DOCSLIB.ORG

UBC Department of Pediatrics Y3 Orientation Manual Appendix

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
UBC Department of Pediatrics Y3 Orientation Manual Appendix UBC Department of Pediatrics Y3 Orientation Manual Appendix Clinical Resources Academic Year 2012- 2013 Appendix – Clinical Care Resources Summary The following documents are available from the UBC Pediatrics Website, Undergraduate Program Student Orientation Manual http://pediatrics.med.ubc.ca/education/undergraduate/year‐3‐student‐orientation‐manual 1. Asthma 2. Croup 3. Dehydration 4. Developmental Milestones 5. Febrile Seizure 6. Febrile UTI 7. Fever in Infants 0 – 60 days of age 8. Fluid and Electrolytes 9. Immunization Schedule 2012 10. Normal Lab Values September 2012 EMERGENCY DEPARTMENT MANAGEMENT OF ASTHMA Division of Emergency Medicine Patient > 1yr. presents to Emergency Department with 2 previous episodes of wheeze or diagnosis of asthma Mild (1) Accessory Muscle - minimal intercostal retractions Nurse categorizes Minimal wheeze - end-expiratory wheeze mild, moderate, Dyspnea - normal activity and speech, minimal dyspnea moderate severe, Peak Flow vs Personal Best - >70% severe Oxygen Sats on Room Air - >95% Moderate (2) Accessory Muscle - intercostal and substernal retractions Wheeze - pan-expiratory + inspiratory wheeze Moderate or Dyspnea - decreased activity 5-8 word sentences Moderate/Severe Peak Flow vs Personal Best - 51-70% Mild Case Severe Case Case Oxygen Sats on Room Air - 91-95% Moderate/Severe (3) Accessory Muscle - nasal flaring Notify Physician Salbutamol * Wheeze - wheeze audible without stethoscope Immediately and Exit every 20 minutes x 3 Salbutamol * every 20 Dyspnea - decreased activity <5 word sentences Pathway doses and minutes x 1-2 doses in Oxygen Sats on Room Air - 86-90% Transfer Patient to Ipratropium ** every the first hour Resuscitation Room 20 minutes x 3 doses Reassess after 1 hour Severe (4 ) EXIT PATHWAY in the first hour Accessory Muscle - nasal flaring/paradoxal movement Wheeze - silent or wheeze audible without stethoscope Give steroid as per Dyspnea - unable to speak 1-2 word sentences physician orders Oxygen Sats on Room Air - <86% after first MDI No treatment Minimal to no wheeze, no indrawing, no Physician to tachpynea, O sats >95%? reassess severity 2 Physician to assess re: Yes and categorize Severe discharge mild, moderate, Discharge Home moderate/severe, Discharge instructions: severe See asthma discharge form, Asthma education referral Follow-up With Primary Care Moderate/Severe Moderate Mild MD Within 3-7 Days Air entry Oxygen by NP/Mask Salbutamol * every 1 improved, no salbutamol * every 20 hour PRN until No indrawing, no Dose References: minutes until able to tolerate physician tachpynea every 1 hour. If vomiting reassessment O2 sats > 95%? repeat steroid or give IV * Salbutamol 5 puffs (<20 kg) or 10 puffs (>20 kg) via spacer Yes ** Ipratropium Salbutamol * every 1 Air entry improved, few 3 puffs (<20 kg) or 6 puffs (>20 kg) via spacer hour regularly and Observe for 2 hrs No wheezes, no indrawing, every 30 minutes If stable and no no tachpynea PRN further ER O sats > 95%? 