Approaches to treating young and adult patients differ significantly.

A child’s body is in a stage of active growth and development. Some organs are still forming, so they have completely different anatomical and physiological parameters. 

It is obvious that the knowledge of a general practitioner will not be enough to provide qualified care to a child.  For this reason, there is an entire branch of medicine specializing in the examination and treatment of children – pediatrics. 

When to consult a pediatrician?

A child’s examination can be preventive or related to certain problems.

Preventive examinations are conducted regularly, especially in the first years of a baby’s life. At an older age, a routine examination will be required for admission to kindergarten, school, or a sports club.

In the second case, parents make an appointment with specific complaints. These can be symptoms of a cold, pain of various localizations, skin rashes, stool disorders, psycho-emotional agitation of the child, and much more. The pediatrician diagnoses any childhood diseases and, if necessary, refers for further examination and treatment to a specialist.

Features of the child’s body

Knowledge of the norms of the structure and functioning of a child’s body is necessary for a correct examination and accurate diagnosis.

• Body weight and its proportions. A child’s height and weight gradually increase with age. At the same time, its proportions also change: in a newborn, the head makes up approximately 1/4 of the entire body, while in an adult, this indicator will be only 1/8.
• The bone-joint and muscular systems also differ in their immaturity. Bone tissue is more flexible and pliable; it is easily deformed under the influence of various external factors. For example, this can be spinal curvature due to an incorrect posture at a school desk or flat feet as a result of poor-quality shoes at an early age. 

 A newborn already has formed muscles, but they are weak and not capable of large and prolonged loads.

• Cardiovascular system. The heart rate in children is significantly higher; it gradually decreases with age and reaches the generally accepted norm by about 10 years of age. At the same time, the heart itself is larger in relation to the body than in an adult and has different projection boundaries, which must be known for proper auscultation.
• Respiratory system. A child’s lungs are characterized by underdeveloped alveoli – areas where gas exchange occurs. This fact is compensated by an increase in the frequency of respiratory movements per minute.
• Digestive system. It is characterized by imperfect salivary glands and enzymatic system, as well as the absence of teeth at birth and their gradual eruption (first temporary milk teeth, and then permanent ones). All this directly affects the diet and the ability to assimilate certain foods.
• Urinary system. In childhood, the kidneys are more mobile and located lower, so they are accessible for examination by palpation. Their functioning is insufficient, so they cope worse with the excretion of waste products and toxins. Weak concentrating ability and small bladder volume lead to an increase in the frequency of urination.

Features of examination

1. Every doctor traditionally begins their examination with an interview and history taking. When the patient is a child, it is most often necessary to deal with their parents. Young children will not be able to answer themselves what bothers them and show where it hurts.  Therefore, it is very important to question the mother or father in detail, and also to carefully monitor the behavior and condition of the small patient.  Sometimes this is already enough to make a preliminary diagnosis.

 It is also important to establish contact with the child so that they do not worry during the examination: talk to them or even play a little. 

• Special attention must be paid during laboratory testing. When taking smears and scrapings, it should not be forgotten that the mucous membrane in children is delicate and easily injured. 

 Blood collection for analysis is invariably accompanied by pain, so one should try to calm and distract the baby, and then perform the unpleasant procedure as quickly and carefully as possible.

 St. Luke’s Clinic employs experienced pediatric specialists who know how to approach each child and conduct a quality examination.

• Regarding instrumental and hardware examination methods, it should be noted that some of them are not applicable in pediatric practice due to the patient’s age. For example, a one-year-old baby cannot undergo a bicycle ergometry test to assess cardiovascular system function.

 Also, unlike adults, some standard examinations in children are performed under anesthesia. For example, MRI, where prolonged immobility is required.

Features of treatment

The treatment of childhood diseases has its own characteristic features.

First of all, when prescribing a particular drug, it is necessary to consider its indications and contraindications. A number of medications are prohibited for use in pediatric practice and can lead to serious consequences. For example, the antibiotic erythromycin has ototoxicity and can cause irreversible hearing loss.

It is absolutely necessary to accurately calculate the prescribed dosage of the medicine, which will obviously be less than for an adult.

It should be added that a number of childhood diseases are treated quite quickly because they are detected at early stages thanks to the vigilance of parents or regular preventive examinations by a pediatrician.