Preparing for Pediatrics ^_^

Assalamu Alaykum! (Peace be upon you all!)

My block’s next rotation starting this month (January) is with the Department of Pediatrics. Yes, the wonderful world of Medicine for the little ones! We will be training in Pedia for a duration of four weeks just like our past rotation (in OB-GYN). It is also among the “Big Four” departments that all medical students must be familiar with in order to, well, pass. But like all other departments that we have been to, what I am really looking forward is learning more about dealing with patients in this department, enjoy my stay in this rotation and see for myself if I will be comfortable with it—you know, for future references.

And with our experiences in Pediatrics for the past two years, whenever I hear the term “Pedia”, the very first thing that would come in mind: There’re too many graphs and charts! This is perhaps the only field of medicine that has so many graphs and charts that one needs to be familiar with in order to survive. Growth charts, weight-for-length chart for boys and girls, BMI-for-age graphs, Childhood immunization schedules, developmental milestones, and they even have a separate BP readings by age!

“Children are not small adults” our professors would always remind us. They are not like adult humans; we cannot treat them the way we treat the adults. They have a lot different physiologic processes that are either absent or are still undergoing maturity compared to an adult human. Thus, taking care of them is pretty much on the more delicate side: we have to look for a lot of danger signs especially in administering medications. Plus, most of them don’t even know yet how to express what they are feeling! (Good luck interviewing a crying 8 month old baby).

Thus, any medical student who will go on training in the field of Pediatrics must really be well-prepared for all these. He must learn how extract information from both the parents and the child if possible. He must be alert and observant in the child’s actions and expressions. He must have a good background of the normal developmental milestones of the child, what is in the normal range and what is not (ha! Good luck to me on that!). And lastly, he must learn how to be child-friendly and don’t scare the hell out of every child he interviews. They say having a toy with you will “make or break” your history-taking. Hmm, now where is that teddy bear of mine? (Just kidding, I don’t own things like that)

Now for the preparations. What an ICC Student must have to prepare for the month long training in Pedia:

1. First in the list is the bible: Nelson’s Pediatrics 19^th Edition. 

It’s up to you if you will buy the book or just get an electronic copy (it’s illegal, isn’t it?). I don’t have the book, so yeah, you already know what I have. You really don’t have to read the book cover to cover (no one have ever done that I am pretty sure). According to the orientation slides I have read, we will only focus on the top 10 Ambulatory Morbidities in the PGH for Pediatrics. On what those are, we will still find out along the way. There will be a lot of Patient preceptorials and SGD’s right after that. So, it is pretty wise to have an electronic copy to sneak in and read some basic concepts on your case while waiting for your preceptor to arrive.

The original book costs around P5,000+ but you can buy it in a cheaper price in Recto (I found one arounf P4100) or in any of the fraternity/sorority book-sales.

Dr. Fe Del Mundo's Textbook on Pediatrics and Child Health is also another option if you have the luxury of time and money. But it's pretty hard to find a copy of it. It's pretty old and I don't when's the last time they published a new set of copies. A lot of my friends recommend this though. Don't expect me to give you a review of this one, haven't read much on it. 

2. The “Red Book” aka Preventive Pediatric Health Care Handbook 7^th Edition (2014) published by the Philippine Pediatric Society. Before our ICC rotations started we were asked if we wanted to purchase these beautiful thing, of course most of us bought their own personal copy. It’s pretty helpful I think, maybe until your own medical career in the future. It costs around P200 (I forgot the original price).

The "Red Book"
Published by the Philippine Pediatric Society

 I have not read all the contents yet. Just scanned through them and I find it very useful because for once all the necessary charts and graphs I have been worried about are attached in the booklet! ^_^ Happiness! I mean, I no longer need to print a separate copy of them all.

Colored growth charts for girls

Childhood Immunzation schedule

Preventive Pediatric Healthcare recommendations

And look! The book also comes with this Visual Acuity chart for kids :)
Wonder if I will be able to use this though

3. The other ICC essentials

We already talked about this in our separate post: The ICC Essentials #link#. Perhaps what would really be useful here are the measuring tapes to measure all those circumferences and lengths of growing limbs and parts of every child patient you meet in the wards.

My ICC Pouch ^_^ with a touch of Tausug Piys

My ICC Stash. Sorry it's always messy.

 And with the special performance from these two:

4. Pediatric Stethoscope

This one is not really mandatory but very highly encouraged. You’ll, there are things that you can’t hear with your adult stethoscope and a Pedia Steth would really save your day.

My new Pediatric Stethoscope ^_^

Finally I can use this Pedia Steth my beloved sister gave me :D Thanks Inn!

5. Sphyg wit Pedia Cuff

An attachable pedia or infant cuff for your aneroid sphyg will surely be handy. Do not expect to get an accurate BP of your infant patient using your adult cuff! You can buy these awesome things in Bambang (Medical Equipment Center—as I call that place) for about P400 a piece without the aneroid.

A Child-size Sphyg cuff would really be helpful.

I wonder if I missed anything else? Hmm. For now that would be the things we need in preparation for Pediatrics. Oh yes, I almost forgot this one:

6. An Approachable, child-friendly, non-monstrous face.

Try to be as child-friendly as possible. Keep a smiling face whenever you approach a pedia patient. Most of the time they would be shy and scared on your first visit, but when they realized later on that you are harmless and you are there to help them, I am pretty sure the kids will like you and be more comfortable with you. If you are doing well, you would even receive a bonus: a heartfelt smile and "thank you, doc" and a cheerful wave after your stay with them.

Now that we are pretty much “prepared” for the training, what’s next? Simple: Enjoy your learning experience! :)

Personal Note: Ahmad, there are a lot of children in Pandami and Siasi and even Jolo who never really had seen any doctors in their whole lives! So you really have to learn a lot from your short stay here so that you can at least give them something in terms of service. And you love kids don’t you? Plus, this rotation will surely be important in your training if you plan on applying for an Off-campus Elective in Pediatrics in Zamboanga (or Sulu). Just do your best. And stop slacking around!

Salam Kasilasa!

-Anakiluh