2 treatment required Asthma Education Referral Criteria: Yes Diagnosis of Asthma Still 18 months of age or older Discharge Home tachypneic, Medical team and family aware of referral Observe for 2 hrs Discharge instructions: See decreased air entry, Need to have a BCCH medical record No If okay and no asthma discharge form, wheezy, indrawing, O number 2 further ER Asthma education referral sats <95% or salbutamol treatment required Follow-up With Primary Care >q4h after 8 hours? MD Within 3-7 Days BCCH Emergency Management of Admit to ERO or Asthma Clinical Pathway th Yes hospital Revised: October 28 , 2008 Name DOB: EMERGENCY DEPARTMENT ASTHMA DISCHARGE/ASTHMA EDUCATION REFERRAL This form is your child’s asthma plan and is completed by the doctor. Please follow this plan until you see your family doctor in 3-7 days. RELIEVER/RESCUE INHALER Relaxes tight muscles around the airways, starts working within 5 minutes and should last 4 hours. Used daily for a few days when recovering from an asthma attack, then only if needed. Inhale: Salbutamol/Ventolin Metered Dose Inhaler (blue) 100ug (micrograms) Other: ______ puff(s) every ______ hours for ______ days then ______ puff(s) every ______ hours as needed Next due: PREVENTER INHALER Use every day, reduces swelling and mucous in the airways. Always drink water or rinse mouth with water after each use. Inhale: Fluticasone/Flovent Metered Dose Inhaler (orange) 125ug 250ug Fluticasone/Flovent Diskus (orange) 100ug 250ug 500ug Budesonide/Pulmicort Turbuhaler (brown) 100ug 200ug 400ug Other: ______ puff(s) in the morning and at night until reassessed by your doctor Next due: ORAL STEROID Reduces airway swelling. Take by mouth: Dexamethasone ______ mg(milligrams) by mouth once a day for ______ day(s) Prednisone______ mg by mouth once a day for ______ day(s) Next due: CALL 911 IF YOUR CHILD: . has severe trouble breathing, talking, walking, or is feeling dizzy . has blueness of skin, lips or fingernails GO TO NEAREST EMERGENCY IF YOUR CHILD: . is using the reliever more than every 4 hours . has hard, fast breathing at rest and has pulling in of skin between the ribs While waiting for the ambulance or on the way to Emergency, you may give the reliever every 10 minutes as needed. INFORMATION HANDOUTS: FOLLOW UP APPOINTMENTS: “About Asthma” Pamphlet Family Doctor or Pediatrician: __________________________________________ Other Handouts A referral to the Asthma Education Clinic has been made. The clinic will call you. If you have any questions please call 604-875-2345 ext. 7461 MD Signature Date/Time Parent/Guardian/Patient’s Signature HEALTH RECORDS Name DOB: EMERGENCY DEPARTMENT ASTHMA DISCHARGE/ASTHMA EDUCATION REFERRAL This form is your child’s asthma plan and is completed by the doctor. Please follow this plan until you see your family doctor in 3-7 days. RELIEVER/RESCUE INHALER Relaxes tight muscles around the airways, starts working within 5 minutes and should last 4 hours. Used daily for a few days when recovering from an asthma attack, then only if needed. Inhale: Salbutamol/Ventolin Metered Dose Inhaler (blue) 100ug (micrograms) Other: ______ puff(s) every ______ hours for ______ days then ______ puff(s) every ______ hours as needed Next due: PREVENTER INHALER Use every day, reduces swelling and mucous in the airways. Always drink water or rinse mouth with water after each use. Inhale: Fluticasone/Flovent Metered Dose