A Lange Medical Book Pediatrics on call - part 1 pptx

A Lange Medical Book
PEDIATRICS
ON CALL
Edited by
Charles A. Pohl, MD
Clinical Associate Professor of Pediatrics
Associate Dean for Student Affairs and Career Counseling
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Series Editor
Leonard G. Gomella, MD
The Bernard W. Godwin, Jr., Professor of Prostate Cancer
Chairman, Department of Urology
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Lange Medical Books/McGraw-Hill
Medical Publishing Division
New York Chicago San Francisco Lisbon London Madrid
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DOI: 10.1036/0071436553
To the girls in my life . . . especially Emma and Annie . . .
and
To Donald R. Pohl, MD, my pediatrician and dad.

Thanks for all of your love and support!
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Contents
Associate Editors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxiii
Common Abbreviations and Acronyms . . . . . . . . . . . . . . .xxv
I. On Call Problems
1. Abdominal Distention . . . . . . . . . . . . . . . . . . . . . . . . .1
2. Abdominal Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
3. Acidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
4. Airway Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
5. Alkalosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
6. Altered Mental Status . . . . . . . . . . . . . . . . . . . . . . . .26
7. Anaphylactic Reaction . . . . . . . . . . . . . . . . . . . . . . . .34
8. Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
9. Apnea and Apparent Life-Threatening Event . . . . . .44
10. Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
11. Bradycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
12. Cardiopulmonary Arrest . . . . . . . . . . . . . . . . . . . . . .56
13. Chest Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
14. Child Abuse: Physical . . . . . . . . . . . . . . . . . . . . . . . .69
15. Child Abuse: Sexual . . . . . . . . . . . . . . . . . . . . . . . . .74
16. Coagulapathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
17. Coma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
18. Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
19. Cough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
20. Cyanosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
21. Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
22. Dysuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

23. Epistaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
24. Eye Discharge (Conjunctivitis) and Swelling . . . . . .120
25. Failure to Thrive . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
26. Feeding Problems . . . . . . . . . . . . . . . . . . . . . . . . . .128
27. Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
v
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vi CONTENTS
28. Fever of Unknown Origin . . . . . . . . . . . . . . . . . . . . .139
29. Foreign Body: Gastrointestinal Tract . . . . . . . . . . . .143
30. Foreign Body: Respiratory Tract . . . . . . . . . . . . . . .147
31. Gastrointestinal Bleeding: Lower Tract . . . . . . . . . .150
32. Gastrointestinal Bleeding: Upper Tract . . . . . . . . . .155
33. Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160
34. Heart Murmurs and Heart Sound
Abnormalities . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
35. Hematuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172
36. Hemoptysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
37. Hyperbilirubinemia, Direct (Conjugated) . . . . . . . . .180
38. Hyperbilirubinemia, Indirect (Unconjugated) . . . . . .185
39. Hypercalcemia . . . . . . . . . . . . . . . . . . . . . . . . . . . .189
40. Hyperglycemia . . . . . . . . . . . . . . . . . . . . . . . . . . . .194
41. Hyperkalemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196
42. Hypermagnesemia . . . . . . . . . . . . . . . . . . . . . . . . .201
43. Hypernatremia . . . . . . . . . . . . . . . . . . . . . . . . . . . .203
44. Hyperphosphatemia . . . . . . . . . . . . . . . . . . . . . . . .209
45. Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
46. Hypocalcemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218
47. Hypoglycemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . .223
48. Hypokalemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .226

