermolysis bullosa (EB)
Topical steroids
Further reading
Useful websites
12 Development
Common abbreviations
Normal patterns of development
Developmental red flags
Developmental assessment
Behavior issues
Early developmental impairment and intellectual disability
Autism spectrum disorder
Cerebral palsy
Attention deficit/hyperactivity disorder
Specific learning disorders
Speech and language disorders
Developmental coordination disorder
13 Diagnostic imaging
Common abbreviations
General principles
Approach to imaging
Head
Cervical spine
Chest
Abdomen
Musculoskeletal system
Genitourinary tract
Radiographic appearance of lines and tubes
Further reading
Useful websites
14 Endocrinology
Common abbreviations
Diabetes mellitus
Type 1 diabetes mellitus
Diabetic ketoacidosis
Type 2 diabetes mellitus
Other forms of diabetes
Hypoglycemia
Thyroid disorders
Congenital hypothyroidism
Acquired hypothyroidism
Thyrotoxicosis
Graves’ disease
Calcium disorders
Hypocalcemia
Hypercalcemia
Puberty
Normal pubertal development
Precocious puberty
Delayed puberty
Disorders of sex development
Congenital adrenal hyperplasia
Adrenal disorders
Adrenal insufficiency
Cushing syndrome
Short stature
Growth hormone deficiency
Disorders of water balance
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion
Further reading
Useful websites
15 Fluids, electrolytes, and acidbase
Common abbreviations
Components of fluid therapy
Approach to fluid management
Dehydration
Salt and water
Hyponatremia
Hypernatremia
Potassium
Hypokalemia
Hyperkalemia
Magnesium
Hypomagnesemia
Hypermagnesemia
Phosphate
Hypophosphatemia
Hyperphosphatemia
Calcium
Acid–base disturbances
Blood gas interpretation
Metabolic acidosis
Renal tubular acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
16 Gastroenterology and hepatology
Common abbreviations
Gastrointestinal tract investigations
Gastrointestinal emergencies
Acute gastrointestinal bleeding
Acute abdominal pain
Bilious vomiting
Gastrointestinal tract presentations
Chronic abdominal pain
Functional abdominal pain disorders
Vomiting
Gastroesophageal reflux
Dysphagia
Eosinophilic esophagitis
Inflammatory bowel disease
Celiac disease
Small bowel bacterial overgrowth
Malabsorpton
Protein-losing enteropathy
Cow’s milk protein allergy
Diarrhea (acute and chronic)
Constipation
Pancreatitis
Liver disease
Viral hepatitis
Nonalcoholic fatty liver disease
Acute liver failure
Chronic liver failure
Gallbladder and biliary tract
Hyperbilirubinemia/cholestasis in infancy
Hyperbilirubinemia outside of infancy
Acute ascending cholangitis
Gallstones (cholelithiasis)
Liver transplant
17 General surgery
Common abbreviations
Obstruction—neonatal
Tracheoesophageal fistula (TEF) and esophageal atresia (EA)
Intestinal atresia
Hirschsprung disease
Meconium ileus
Anorectal malformation (ARM)
Obstruction—early infancy
Hypertrophic pyloric stenosis
Obstruction—childhood
Intussusception
Bowel obstruction
Acute abdomen
Neonatal necrotizing enterocolitis
Malrotation and midgut volvulus
Appendicitis
Congenital diaphragmatic hernia
Bochdalek hernia
Morgagni hernia
Gastroschisis and omphalocele
Hernias and the groin
Umbilical hernia
Inguinal hernia
Hydrocele
Cryptorchidism
Preoperative fasting guidelines
18 Genetics and teratology
Common abbreviations
Definitions
Modes of inheritance
Genetic testing
Child with multiple congenital anomalies
Selected genetic conditions
Teratology
Perimortem workup in child with dysmorphisms
19 Growth and nutrition
Common abbreviations
Energy requirements
Assessment of growth
Weight
Length
Head circumference
Weight for height and body mass index
Malnutrition indicators
Enteral feeding
Breastfeeding
Alternative choice of feeding selection
Cow’s milk protein allergy (CMPA)
Energy/nutrient density of feeds and thickening
Solids