Inhaler (orange) 125ug 250ug Fluticasone/Flovent Diskus (orange) 100ug 250ug 500ug Budesonide/Pulmicort Turbuhaler (brown) 100ug 200ug 400ug Other: ______ puff(s) in the morning and at night until reassessed by your doctor Next due: ORAL STEROID Reduces airway swelling. Take by mouth: Dexamethasone ______ mg (milligrams) by mouth once a day for ______ day(s) Prednisone______ mg by mouth once a day for ______ day(s) Next due: CALL 911 IF YOUR CHILD: . has severe trouble breathing, talking, walking, or is feeling dizzy . has blueness of skin, lips or fingernails GO TO NEAREST EMERGENCY IF YOUR CHILD: . is using the reliever more than every 4 hours . has hard, fast breathing at rest and has pulling in of skin between the ribs While waiting for the ambulance or on the way to Emergency, you may give the reliever every 10 minutes as needed. INFORMATION HANDOUTS: FOLLOW UP APPOINTMENTS: “About Asthma” Pamphlet Family Doctor or Pediatrician: __________________________________________ Other Handouts A referral to the Asthma Education Clinic has been made. The clinic will call you. If you have any questions please call 604-875-2345 ext. 7461 MD Signature Date/Time Parent/Guardian/Patient’s Signature PATIENT CARBON COPY EMERGENCY DEPARTMENT ASTHMA DISCHARGE/ASTHMA EDUCATION REFERRAL Health Care Professionals: Please check appropriate device for patient. HOW TO USE A PUFFER/MDI (METERED DOSE INHALER) WITH A SPACER AND MASK (UP TO AGE 5 YEARS) 1. Take the cap off the puffer (MDI) 6. Hold on face for 5-10 breaths or hold breath for 2. Shake the puffer (MDI) for 30 seconds 10 seconds 3. Put the puffer into spacer 7. Slow deep breaths are best 4. Cover the mouth and nose with mask and seal 8. For second puff wait 30 seconds and repeat steps 2-7 against face 5. Push puffer (MDI) down once HOW TO USE A PUFFER (MDI) WITH A SPACER AND MOUTHPIECE (5 YEARS AND UP) 1. Take the cap off the puffer and spacer 8. Note: if you are using a blue Aerochamber, and you 2. Shake the puffer for 30 seconds hear a “whistling” sound, you are breathing in too 3. Put puffer into spacer fast! 4. Breathe out 9. Hold breath for 10 seconds (if unable to hold breath, 5. Seal lips around spacer mouthpiece take 5 slow, deep breaths) 6. Push puffer down once 10. For second puff wait 30 seconds and repeat steps 2 to 7. Breathe in slowly and deeply 9 HOW TO USE A DISKUS (ABOUT 4 YEARS AND UP) 1. Open the Diskus 5. Hold breath for 10 seconds 2. Slide the lever to click 6. Close the Diskus 3. Breathe out, then seal lips around the mouthpiece 7. For second dose repeat steps 1-6 4. Breathe in deeply and fast HOW TO USE A TURBUHALER (ABOUT 6 YEARS AND UP) 1. Remove cover 6. Place between lips 2. Hold Turbuhaler upright 7. Breathe in deeply and quickly 3. Turn the base in one direction and back 8. Hold breath for 10 seconds 4. Listen for a “click” sound 9. For second dose repeat steps 2-9 5. Breathe out away from device 10. Replace cover BACK OF PATIENT COPY PHYSICIANS’ ORDERS WRITE FIRMLY WITH A BALLPOINT PEN WEIGHT kg HEIGHT cm Pharmacy Date & Time Noted by Use Only PROVIDE PHYSICIAN NAME, COLLEGE NUMBER, PAGER NUMBER, SIGNATURE RN/UC Emergency Management of Asthma 1 hour after clinical pathway initiated by registered nurse (see flowchart overleaf) 1. Mild Exacerbation Hold further Salbutamol 2.
