Treatment: Mostly supportive care Ribavirin – only in select patients (complicated congenital heart disease, chronic lung disease, bronchopulmonary dysplasia, immunocompromised patients) Beta-agonists or race epinephrine – not usually used Corticosteroids, hypertonic saline or antibiotics are also not usually used. Prophylaxis: Palivizumab: 15 mg/kg/dose; prophylaxis is not recommended if > 29 weeks gestation (risk factors not considered) Neonates […]
Pediatrics
Meningitis
Signs and Symptoms: Tsai J, Nagel MA, Gilden D. Skin rash in meningitis and meningoencephalitis. Neurology. 2013 May 7;80(19):1808-11. doi: 10.1212/WNL.0b013e3182918cda. PMID: 23650233; PMCID: PMC3719428. Treatment: Age Antimicrobial Therapy < 1 month Ampicillin plus cefotaxime; OR ampicillin plus an aminoglycosideStreptococcus agalactiae, Escherichia coli, Listeria monocytogenes 1-23 months Vancomycin + Ceftriaxone 100 mg/kg/day IV divided every 12 to […]
ADHD
Stimulants: Try amphetamine or methylphenidate before giving up on stimulants Norepinephrine reuptake inhibitors or antidepressants if stimulants don’t work Atomoxetine, clonidine and guanfacine are also choices.***this one needs some flushing out***
Otitis Media
Analgesia: APAP, NSAIDS, rarely opioids. Avoid ASA in kids. Antihistamines and decongestants are not usually recommended. Antibiotics only if: Bulging tympanic membrane, perforation or otorrhea Delay unless fever or otalgia > 48-72 hours in kids > 2 years. Not usually for otitis media with effusion, only if greater than 3 months Not for the persistence of […]