Vitamin and mineral supplementation
Vitamin D
Iron
Vitamin B12
Fluoride supplementation
Parenteral nutrition (PN)
Failure to thrive (FTT)
Obesity
Micronutrient deficiencies
Xerophthalmia
Scurvy
Rickets
Iron deficiency
Further resources
20 Gynecology
Common abbreviations
Anatomy of the external genitalia
Genital examination of pediatric and adolescent females
Prepubertal gynecological issues
Neonatal vaginal bleeding
Prepubertal vaginal bleeding
Prepubertal vulvovaginitis
Labial adhesions
Genital infections
Postpubertal vulvovaginitis
Ulcerative disorders
Cervicitis
Pelvic inflammatory disease
Genital warts (condylomata acuminata)
Ovarian/adnexal pathology
Ovarian masses
Adnexal torsion
Polycystic ovarian syndrome
Dysmenorrhea and pelvic pain
Primary dysmenorrhea
Endometriosis
Imperforate hymen/transverse vaginal septum
Abnormal uterine bleeding
Amenorrhea
Heavy menstrual bleeding
Irregular menstrual bleeding
21 Hematology
Common abbreviations
Anemia
Approach to anemia
Physiological anemia of infancy
Iron deficiency anemia
Hemolytic anemia
Hemoglobinopathies
Sickle cell disease (SCD)
Thalassemia
Thrombocytopenia
Immune thrombocytopenia (ITP)
Neonatal alloimmune thrombocytopenia (NAIT)
Neonatal autoimmune thrombocytopenia (NATP)
Neutropenia
Bleeding disorders
Thrombosis
Venous thromboembolic event (VTE)
Unfractionated heparin (UFH)
Low-molecular-weight heparin (LMWH)
Warfarin
Transfusion medicine
Obtaining consent
Blood products
Managing transfusion reactions
Transfusion-associated graft-versus-host disease
Further reading
Useful sites
22 Immunology
Common abbreviations
Diagnostic tests
Screening tests and interpretation
Specific tests for suspected immunodeficiencies
Approach to immunodeficiencies
Primary immunodeficiencies
Immunodeficiencies affecting cellular and humoral immunity
Predominantly antibody deficiency disorders
Immune dysregulatory disorders
Phagocyte defects
Complement deficiencies
Defects in innate immunity (other than phagocytes and complement)
Autoinflammatory disorders
Secondary immunodeficiencies
23 Immunoprophylaxis
Common abbreviations
Immunizations
Selected infections and prophylaxis
Hepatitis A
Hepatitis B
Influenza
Measles
Meningococcal disease
Pertussis
Rabies
Respiratory syncytial virus
Tetanus
Varicella
Asplenic patients
Needlestick injuries
Expressed breast milk: Administration errors
24 Infectious diseases
Common abbreviations
Classification of bacteria
Bacterial infections
Focal bacterial infections
Multisystem bacterial infections
Tuberculosis
Lyme disease
Viral infections
Herpes simplex virus (HSV)
EBV
Varicella-Zoster virus
HIV
Fungal infections
Parasitic infections
Malaria
Congenital/perinatal infections
CNS infections
Encephalitis
Meningitis
Management of infant with fever of uncertain source
Special populations
Fever in the returning traveler
Immigrant and refugee children
Immunocompromised patients
25 Mental health
Common abbreviations
Principles of assessment and diagnosis
Common management principles
Adverse childhood experiences
Depression
Major depressive disorder
Externalizing disorders (disruptive behavioral disorders)
Oppositional defiant disorder
Conduct disorder
Anxiety
Generalized anxiety disorder
Separation anxiety disorder
Obsessive–compulsive disorder
Post-traumatic stress disorder
Somatic symptom and related disorders
Somatic symptom disorder
Psychosis and delirium
Psychosis
Delirium
Further resources
26 Metabolic disease
Common abbreviations
Useful calculations
General metabolic concepts
Classification of inborn errors of metabolism
Small molecule disorders
Organelle disorders
Diagnostic tests
Approach to inborn errors of metabolism
Management of inborn errors of metabolism
Hypoglycemia
Hyperammonemia
Metabolic acidosis
Lactic acidosis
Hepatocellular dysfunction
Cardiomyopathy