Load more

Recommended publications
  • A Pediatric Role in Enhancing Development in Young Children
    CLINICAL REPORT Guidance for the Clinician in Rendering Pediatric Care The Power of Play: A Pediatric Michael Yogman, MD, FAAP,a Andrew Garner, MD, PhD, FAAP, b Jeffrey Hutchinson, MD, FAAP, c RoleKathy Hirsh-Pasek, in PhD, Enhancing d Roberta Michnick Golinkoff, PhD, Development e COMMITTEE ON PSYCHOSOCIAL inASPECTS Young OF CHILD AND FAMILY Children HEALTH, COUNCIL ON COMMUNICATIONS AND MEDIA Children need to develop a variety of skill sets to optimize their development abstract and manage toxic stress. Research demonstrates that developmentally appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language, and self-regulation skills that build executive function and a prosocial brain. Furthermore, play aDepartment of Pediatrics, Harvard Medical School, Harvard University and Mount Auburn Hospital, Cambridge, Massachusetts; bDepartment supports the formation of the safe, stable, and nurturing relationships with of Pediatrics, School of Medicine, Case Western Reserve University and University Hospitals Medical Practices, Cleveland, Ohio; cDepartment all caregivers that children need to thrive. of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, Maryland; dDepartment of Psychology, Brookings Play is not frivolous: it enhances brain structure and function and promotes Institution and Temple University, Philadelphia, Pennsylvania; and executive function (ie, the process of learning, rather than the content), eSchool of Education, University
    [Show full text]
  • The Long-Term Effects of Breastfeeding on Development
    3 The Long-Term Effects of Breastfeeding on Development Wendy H. Oddy1, Jianghong Li1,3, Monique Robinson1 and Andrew J.O. Whitehouse1,2 1Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, 2Neurocognitive Development Unit, School of Psychology, The University of Western Australia, Perth, 3Centre Population Health Research, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia 1. Introduction The link between breastfeeding duration and subsequent development, cognition, educational, mental, psychomotor and behavioural functioning of the infant has been the subject of much scientific enquiry. Indeed, the effect of feeding on infant health and development was first discussed more than half a century ago when breastfed babies were reported to have better cognitive outcomes in childhood than artificially fed babies (Hoefer and Hardy 1929). Some studies have found striking results pertaining to the relative advantages that breastfeeding can confer on child neurodevelopment (Oddy, Kendall et al. 2003; Vohr, Poindexter et al. 2006; Kramer, Aboud et al. 2008). Breastfeeding has previously been associated with improvements across neurodevelopmental domains for low birthweight babies in comparison with not breastfeeding at all (Vohr, Poindexter et al. 2006). One study reported results from a large randomized controlled trial and found that breastfeeding for a longer duration and exclusive breastfeeding were associated with significant increases in
    [Show full text]
  • ACT Early Milestone Moments
    Milestone Moments Learn the Signs. Act Early. Learn the Signs. Act Early. www.cdc.gov/milestones 1-800-CDC-INFO Adapted from CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5, Fifth Edition, edited by Steven Shelov and Tanya Remer Altmann © 1991, 1993, 1998, 2004, 2009 by the American Academy of Pediatrics and You can follow your child’s development by watching how he or BRIGHT FUTURES: GUIDELINES FOR HEALTH SUPERVISION OF INFANTS, CHILDREN, AND ADOLESCENTS, Third she plays, learns, speaks, and acts. Edition, edited by Joseph Hagan, Jr., Judith S. Shaw, and Paula M. Duncan, 2008, Elk Grove Village, IL: American Academy of Pediatrics. Special acknowledgements to Susan P. Berger, PhD; Jenny Burt, PhD; Margaret Greco, MD; Katie Green, MPH, Look inside for milestones to watch for in your child and how you CHES; Georgina Peacock, MD, MPH; Lara Robinson, PhD, MPH; Camille Smith, MS, EdS; Julia Whitney, BS; and can help your child learn and grow. Rebecca Wolf, MA. Centers for Disease Centers for Disease Control and Prevention Control and Prevention www.cdc.gov/milestones www.cdc.gov/milestones 1-800-CDC-INFO 1-800-CDC-INFO 220788 Milestone Moments How your child plays, learns, speaks, and acts offers important clues about your child’s development. Developmental milestones are things most children can do by a certain age. The lists that follow have milestones to look for when your child is: 2 Months ............................................................... page 3 – 6 Check the milestones your child has reached at each age. 4 Months ............................................................... page 7 –10 Take this with you and talk with your child’s doctor at every visit about the milestones your child has reached and what to 6 Months ..............................................................
