| PICC insertion: Caring for your child at home after the procedure | P | PICC insertion: Caring for your child at home after the procedure | PICC insertion: Caring for your child at home after the procedure | | English | Other | Child (0-12 years);Teen (13-18 years) | NA | Veins | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2020-11-18T05:00:00Z | | | | | | 7.00000000000000 | 75.9000000000000 | 2444.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn how to care for your child at home after a peripherally inserted central catheter (PICC) insertion.</p> | <p>Your child has had a <a href="https://www.aboutkidshealth.ca/Article?contentid=1012&language=English">peripherally inserted central catheter (PICC)</a> insertion. The information on this page explains how to look after your child at home after the procedure, and when to call for help. When your child goes home, a home-care nurse will take care of your child’s PICC and can teach you how to provide some of this care yourself.</p> | <h2>Key points</h2><ul><li>Keep the PICC site and line dry at all times, and leave the dressing in place.</li><li>Your child can have <a href="https://www.aboutkidshealth.ca/Article?contentid=62&language=English">acetaminophen</a> for pain.</li><li>Your child may return to gentle activity 24 hours after the procedure.</li><li>Your child should not swim at any time.</li><li>A nurse will teach you how to take care of your child’s PICC, including what to do if it breaks, the cap falls off, the dressing comes loose, or it falls out.</li></ul> | | | | | <p>Complications may occur with your child’s PICC. It may break, the cap may fall off, the dressing can come loose or the PICC can fall out. Broken PICCs will need to be removed and replaced. It is important that you are prepared to handle these situations.</p><p>Other possible complications include clotting of the PICC, blood in the catheter or cap, and infection. Remember to wash your hands before handling the PICC.</p><h2>Catheter damage</h2><p>Catheter damage can happen from rough handling, pulling, cutting with scissors, general wear and tear, or puncturing with a sharp object. If this happens, fluid may leak out of the catheter at the damaged point, germs can get inside, and blood may back up into the catheter. You may notice that the catheter is wet if there is a small tear in the line.</p><h2>What to do if the PICC breaks or leaks</h2><p>Before you leave the hospital, you will be given a PICC Emergency Kit. The kit contains the supplies you will need if your child’s PICC breaks. A nurse will give you the kit and review it with you before you leave. You should always make sure the kit is with your child.</p><p>If the PICC breaks, do the following:</p><ol><li>Stay calm.</li><li>Clamp the PICC between the break and your child using the padded clamp that has been provided. If you do not have a clamp, bend the line over and tape it together.</li><li>Stop the infusion if your child has one running.</li><li>Clean the broken area with an alcohol swab.</li><li>Place clean gauze under the broken area and tape the PICC to the gauze.</li><li>Wrap the gauze around the catheter, then tape this gauze roll to your child’s arm.</li><li>If the hole is small, and you have been taught how, you should try to heparinize the PICC to help prevent it from becoming blocked.</li><li>Call the Vascular Access Service as soon as you have secured the PICC for further instructions. You will be asked to bring your child to the hospital for further assessment.</li><li>Bring the broken line with you. This is the fastest way of knowing the correct size.</li></ol><p>Some PICCs can be repaired without having to be replaced. Some broken PICCs will need to be removed and replaced.</p><h2>What to do if the cap falls off</h2><p>If the cap falls off:</p><ol><li>Wipe the end of the PICC with an alcohol swab.</li><li>Take a new cap and place it on the end of the line by screwing it onto the hub.</li><li>Wrap clean gauze around the cap and then tape the gauze to your child’s arm.</li><li>Have the cap changed as soon as possible. You can perform the cap change using
<a href="https://www.aboutkidshealth.ca/Article?contentid=3391&language=English">aseptic non-touch technique (ANTT)</a>, if you have been taught, or the home-care nurse can do it.</li></ol><h2>What to do if the dressing comes loose</h2><ol><li>If the dressing comes loose, reinforce it with tape.</li><li>If the dressing comes off, secure the line with a new clean dressing.</li><li>As soon as possible, a new dressing needs to be applied. You can perform the dressing change using ANTT, if you have been taught, or the home-care nurse can do it.</li></ol><h2>What to do if the PICC falls out</h2><p>If the catheter falls out or gets pulled out:</p><ol><li>To stop the bleeding, apply pressure for 10 minutes to the site where the catheter enters the vein in the child’s arm.</li><li>Clean the exit site with the usual cleaning solution, and apply a bandage over the area.</li><li>Observe the entry site for any swelling or bruising.</li><li>Contact a member of your health-care team for further instructions. The procedure to re-insert the PICC may not be possible right away.