49. Hypomagnesemia . . . . . . . . . . . . . . . . . . . . . . . . . .229
50. Hyponatremia . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
51. Hypophosphatemia . . . . . . . . . . . . . . . . . . . . . . . . .236
52. Hypotension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .240
53. Hypothermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245
54. Hypotonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .248
55. Inability to Void (Urinary Retention) . . . . . . . . . . . . .252
56. Increased Intracranial Pressure . . . . . . . . . . . . . . .255
57. Intravenous Access Problems . . . . . . . . . . . . . . . . .260
58. Irritability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
59. Joint Swelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . .268
60. Leg Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271
61. Lethargy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .276
62. Leukocytosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .282
63. Leukopenia and Neutropenia . . . . . . . . . . . . . . . . .287
64. Limp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .291
65. Macrocephaly . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295
66. Metabolic Diseases . . . . . . . . . . . . . . . . . . . . . . . . .299
67. Nasogastric Tube Management . . . . . . . . . . . . . . . .305
68. Neck Swelling and Masses . . . . . . . . . . . . . . . . . . .309
69. Nutrition in the Pediatric Patient . . . . . . . . . . . . . . .316
70. Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . .320
71. Pharyngitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325
72. Phlebitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .330
73. Pneumothorax . . . . . . . . . . . . . . . . . . . . . . . . . . . . .332
74. Poisoning and Overdoses . . . . . . . . . . . . . . . . . . . .337
75. Polyuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .350
76. Proteinuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .353
77. Rectal Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . .357
78. Renal Failure, Acute . . . . . . . . . . . . . . . . . . . . . . . .360

79. Respiratory Distress . . . . . . . . . . . . . . . . . . . . . . . .369
80. Scrotal Swelling . . . . . . . . . . . . . . . . . . . . . . . . . . . .374
81. Sedation and Analgesia . . . . . . . . . . . . . . . . . . . . .377
82. Seizures, Febrile . . . . . . . . . . . . . . . . . . . . . . . . . . .384
83. Seizures, Nonfebrile . . . . . . . . . . . . . . . . . . . . . . . .387
84. Stridor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393
85. Syncope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396
86. Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401
87. Thrombocytopenia . . . . . . . . . . . . . . . . . . . . . . . . .408
88. Transfusion Reaction . . . . . . . . . . . . . . . . . . . . . . . .412
89. Trauma and Injuries . . . . . . . . . . . . . . . . . . . . . . . . .415
90. Urinary Incontinence . . . . . . . . . . . . . . . . . . . . . . . .421
91. Urinary Tract Infections . . . . . . . . . . . . . . . . . . . . . .423
92. Vaginal Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . .429
93. Vaginal Discharge . . . . . . . . . . . . . . . . . . . . . . . . . .432
94. Vomiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .435
95. Wheezing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .441
II. Laboratory Tests and Their Interpretation . . . . . . . . . . .449
III. Bedside Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . .488
1. Arterial Line Placement . . . . . . . . . . . . . . . . . . . . . .488
2. Arterial Puncture . . . . . . . . . . . . . . . . . . . . . . . . . . .490
3. Bladder Catheterization . . . . . . . . . . . . . . . . . . . . . .491
4. Chest Tube Insertion . . . . . . . . . . . . . . . . . . . . . . . .492
5. Cricothyrotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . .495
6. Endotracheal Intubation (Oral and Nasal) . . . . . . . .497
7. Gastrointestinal Tube Insertion . . . . . . . . . . . . . . . .500
8. Gynecologic Evaluation . . . . . . . . . . . . . . . . . . . . . .503
9. Heelstick (Capillary Blood Sampling) . . . . . . . . . . .505
10. Intraosseous Cannulation . . . . . . . . . . . . . . . . . . . .505
11. Knee Arthrocentesis . . . . . . . . . . . . . . . . . . . . . . . .507

12. Lumbar Puncture . . . . . . . . . . . . . . . . . . . . . . . . . . .509
13. Paracentesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .511
14. Percutaneous Central Venous Catheterization . . . .513
CONTENTS vii
viii CONTENTS
15. Percutaneous Venous Catheterization . . . . . . . . . .517
16. Skin Biopsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .519
17. Splinting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .520
18. Thoracentesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . .527
19. Tympanocentesis . . . . . . . . . . . . . . . . . . . . . . . . . .529
20. Umbilical Vein Catheterization . . . . . . . . . . . . . . . . .530
21. Venipuncture (Phlebotomy) . . . . . . . . . . . . . . . . . . .532
22. Wound Care and Suturing . . . . . . . . . . . . . . . . . . . .533
IV. Fluids and Electrolytes . . . . . . . . . . . . . . . . . . . . . . . . .542
1. Maintenance Fluids and Electrolytes . . . . . . . . . . .542
2. Deficit Replacement . . . . . . . . . . . . . . . . . . . . . . . .544
V. Blood Component Therapy . . . . . . . . . . . . . . . . . . . . . .547
1. Blood Components and Their Uses in Pediatrics . .547
2. Transfusion Reactions . . . . . . . . . . . . . . . . . . . . . . .547
VI. Ventilator Management . . . . . . . . . . . . . . . . . . . . . . . . .551
1. Indications for Ventilatory Support . . . . . . . . . . . . . .551
2. Ventilation Options and Classification . . . . . . . . . . .553
3. Ventilator Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . .555
4. Modification of Ventilator Settings . . . . . . . . . . . . . .560
5. Special Modes of Ventilation . . . . . . . . . . . . . . . . . .564
6. Equations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .565
VII. Preoperative Management . . . . . . . . . . . . . . . . . . . . . .567
1. Preoperative Assessment . . . . . . . . . . . . . . . . . . . .567
2. Postoperative Care . . . . . . . . . . . . . . . . . . . . . . . . .578
VIII. Commonly Used Medications . . . . . . . . . . . . . . . . . . . .580