Storage disorders
Perimortem/postmortem investigations
27 Neonatology
Common abbreviations
Classification of the neonate
Newborn resuscitation
Case room equipment
Neonatal resuscitation algorithm
Additional factors in initial management
Newborn care
Newborn physical examination
Routine newborn interventions
Prenatal counseling and screening
Planning for preterm birth
Nutrition and growth
Fluids and electrolytes
Hyponatremia
Hypernatremia
Hyperkalemia and hypokalemia
Hypocalcemia
Acid-base status
Glucose dysregulation
Hypoglycemia
Hyperglycemia
Respiratory conditions
Respiratory distress
Respiratory distress syndrome
Transient tachypnea of the newborn
Apnea
Bronchopulmonary dysplasia
Mechanical ventilation
Cardiac conditions
Persistent pulmonary hypertension
Patent ductus arteriosus
Heart failure
Neurological conditions
Neonatal encephalopathy
Neonatal seizures
Intraventricular hemorrhage
Neonatal drug withdrawal
Hematological conditions
Jaundice
Polycythemia
Platelet disorders
Neonatal sepsis
Gastrointestinal conditions
Necrotizing enterocolitis
Abdominal wall defects
Obstruction
Retinopathy of prematurity
28 Nephrology and urology
Common abbreviations
Clinical evaluation of renal function
Useful calculations and values
Congenital abnormalities of the kidneys and urinary tract (CAKUT)
Antenatal hydronephrosis
Vesicoureteral reflux
Obstructive uropathy
Ureteropelvic junction obstruction
Prune-Belly syndrome
Posterior urethral valves
Urinary tract infection
Hypertension
Proteinuria
Nephrotic syndrome
Primary idiopathic nephrotic syndrome
Hematuria
Nephritic syndrome
Alport syndrome
Henoch-Schönlein purpura nephritis
IgA nephropathy (Berger disease)
Post-infectious glomerulonephritis
Hemolytic uremic syndrome
Acute kidney injury
Chronic kidney disease
Renal replacement therapy
Renal transplant
Renal stones
Nephrocalcinosis
Differential diagnosis by stone composition
Tubular disorders
Scrotal disorders
Penile disorders
Phimosis
Paraphimosis
Penile infection and inflammation
Hypospadias
Bladder disorders
Enuresis
Bladder and bowel dysfunction
Neurogenic bladder
Further reading
Useful websites
29 Neurology and neurosurgery
Common abbreviations
Neurological examination
Neurology tests
Seizures and paroxysmal movements
Seizures
Neonatal seizures
Febrile seizures
First unprovoked afebrile seizure
Headache
Raised intracranial pressure
Acute hemiparesis and stroke
Weakness
Guillain-Barré syndrome
Floppy infant
Movement disorders
Tics
Acute ataxia
Acute (post-infectious) cerebellar ataxia
Neuroinflammatory conditions
Acute disseminated encephalomyelitis/transverse myelitis
Anti–N-methyl-D-aspartate receptor encephalitis
Spinal cord lesions
Acute spinal cord lesions
Spinal dysraphism
Tethered cord
Chiari malformations
Chiari I malformations
Chiari II malformations
Ventriculoperitoneal shunt failure
30 Oncology
Common abbreviations
Overview of pediatric malignancies
Oncological emergencies
Tumor lysis syndrome
Fever and neutropenia
Other oncological emergencies
Leukemia
Lymphoma
Neuroblastoma and wilms tumor
Histiocytic disorders
Langerhans cell histiocytosis (LCH)
Hemophagocytic lymphohistiocytosis (HLH)
Malignant bone tumors
Central nervous system malignancies
Chemotherapy
Hematopoietic stem cell transplantation
Procedure
Novel treatments
Immunotherapies
Targeted therapies
Supportive care
Anemia
Thrombocytopenia
Neutropenia
Late effects in childhood cancer survivors
Further reading
Useful websites
31 Ophthalmology
Common abbreviations
Physical examination of the eye
Routine eye screening
Eyelids
Orbit
Nasolacrimal duct
Conjunctival disease
Cornea
Anterior chamber
Pupil and iris
Retina
Glaucoma
Optic nerve
Strabismus
Amblyopia
Traumatic eye injuries
Common ocular complaints
Findings on ophthalmologic examination linked to systemic disease
32 Orthopedics