    [Show full text]
  • Cross-Linguistic Patterns in Infant Babbling
    Cross-linguistic Patterns in Infant Babbling Andreea Geambașu, Mariska Scheel, and Clara C. Levelt 1. Introduction Infants begin to vocalize very soon after birth, and they begin to babble about six months after they are born (Oller, 1980). The babbling stage is distinct from the previous phase of vocalizations in that sounds – or gestures in infants acquiring sign language – are now clearly organized in a syllabic structure. As such, these utterances are the infant’s first linguistic productions. In the works of Stark (1980) and Oller (1980), two stages were identified within the babbling phase. Babies start with reduplicated babbling when they are six to eight months old, and progress into “variegated” (Oller, 1980) or “non- reduplicated” (Stark, 1980) babbling at 10 to 12 months. Work by Koopmans- van Beinum and van der Stelt (1986) outlines a similar line of development, with reduplicated babbling beginning at six months and lasting up until at least 12 months. They do not identify a specific non-reduplicated stage during this period. In addition, Roug, Landberg, and Lundberg (1989) also identified babbling stages similar to those proposed by Oller and Stark, with reduplicated (consonant) babbling beginning at seven months, and variegated babbling beginning at 12 months. The stages identified by these researchers differ only slightly. Where they crucially converge is on the consensus that infants begin their babbling at around six to eight months old, that they begin with reduplicated utterances, and that they transition into producing variegated utterances at around 10 to 12 months. The existence of these two stages has been disseminated in introductory linguistics textbooks for years (e.g., Hoff, 2008).
    [Show full text]
  • Infant Risk Identifier Worksheet
    Infant Risk Identifier Worksheet Demographics Infant Demographic Information Screening Date (MM/DD/YYYY) Medicaid ID First Name M.I. Legal Last Name Sex Female Male City County What is your infant’s date of birth? (MM/DD/YYYY) Caregiver Demographic Information Non-Traditional Caregiver Foster Other Medicaid ID First Name M.I. Legal Last Name Sex Female Male City County What is your date of birth? (MMDDYYYY) What is your marital status? Married Unmarried Widowed Separated Divorced Refused Maternal/Infant Basics Infant Basic Information What do you identify as the infant’s race/ethnic background? (Check all that apply) ☐Asian ☐American Indian or Alaskan Native ☐Black or African American ☐Native Hawaiian or other Pacific Islander ☐White/Caucasian ☐Arab/Chaldean ☐Hispanic/Latino ☐Refused Maternal Basic Information Mother’s age at time of birth Years How many grades of school have you completed? Less than 8th Jr. high/middle school Trade School High School Diploma/GED Associate’s degree Bachelor’s degree Graduate degree 1 IRI Worksheet 1.31.18 rev. 2.6.19 Infant Risk Identifier Worksheet What do you identify as your race/ethnic background? (Check all that apply) ☐Asian ☐American Indian or Alaskan Native ☐Black or African American ☐Native Hawaiian or other Pacific Islander ☐White/Caucasian ☐Arab/Chaldean ☐Hispanic/Latino ☐Refused Maternal Family Planning Are you or your husband or partner doing anything now to keep from getting pregnant? Yes No If yes, what kind of birth control are you or your husband or partner using now to keep from getting pregnant? If No, skip to the next question.
    [Show full text]
  • Supporting Feeding & Oral Development in Young Children
    Supporting Feeding & Oral Development in Young Children Guidelines for Parents Support Feeding & Oral Development in young children with Down Syndrome, Congenital Heart Disease and Feeding difficulties. A JOINT PROJECT WITH CONTENTS 1. Introduction........................................................................................................................................... 2 2. How Feeding Works....................................................................................................................... 3 2.1 Oral Phase............................................................................................................................................ 3 2.2 Pharyngeal Phase.............................................................................................................................. 3 2.3 Oesophageal Phase......................................................................................................................... 4 2.4 Breathing and Feeding................................................................................................................... 4 3 Principles of Good Feeding.......................................................................................................... 5 3.1 Breast and Bottle Feeding............................................................................................................ 5 3.2 Nutrition...............................................................................................................................................