1. Classes of Generic Drugs, Minerals, and Vitamins .580
2. Generic Drugs: Indications, Actions, Dosage,
Supplied, and Notes . . . . . . . . . . . . . . . . . . . . . . . .594
3. Minerals: Indications/Effects, RDA/Dosage, Signs/
Symptoms of Deficiency and Toxicity, and Notes . .740
4. Vitamins: Indications/Effects, RDA/Dosage, Signs/
Symptoms of Deficiency and Toxicity, and Notes . . .745
5. Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .750
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .757
A. Blood Cell Indices: Age-Specific . . . . . . . . . . . . . . .758
B. Blood Pressure Measurement Percentiles
(Girls and Boys): Age Specific . . . . . . . . . . . . . . . . .759
C. Body Surface Area . . . . . . . . . . . . . . . . . . . . . . . . .759
D. Childhood Immunization Schedule . . . . . . . . . . . . .759
E. Denver Developmental Assessment . . . . . . . . . . . .762
F. Glasgow Coma Scale . . . . . . . . . . . . . . . . . . . . . . .765
G. Growth Charts (Girls and Boys) . . . . . . . . . . . . . . .766
H. Heart Rates: Age Specific . . . . . . . . . . . . . . . . . . . .768
I. SBE Prophylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . .768
J. Specimen Tubes for Phlebotomy . . . . . . . . . . . . . . .770
K. Temperature Conversion . . . . . . . . . . . . . . . . . . . . .770
L. Tetanus Prophylaxis . . . . . . . . . . . . . . . . . . . . . . . .771
M. Weight Conversion . . . . . . . . . . . . . . . . . . . . . . . . .773
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .775
Commonly Used Pediatric Resuscitation
Drugs and Algorithms . . . . . . . . . . . . . . . . . . . . . . .Inside Front
and Back Covers
CONTENTS ix
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Associate Editors

Clara A. Callahan, MD
Clinical Associate Professor of Pediatrics
Vice Dean for Academic Affairs
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
J. Carlton Gartner, Jr., MD
Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Pediatrician-in-Chief
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Kathleen Kilroy Bradford, MD
Assistant Professor of Pediatrics
University of North Carolina School of Medicine
Chapel Hill, North Carolina
xi
Copyright © 2006 by The McGraw-Hill Companies, Inc. Click here for terms of use.
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Contributors
Sheeja K. Abraham, MD
Assistant Professor of Pediatrics
Division of Pediatric Gastroenterology
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Ellen Arch, MD
Staff Physician/Clinical Geneticist
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Magdy William Attia, MD
Associate Professor of Pediatrics

Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Jeanne Marie Baffa, MD
Clinical Associate Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Pediatric Cardiologist
The Nemours Cardiac Center
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Mara L. Becker, MD
Pediatric Rheumatology Fellow
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Caroline D. Boyd, MD
Pediatric Critical Care Fellow
Alfred I. duPont Hospital for Children
Wilmington, Delaware
xiii
Copyright © 2006 by The McGraw-Hill Companies, Inc. Click here for terms of use.
xiv CONTRIBUTORS
Kathleen Kilroy Bradford, MD
Assistant Professor of Pediatrics
University of North Carolina School of Medicine
Chapel Hill, North Carolina
B. Randall Brenn, MD
Assistant Professor of Anesthesiology and Pediatrics
Jefferson Medical College of Thomas Jefferson University
Senior Staff Anesthesiologist
Alfred I. duPont Hospital for Children
Wilmington, Delaware

