A decade after Wrenn and Slovis gave us the ‘Ten Commandments of Emergency Medicine‘, Timothy Givens proposed the following ‘Ten Commandments of Pediatric Emergency Medicine’ to supplement the originals:
- Children are not small adults
— anatomy, physiology, cognition and emotion varies with age- Ill and injured children regress
— the sick teenager may act like a toddler, give them time and space.- The “patient” might be the one holding the child
- Kids are the real deal
— In the majority of cases, their symptoms are real and not factitious.- Laboratory tests and X-rays seldom beat a good history and physical examination
— investigations are rarely needed- Many hands make light work
— get help with procedures: do it right, do it once.- Check and double-check. then, check again
— especially drug doses- Children feel pain just like you do — treat it
- Close the loop
— Follow-up care is the cornerstone of pediatric care- Above all, you are the child’s advocate
Reference
- Givens T. The Ten Commandments of Pediatric Emergency Medicine. J Emerg Med. 2004 Aug;27(2):193-4. PubMed PMID: 15261366.
About Chris Nickson
I’ve got plenty of injured adults who regress, too.
G’day Graham -- some act like small children even without regressing!
Had the opposite experience on one of my a recent shifts -- a kid said to me, ” F U, see you next tuesday!” or something like that…
Cheers,
Chris
BTW, Congrats on achieving the pinnacle of F.UCEM-ness!
Amen to all!
But especially 7 & 8.
I have a really hard time dealing with docs who give sub-therapeutic doses of analgesic to peds. One of the things that used to make me crazy when I was a nurse. It wasn’t until I worked in a ski-town ED with loads of peds ortho trauma that I saw wonderfully managed pain in both adults and peds. Made the subsequent departments seem medieval. And not in a funny, “Theodoric of York: Medieval Barber” sort of way!
The reluctance of some doctors and nurses to give kids potent analgesia when they need really gets under my skin… Our powers in medicine are in many ways limited, but we can always try to relive pain and suffering.
C
Amen to all!
But especially 7 & 8.
I have a really hard time dealing with docs who give sub-therapeutic doses of analgesic to peds. One of the things that used to make me crazy when I was a nurse. It wasn’t until I worked in a ski-town ED with loads of peds ortho trauma that I saw wonderfully managed pain in both adults and peds. Made the subsequent departments seem medieval. And not in a funny, “Theodoric of York: Medieval Barber” Steve Martin sort of way!
My apologies for the double comment posting! The last couple of times I’ve tried it seems to freeze the site and then when I try to repost it says that it is a repeat comment (even though the original isn’t there!) I will just try to cool my jets in the future and wait and see what happens. (In the meantime, please excuse my damn impatient blogger behavior.)