    [Show full text]
  • The New Family
    The New Family Your Child’s Early Months Key Points for New Families If you need more information about any of these topics, please tell your nurse before leaving the hospital. In the Hospital: Things You Should Know Before You Leave: Things You Should Do Right after delivery: ☐ Fill out paperwork for your baby’s birth certificate and social security card ...... page c ☐ Mom’s recovery and comfort care ......page 4 ☐ Make sure you have a rear-facing car seat for ☐ Hospital security ...............................page 4 your baby ........................................page 24 ☐ Early breastfeeding ..........................page 29 After You Go Home ☐ Skin-to-skin contact ........................page 29 ☐ Get help if you have trouble Safety: breastfeeding ..................................... page a ☐ Signs of jaundice ............................ page 13 ☐ Schedule your baby’s first doctor visit ........................................ page a ☐ Shaken Baby Syndrome ...................page 23 ☐ Know when it’s safe to resume sex .....page 5 ☐ Safe sleep .........................................page 24 ☐ Choose a method of birth control .....page 5 ☐ Newborn safety ...............................page 24 ☐ Know when to call: Baby-care skills: Your doctor ..................................page 6 Your baby’s doctor ......................page 25 ☐ Circumcision care ...........................page 16 ☐ Watch for signs of depression ............page 8 ☐ Cord care ........................................page 18 ☐ Schedule a postpartum visit ☐ Bathing
    [Show full text]
  • 9-Month Well Child Handout
    June 10, 2010 Dear Mr. Smith Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam9-Month voluptua. At vero eos Handout et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata 9-MONTH DEVELOPMENT QUESTIONS sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy 1.eirmod Can temporyour baby invidunt pull ut herself labore toet adolore standing magna position? aliquyam erat, sed diam voluptua. At vero eos et accusam et 2.justo Can duo your dolores baby et crawl?ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. 3.Duis Can autem your vel baby eum sit iriure upright dolor onin hendrerithis own, in with vulputate no extra velit support? esse molestie consequat, vel illum dolore eu feugiat 4.nulla Does facilisis your at baby vero makeeros et babbling accumsan noises et iusto (ma-ma, odio dignissim da-da)? qui blandit praesent luptatum zzril delenit augue duis 5.dolore Does te yourfeugait baby nulla use facilisi. her thumb Lorem andipsum fingers dolor sitto amet,grasp consectetuer small objects? adipiscing elit, sed diam nonummy nibh 6.euismod Will your tincidunt baby ut feed laoreet himself dolore using magna his aliquam fingers? erat volutpat.
    [Show full text]
  • 2 Month Well Child
    Cornerstone Pediatrics Michael Marsh, M.D. Phone Number: (817)596-3531 Website: www.cornerstonekid.com 2 Month Well Child Name: _______________________________________ Date: ___________________ Weight: _______ lbs _______ oz Length: _______ in Head Circumference: _______ cm Age: _______ Next Scheduled Appointment: _________________________________ General Nutrition: A simple diet of breast milk or iron-fortified formula is all your baby needs until 6 months of age. Solid foods, juices, cow’s milk given too early can lead to allergies, anemia and poor nutrition. Breast feed or bottle feed on demand. Babies should not be laid flat on their backs while feeding and bottles should always be held by a caregiver and not propped up. These can lead to choking and increased ear infections. Always cuddle baby during feedings. Babies will need fluoride by 6 months. Check whether the water you use is fluoridated. We will prescribe a fluoride supplement at six months if your household water is not fluoridated. Please do not give your baby honey during the first year. Honey can contain harmful bacteria that infants cannot process. Please do not give honey, tomatoes, or citrus until after 12 months of age. Please do not give hen eggs until 24 months of age. Please do not give peanuts, tree nuts, fish or seafood until 24 months of age. If your baby is wetting 6-8 diapers a day and gaining weight appropriately the baby’s feeding is adequate. Babies do not need extra water until at least 6 months of age and only in the summer. They are highly sensitive to water and can get water overloaded very easily.