AnneMarie C. Brescia, MD
Attending Physician
Division of Rheumatology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Robert P. Brislin, DO
Staff Attending Anesthesiologist
Department of Anesthesiology and Critical Care Medicine
Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Michael P. Carboni, MD
Clinical Assistant Professor
Division of Pediatric Cardiology
Duke University Medical Center
Durham, North Carolina
Aaron S. Chidekel, MD
Assistant Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Maria Childers, MD
Assistant Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Esther K. Chung, MD, MPH
Assistant Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Pediatrician
Alfred I. duPont Hospital for Children
Philadelphia, Pennsylvania
Sandra Como-Fluehr, MSN, RN, APRN, BC

Pain Management Nurse Specialist
Department of Anesthesiology and Critical Care Medicine
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Deborah M. Consolini, MD
Assistant Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Pediatrician
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Steven P. Cook, MD, FACS, FAAP, FRSM
Clinical Assistant Professor
Department of Otolaryngology/Head and Neck Surgery
Jefferson Medical College of Thomas Jefferson University
Chief, Division of Pediatric Otolaryngology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Andrew T. Costarino, Jr., MD
Professor of Anesthesiology and Chairman of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Kate Cronan, MD
Associate Professor
Department of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Shermine Dabbagh, MD
Chief, Division of Pediatric Nephrology
Alfred I. duPont Hospital for Children
Wilmington, Delaware

CONTRIBUTORS xv
xvi CONTRIBUTORS
Parul P. Dand, MD
Pediatrician
Shah Associates
Lexington Park, Maryland
Allan R. De Jong, MD
Director, Children at Risk Evaluation (CARE) Program
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Ellen S. Deutsch, MD, FACS, FAAP
Associate Professor of Otolaryngology and Pediatrics
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Joan S. Dipalma, MD
Attending Physician
Division of Pediatric Gastroenterology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Maureen F. Edelson, MD
Medical Director of Blood Bank
Department of Laboratory Medicine
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Gary A. Emmett, MD, FAAP
Clinical Associate Professor of Pediatrics
Director of General Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
T. Ernesto Figueroa, MD, FAAP, FACS

Chief, Division of Pediatric Urology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Christopher N. Frantz, MD
Chief, Division of Hematology/Oncology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
J. Carlton Gartner, Jr., MD
Professor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Pediatrician-in-Chief
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Michael H. Goodman, MD
Chief, Division of Neurology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Gregory C. Griffin, MD
Attending Physician
Division of Pediatric Hematology/Oncology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Louis H. Guernsey, Jr., MD
Pediatric Pulmonologist
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Hazel Guinto-Ocampo, MD, FAAP
Attending Physician
Division of Emergency Medicine
Alfred I. duPont Hospital for Children

Wilmington, Delaware
Jason B. Hann-Deschaine, MD
Appoquinimink Pediatrics
Townsend, Delaware
James H. Hertzog, MD
Pediatric Intensivist
Department of Anesthesiology and Critical Care Medicine
Alfred I. duPont Hospital for Children
Wilmington, Delaware
CONTRIBUTORS xvii
xviii CONTRIBUTORS
Laszlo Hopp, MD
Associate Professor
Division of Nephrology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Laura S. Inselman, MD
Pediatric Pulmonologist
Medical Director of Pulmonary Function Laboratory
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Elizabeth P. Ives, MD
Urology Resident
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
Bruce Kaiser, MD
Pediatric Nephrologist
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Susanne Kost, MD

Associate Professor
Division of Emergency Medicine
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Kelly R. Leite, DO
Assistant Professor of Pediatrics
Assistant Director, Pediatric Residency Program
Penn State College of Medicine
Hershey, Pennsylvania
James Jeffrey Malatack, MD
Director of Diagnostic Referral Service
Pediatric Medical Liver Transplantation Program
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Keith J. Mann, MD
Associate Director, Pediatric Residency Program
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Stephen J. McGeady, MD
Associate Professor of Pediatrics
Division of Allergy, Asthma, and Immunology
Jefferson Medical College of Thomas Jefferson University
Chief, Division of Pediatric Allergy, Asthma, and Immunology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Charles P. McKay, MD
Director, Bone and Mineral Program
Division of Pediatric Nephrology
Alfred I. duPont Hospital for Children
Wilmington, Delaware