Common abbreviations
Fractures
Approach to the limping child
Infections
Osteomyelitis
Septic arthritis
Transient synovitis
Disorders of the hip
Developmental dysplasia of the hip (DDH)
Legg-Calvé-Perthes disease
Slipped capital femoral epiphysis
Nontraumatic disorders of the knee
Osgood-Schlatter disease
Patellofemoral pain syndrome
Disorders of lower limb alignment
Physiological bowing and knock-knee deformity
Pathological varus knee (bowed legs)
In-toeing
Toe walking (equinus gait)
Congenital and acquired deformities of the foot
Disorders of the spine
Torticollis
Back pain
Spondylolysis and spondylolisthesis
Scoliosis
Bone lesions
33 Otolaryngology
Common abbreviations
Ear
Approach to ear examination
Ear pain (otalgia)
Otitis externa
Otitis media
Traumatic tympanic membrane perforation
Mastoiditis
Hearing loss
Newborn hearing loss and screening
Nasal cavity
Epistaxis
Sinusitis
Nasal bone fractures
Neck
Neck masses
Oropharynx
Adenoids and tonsils
Retropharyngeal abscess
Pharyngitis
Upper airway obstruction
Stridor
Foreign bodies
34 Plastic surgery
Common abbreviations
Basics of wound closure
High-risk wounds
Bite wounds
Hand injuries
Fingertip injuries
Hand fractures
Intravenous burns
Cleft lip and palate
Skull deformities
Obstetric brachial plexus injury
Burn management
Further reading
35 Respirology
Common abbreviations and variables
Common abbreviations
Respiratory variables
Respiratory investigations
Congenital lung disease
Bronchiolitis
Pleural effusion
Pulmonary hemorrhage
Asthma
Pneumothorax
Cystic fibrosis
Sleep-disordered breathing
Obstructive sleep apnea
Central apnea and hypoventilation syndromes
Cough
Wheezing
Hemoptysis
36 Rheumatology
Common abbreviations
Approach to the child with rheumatological disease
Limb pain
Juvenile idiopathic arthritis
Systemic autoimmune rheumatic diseases
Systemic lupus erythematosus
Neonatal lupus erythematosus syndrome
Juvenile dermatomyositis
Scleroderma
Mixed connective tissue disease
Sjögren syndrome
Vasculitis
Approach to childhood vasculitis
Kawasaki disease
Henoch-Schönlein purpura
Autoinflammatory syndromes
Chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis
Macrophage activation syndrome
Noninflammatory/pain amplification syndromes
Fibromyalgia
Complex regional pain syndrome/reflex sympathetic dystrophy
Hypermobility/overuse syndromes
Growing pains
Pharmacological management of rheumatological disease
37 Technology and medical complexity
Common abbreviations
Enteral feeding tubes
Respiratory technology
Noninvasive positive airway pressure
Tracheostomy tubes
Home invasive ventilation
Cough augmentation
Vascular access
The child with medical complexity
Nutrition
Respiratory issues
Musculoskeletal issues
Neurologic issues
38 Transplantation
Common abbreviations
Pediatric solid organ transplantation
Immunosuppression
Post-transplant complications
Rejection
Infection
Post-transplant lymphoproliferative disease
Nephrotoxicity
Growth delay
Approach to common post-transplant problems
Fever
Vomiting and diarrhea
Varicella exposure
Herpes simplex infection
Long-term post-transplant outcomes
Neurocognitive
Quality of life
Further reading
Useful websites
Section III Laboratory Reference Values and Transfusion Medicine
39 Laboratory reference values and transfusion medicine
Common abbreviations
Clinical biochemistry
Hematology
Cerebrospinal fluid
Urine
Stool
Therapeutic drug monitoring
Toxicology
Blood products
Section IV Drug Dosing Guidelines
40 Drug dosing guidelines
Common abbreviations
Body surface area
Ideal body weight
Drug dosage guidelines
Therapeutic drug monitoring
Dose equivalents of commonly used steroids
Endocarditis prophylaxis
Alternative medicine interactions
Drug infusion calculations
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Z
Inside back cover