Hello! I have a character who's five years old and I was wondering what difference that makes medically, if that makes sense? Both like how medical workers will act with her and explain things given she's very young and how that would factor into her medical care, like basic checkups or diagnosing illnesses and stuff like that. Sorry if this is too broad or vague, and thank you for all you do!
Hey there! Congrats on being Janey on the spot with the inbox and being the first ask of June!
So, one quick note. I come from EMS, and particularly now from a critical care service that handles a lot of kids. But I’m assuming for the purpose of this ask that this child is not and has never been critically ill. Okay? Okay!
Pediatrics is its own specialty for a reason, and I have bundles to learn about it. There are all sorts of things that are different in pediatric medicine (and all sorts that of things that are shockingly similar!).
First, let’s talk about “furniture.” As you’ll remember from having once been a child, peds doctors offices and clinics, and even ERs, are often bright, colorful and cheery places. Kids get offered toys and lollipops, they get to see special movies. Doc McStuffins is a very common sight in peds hospitals and waiting rooms.
I’ve heard of peds hospitals that have different mural styles for different wards: one hallway that’s done all up in a baseball theme, another in a princesses and dragons theme, another in trains.
Oh! When little kids get a nebulizer treatment, oftentimes now the mask they get the treatment through looks like a dragon and it’s awesome and I wish they came in adult sizes.
Providers are also, by necessity, gentler with kids. You can’t argue with a kid and tell them to hold still; they’re going to squirm whether the shot is good for them or not. (Don’t get me started on vaccinations, please.)
In terms of the medicine, as someone who works on a pediatric critical care unit, there are two ways you can look at kids.
A) They’re just little adults.
B) They are definitely not little adults.
Both are true. They’re little adults in that they have the exact same functions as adults. They’re not little adults in that there are big social development changes that go on at various ages and there are some physiological changes (mostly that come up in very technical fields) that are different.
For adults, a lot of the med doses are standardized; for kids, they’re almost all weight-based. A 5 year old should weigh roughly 20kg/45lbs (and there’s a really neat method called Handtevy that will give you the estimated weight of any kid up to 10 yrs old based just on their age; it’s stupendously cool and exactly the kind of thing pediatric critical care medics nerd out about!).
IVs are almost always smaller in kids, but that’s because they’re little. I’ve also seen ERs use whole teams to get a single IV in a child, including someone singing happy songs while other people stab the child with needles. (It seemed seriously Clockwork Orange to me, but I have a feeling it’s data-driven with good outcomes, so who knows?)
I get the feeling you’re asking about pediatrics in general and not pediatric critical care, so I’m going to try and focus on the general practice stuff, which is that kids who don’t get seriously ill tend to do pretty well.
Some things they might have done at the doctor’s office if they’re not there for a specific illness:
- Vitals: blood pressure, pulse, oxygen saturation, temperature
- Height/weight checks.
- Scoliosis checks.
- Vision and hearing checks.
- Immunization checks. (I’d say just check the immunization schedule recommended by your region; the CDC’s is here and is as good as any.)
- Allergy scratch-testing
Common reasons a 5 y.o. will go to the doctor:
- Earaches and ear infections
- Fever (usually the flu or an ear infection)
- Asthma. This is incredibly common in some areas, and I’ve worked in a few.
- the snot. so much the snot.
- Something lost in the nose
- Something swallowed
- Mechanical injury (broken wrist, bumped head, etc.) It’s common for good parents to be suspected of child abuse for having clumsy kids.
Kids tend to bounce – both literally and figuratively. They’re little, but pretty tough and hard to injure, and when they do get hurt they heal pretty quickly. They’re still growing, so they do well.
That’s all I can think of about pediatrics when it’s 2 in the morning and I worked a 14+ hour day!
Congrats on getting there first and I hope this was what you needed.
xoxo, Aunt Scripty
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