Robin E. Miller, MD
Attending Physician
Division of Pediatric Hematology/Oncology
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Linda Muir, MD
Pediatric Gastroenterologist
Sacred Heart Medical Center
Providence Physician Services
Spokane, Washington
Ursula Nawab, MD
Neonatology Fellow
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
Robert C. O’Reilly, MD, FACS
Pediatric Otolaryngologist
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Raj Padman, MD
Chief, Division of Pulmonology
Director, Cystic Fibrosis Program
Alfred I. duPont Hospital for Children
Wilmington, Delaware
CONTRIBUTORS xix
xx CONTRIBUTORS
Scott Penfil, MD
Director, Pediatric Critical Care Training Program
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Melanie Pitone, MD, FAAP

Attending Physician
Division of Pediatric Emergency Medicine
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Charles A. Pohl, MD
Clinical Associate Professor of Pediatrics
Associate Dean for Student Affairs and Career Counseling
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Amanda Pratt, MD
Assistant Professor
Division of Pediatric Emergency Medicine
University of Medicine and Dentistry of New Jersey—Robert
Wood Johnson Medical School
New Brunswick, New Jersey
Erin Preston, MD
Instructor of Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
James S. Reilly, MD, MS, FACS
Professor of Otolaryngology and Pediatrics
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Steven B. Ritz, MD
Attending Cardiologist
The Nemours Cardiac Center
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Marianne Ruby, MD, FACOG
Clinical Instructor

Division of Reproductive Endocrinology
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Jean M. Russell, RN, BSN, CRNI
IV Therapy Coordinator
Department of Nursing
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Richard J. Scarfone, MD, FAAP
Associate Professor of Pediatrics
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
Steven M. Selbst, MD
Professor of Pediatrics and Vice Chair for Education
Jefferson Medical College of Thomas Jefferson University
Pediatric Residency Program Director
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Glenn Stryjewski, MD, MPH
Department of Anesthesia and Critical Care
St. Christopher’s Hospital for Children
Philadelphia, Pennsylvania
Shamim Tejani, PharmD
Clinical Pharmacy Coordinator
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Andrew W. Walter, MS, MD
Associate Professor of Pediatrics
Division of Pediatric Hematology/Oncology
Jefferson Medical College of Thomas Jefferson University

Philadelphia, Pennsylvania
CONTRIBUTORS xxi
xxii CONTRIBUTORS
Rhonda S. Walter, MD
Acting Chief, Division of Developmental Medicine
Alfred I. duPont Hospital for Children
Wilmington, Delaware
Philip Wolfson, MD
Professor of Surgery
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Ejaz Yousef, MD
Clinical Assistant Professor
Division of Allergy and Immunology
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania
Preface
I am grateful to be able to bring you the first edition of Pediatrics On Call.
The “on-call” series of which this book is a part is based on a concept
applied by Tricia Gomella, MD, in her book, Neonatology: Basic
Management, On Call Problems, Diseases, and Drugs. The books in this
series reflect how clinicians typically approach and manage patients; that
is, patients usually present with a specific complaint or problem, which
necessitates an evaluation and action rather than a specific diagnosis.
Pediatrics On Call is designed to aid the practitioner and serve as a learning
resource to housestaff and students, enabling them to better understand
medical conditions in children and provide the necessary tools to initiate
the evaluation and care of these young patients.
It would be remiss not to acknowledge those who have made this book
possible. The staff at McGraw-Hill, especially Janet Foltin and Donna

Frassetto, have been supportive and patient. All three associate editors,
Drs. Callahan, Gartner, and Bradford, have devoted significant effort as
well as endless attention to detail to ensure academic integrity. The con-
tributors have provided medical expertise and insight while giving up valu-
able personal time. And finally I must acknowledge and thank our pediatric
patients, who have been our teachers through the years.
Charles A. Pohl, MD
Philadelphia, Pennsylvania
December 2005
xxiii
Copyright © 2006 by The McGraw-Hill Companies, Inc. Click here for terms of use.
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