    [Show full text]
  • 9-Month Handout
    June 10, 2010 Dear Mr. Smith Lorem ipsum dolor sit amet, consetetur9-Month sadipscing elitr, sed Handout diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam 9voluptua.-MONTH At DveroEVELOPMENT eos et accusam QetUESTIONS justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy 1. Can your baby pull herself to a standing position? eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et 2.justo Can duo your dolores baby et crawl?ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. 3. Can your baby sit upright on his own, with no extra support? 4.Duis Does autem your vel babyeum iriuremake dolor babbling in hendrerit noises in (ma-ma, vulputate da-da)? velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis 5. Does your baby use her thumb and fingers to grasp small objects? dolore te feugait nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh 6.
    [Show full text]
  • Immunizations and Developmental Milestones for Your Child from Birth Through 6 Years Old Child’S Name Birth Date 1 2 4 6 Birth MONTH MONTHS MONTHS MONTHS
    Immunizations and Developmental Milestones for Your Child from Birth Through 6 Years Old Child’s Name Birth Date 1 2 4 6 Birth MONTH MONTHS MONTHS MONTHS Recommended Immunizations Recommended Hepatitis B n HepB n HepB1 n HepB continues on back page continues Rotavirus n RV n RV n RV Diphtheria, Tetanus, Pertussis n DTaP n DTaP n DTaP Haemophilus influenzae type b n Hib n Hib n Hib Pneumococcal n PCV n PCV n PCV Inactivated Poliovirus n IPV n IPV n IPV n Influenza, first dose2 Influenza (Flu) n second dose Milestones* Milestones should be achieved n Recognizes caregiver’s voice n Starts to smile n Begins to smile at people n Babbles with expression n Knows familiar faces by the age indicated. n Turns head toward breast n Raises head when on tummy n Coos, makes gurgling n Likes to play with people n Responds to own name or bottle n Calms down when rocked, sounds n Reaches for toy with one hand n Brings things to mouth Talk to your child’s doctor n Communicates through cradled or sung to n Begins to follow things n Brings hands to mouth n Rolls over in both directions about age-appropriate body language, fussing or with eyes n Pays attention to faces n Responds to affection n Strings vowels together when milestones if your child was crying, alert and engaged n Can hold head up n Holds head steady, unsupported babbling ("ah', "eh", "oh") born prematurely. n Startles to loud sounds WEIGHT / PERCENTILE WEIGHT / PERCENTILE WEIGHT / PERCENTILE WEIGHT / PERCENTILE WEIGHT / PERCENTILE Growth At each well child visit, enter date, length, weight, and percentile information to keep LENGTH / PERCENTILE LENGTH / PERCENTILE LENGTH / PERCENTILE LENGTH / PERCENTILE LENGTH / PERCENTILE track of your child’s progress.
    [Show full text]
  • Developmental Milestones
    Developmental Milestones Rebecca J. Scharf, MD, MPH,* Graham J. Scharf, MA,† Annemarie Stroustrup, MD, MPH‡ *Division of Developmental Pediatrics, Center for Global Health, Department of Pediatrics, University of Virginia, Charlottesville, VA. †Institute for Advanced Studies in Culture, Charlottesville, VA. ‡Division of Newborn Medicine, Departments of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Practice Gap Clinicians should be aware of developmental milestones for children and especially areas of concern that may prompt referral of a child for further evaluation. Pediatric clinicians should carefully monitor developmental progress in children born preterm. Objectives After completing this article, readers should be able to: 1. Discuss progress in typical development in motor, language, social, and cognitive domains. 2. Note differences in development for children born preterm. 3. Identify delays that warrant referral for further evaluation. CHILD DEVELOPMENT The first years of development are crucial for lifelong learning and development. Milestones follow predictable courses in infants and children, and later devel- opmental skills build on previous ones achieved. Understanding normal devel- opment can help clinicians to recognize delayed development. Early identification of developmental delays allows for referral to therapeutic services, and children referred for early intervention are more likely to make gains in developmental milestones. Research into outcomes of intervening early in a child’s life has shown a great variety of benefits when a child receives needed speech/language therapy, physical therapy, occupational therapy, or special education services in a language-rich preschool classroom environment. (1)(2)(3)(4) Coordination of these services is often provided by state-based early intervention programs.
    [Show full text]