1 With the impending #COVID19 pandemic peak in the UK, adult services are going to be hit disproportionately hard. Since paediatricians may be needed to help by looking after older patients, here's a guide to help children's specialists when the time comes to care for an adult.
2 Don't introduce yourself as a paediatrician. Most people think that's a foot doctor. Even if they know what a paediatrician is, confidence will not inspired.
3 Don't use bubbles, stickers or play specialists. These are not evidence based practice in adults.
4 If you want to keep growth and development out of habit, be aware that it is very different.
Development milestones include a political move to the right and going into a room and forgetting why.
Growth is mainly out and the development of hair in unwanted places.
Development milestones include a political move to the right and going into a room and forgetting why.
Growth is mainly out and the development of hair in unwanted places.
5 Developmental regression is common and not the red flag that you think it to be. Don't request brain MRI just because your patient is no longer able to do previously possible activities.
6 Physiology in response to illness is different in adults. Don't look at a 75yr old with a temp of 40, a heart rate of 160 and make a management plan of analgesia & review in one hour.
The poor cure rate with paracetamol (acetaminophen) in the elderly will be your biggest shock.
The poor cure rate with paracetamol (acetaminophen) in the elderly will be your biggest shock.
7 If you need to put an IV cannula in, you may find that your adult colleagues are impressed with your skills. Old people often have terrible veins but compared to a chubby 18 month old with a ground speed of 5mph your 70 year old is a piece of cake.
8 Endotracheal intubation is paradoxically much more difficult. Don't expect easy neck movement and do expect a different spectrum of foreign objects. "Why is the back of the throat smiling at me?" means it's time to grab the forceps.
9 Considering how abusive children are to their parents, adults are surprisingly consistent with their emotional attachment to their offspring. Make no such assumption in dealing with the family of your adult and elderly patients. Where there's a will there's a family.
10 Post illness recovery periods are considerably longer in the elderly than in children. Fortunately the main reason for not getting better that no-one can figure out is the same as in children, constipation. So maybe we are perfect for the job.
