Basic principles and management of Pediatric care

Pediatrics is an important field of medical science which deals the health problems and medical care of infants, children, and adolescents, and the age limit usually ranges from birth up to 18 years of age. In some places, it covers the health issues until completion of secondary education, and until age 21 such as in United States. A medical consultant who specializes in this area is called as a paediatrician. Paediatricians work both in hospitals, mainly those working in its specialized subfields such as neonatology, and as primary care physicians who specialize in children.

 

An accepted component of well child care is the measurement of growth parameters at each health visit. Height, weight and circumference are measured and plotted at each check-up. Professionals who interact with children should be familiar with basic developmental stages and child’s progress through them (Susan Riddick-Grisham, 2011). Children with complex health care for chronic illness and disability require range of services to achieve an acceptable quality of life. As a result, case management has become important aspect of paediatric care as it helps to ensure that these services are coordinated and delivered in effective way. Paediatric case managers play various role such as locating, accessing and coordinating services.

 

Family centred care and care management are major practices in paediatric care. Major elements of Family centred care include the following assumptions (Jackson, 2002):

1.      The family is the constant but health care system and personal change.

2.      Family diversity, strengths and individuality are recognized.

3.      Information is exchanged in complete and unbiased manner.4.      Family to family support is encouraged.

 

Management of Paediatric Care:

Paediatric Care Management is vital element of the home healthcare industry. Paediatric Nurses and doctors are qualified to perform numerous specialized services in several critical situations such as:

1.      Basic Newborn Care

2.      Adolescent AIDS

3.      Autism Spectrum Disorder

4.      Childhood Cancers and Blood Disorders

5.      Diabetes

6.      Epilepsy

7.      Neuromuscular Disorder

8.      Sensory Disorders

9.      Occupational and Physical Therapy Needs

10.  Speech and Language Therapy

11.  Post-Surgical Care

12.  Wound Care

Home care can be a more suitable technique of care management for children that range from new-born to adolescence and their families instead of hospitalization and residential treatment centre options. Many healthcare services can be offered in the child’s own home such as intravenous therapy, tube feeding, tracheotomy and ventilator care, ambulatory patient care, pain and medication management, incontinence care, meal preparation, personal hygiene assistance, and vital sign management and reporting (Access Healthcare Services, 2013).

 

Since last many years, home healthcare for paediatric patients had constantly increased, and is the preferred option for continuous care in the United States. Home healthcare for children is the best way to “optimize each child’s health and function while minimizing recurring or continued hospitalizations through the facility of comprehensive, profitable, family-centred health care reduced in a fostering home environment (Elias and Murphy, 2012).

 

There are several Steps of Paediatric Transitional Care:

Following patient discharge, there are six main issues that primary care providers should be sure to address:

1.      Establish a partnership with the family to recognize the resources available in supporting the transition process and long-term achievement.

2.      Describe, locate, and involve a medical home.

3.      Guarantee that family members and other care providers are sufficiently trained for the challenges ahead.

4.      Help in the selection of a home nursing agency/providers of supplies and equipment.

5.      Recognize respite care providers.

6.      Freely communicate with the patient’s school district to ensure an Individualized Education Plan (IEP) process for school services can be initiated.

Many health professionals have emphasized that parents and caregivers should know these responsibilities and be sure that their primary care provider is ensuring the best possible care for the young patients involved. Paediatric Home Care is a systematic, cooperative effort that must incorporate explicit care coordination, family-centred care, and advanced planning to ensure the best experience for the child, and all those involved in their care.

 

Diagnosing HIV Infection in Infants and Children:

There is a need to address the care and treatment of HIV-exposed and infected infants and children. The aim of paediatric HIV/AIDS care and treatment is to maximize resources while guaranteeing provision of unbiased care.

 

According to medical studies, 90% of HIV infection in children is transmitted through the mother during pregnancy, labour and delivery, and after childbirth through breastfeeding. There is a need to detect HIV infection in infants and children at early stage since the disease progresses rapidly in children with 50% mortality by age two. Passively transferred maternal HIV antibodies make interpretation of positive antibody tests difficult in children under 18 months. In order to diagnose HIV infection in children under 18 months, there is a need to detect the virus or its components (i.e. virologic tests). DNA PCR is the preferred method of choice for HIV diagnosis in infants and children under 18 months. Use of Dried Blood Spots (DBS) for DNA PCR is reliable means of increasing access to infant HIV diagnosis since it is easier to obtain, store and transport for centralized testing. In children 18 months and older, rapid antibody tests reliably diagnose HIV infection.

 

Major goals of early Diagnosis of HIV in Infants and Children are to distinguish HIV-infected infants early in order to provide them with lifesaving ART, not to exclude infection and to help early access to care and treatment which decreases morbidity and death. A child with suspected HIV infection generally indicates a family/family member with suspected HIV.

Counselling must be done to the parents and issues of consent, competence to consent, disclosure and confidentiality needs. HIV-exposed infants need regular follow-up since they are at risk of morbidity and mortality regardless of infection status.

Paediatrician also take care of patients with asthma. Children with acute asthma exacerbations normally present to an emergency department with signs of respiratory distress. The most severe episodes are possibly life-threatening. Effective treatment depends on the precise and rapid assessment of disease severity at presentation.

 

It has been advised by medical experts that along with caring for a child’s primary health concern as well as the requirements of their families, caregivers must address their paediatric patient’s mental health needs. In addition to financial changes, the role of primary care providers must be expanded in promoting the socio-emotional health and well-being of their child and adolescent patients. Effective ways to recover the mental health status of children, and all potentially patients, is through Expressive Therapy techniques. These creative approaches utilize art, music, writing, and movement interactively to help better understand and manage patient’s emotions, promote relaxation, and overcome trauma. While most hospitals deliver children’s life services that integrate these techniques, most children with home care will miss out on the benefits of this type of therapy unless a professional Expressive Therapist is employed for private sessions.

 

It is well recognized the significance of the paediatrician’s role to offer medical services for children with the most critical physical and psycho-social conditions. These families often tolerate severe strain in order to navigate many branches of the health system. These families particularly, need a high functioning paediatric medical home that can quickly and proactively offer best quality care as well as promote their ability to successfully self-manage their children’s requirements.