</li></ol><h2>What to do if there is blood visible in the catheter or cap</h2><p>There may be blood visible in the catheter or cap if there is an increase in pressure in the chest veins from crying, laughing, exercising or leaving the clamp open while the pump is turned off. It will also happen if there is an opening anywhere along the system, such as a loose connection or defective cap.</p><p>If blood appears in the catheter, you should flush it and then heparinize it, if you have been taught how to do so. If you see blood, always check the system for leaks, cracks and loose connections. Replace any parts that are replaceable, and re-check for blood back-up. Let the health-care team know if you cannot fix the problem.</p><h2>What to do if you cannot flush the PICC</h2><p>Most PICCs have clots or sludge build-up. If you notice gradually increasing pressure when flushing the PICC, there may be particles sticking to the inside walls of the PICC, making the pathway for fluids narrower. If you are suddenly not able to flush the PICC, check that the clamp is open and that the PICC is not bent or twisted. If it is not one of these things, the PICC may have a clot stopping the flow of fluids. You must call a member of your health-care team if this happens.</p><p>
<strong>Never try to flush a clot out of the PICC. You may burst the PICC or push a clot into your child’s heart and lungs.</strong> If you find a complete blockage while trying to flush the PICC, report this to your health-care team. You will need to come to the hospital or clinic for help.</p><h2>Infection</h2><p>Having a PICC gives bacteria an easy route into the blood system. Therefore, there is a risk of infection every time you handle the line. The
<a href="https://www.aboutkidshealth.ca/Article?contentid=3391&language=English">aseptic non-touch technique (ANTT)</a> during PICC care is the most important way to prevent an infection. The catheter exit site must be cleaned and dressed properly to prevent the growth of germs. Getting the supplies dirty or wet, or not following the methods of ANTT could allow germs to enter and grow in the body, which could cause a serious infection.</p><p>If your child develops a fever of
<strong>one degree above their normal temperature</strong> or has
<strong>chills</strong> or
<strong>sweats</strong>, call a member of your health-care team right away. Not all fevers mean that there is an infection in the PICC; but infection is always suspected, and the PICC needs to be looked at.</p><p>Before you call:</p><ul><li>Check to see if your child has any other signs of infection, such as a sore throat, cough, runny nose, sleepiness or any change in behaviour.</li><li>Look at the PICC exit site to see if there is any redness, swelling or discharge.</li></ul><table class="akh-table"><thead><tr><th>Signs and symptoms to watch for</th><th>What to do</th></tr></thead><tbody><tr><td>Fever, chills</td><td>Check your child’s temperature.</td></tr><tr><td>Redness, swelling or discharge at the exit site</td><td>Change dressing, and check for red streaking following the tunnel part of the PICC.</td></tr><tr><td>General feeling of tiredness</td><td>Look for other signs of infection.</td></tr><tr><td>Pain</td><td>Ask if your child is experiencing pain, for the location of their pain and for the intensity of their pain.</td></tr><tr><td>Fever over:<br> 38°C by mouth (or 1°C above normal)<br> 37.5°C under arm<br>38.5°C rectally</td><td>Call your health-care team to report the fever and any other symptoms.</td></tr></tbody></table><h3>For secondary caregivers</h3><p>The video below will show family members, teachers, daycare providers and other caregivers how to manage the emergency procedures for a PICC. Review this video with anyone who is caring for your child in case they will need to perform any of these procedures.</p><div class="asset-video">
<iframe src="https://www.youtube.com/embed/B5hYzaCpOwo?rel=0" frameborder="0"></iframe> </div> | <h2>When to see a doctor</h2><p>Call your child’s doctor or go to the nearest Emergency Department right away if your child has any of the following:</p><ul><li>A <a href="https://www.aboutkidshealth.ca/Article?contentid=30&language=English">fever</a> greater than 38°C (100.4°F), or over the normal range provided by your doctors or nurses</li><li><a href="https://www.aboutkidshealth.ca/pain">Pain</a> requiring <a href="https://www.aboutkidshealth.ca/Article?contentid=62&language=English">acetaminophen</a> after 48 hours</li><li>Bleeding that does not stop with pressure</li><li>Leakage or drainage at the PICC site</li><li>Difficulty breathing</li><li>A funny feeling in their heart</li><li>Noticeable swelling in the face, chest, neck or arm on the side where the PICC line is located</li><li>The PICC gets pulled out a little or all the way</li></ul><p>Each child’s situation is different, so you should ask your doctor if there are any specific instructions for your child.</p> | | | | | | | | | | | <h2>Discharge from the hospital</h2><p>How much time your child stays in the hospital depends on the reason for the PICC insertion and on how your child is feeling after the procedure. Some children who have a PICC go home on the same day as their procedure. Others remain in the hospital to receive additional treatment.</p><h2>Dressings after the procedure</h2><p>The area where the PICC comes out of the skin will be covered with a clear bandage. This bandage is put on in a special way to keep the site as clean as possible.</p><p>The PICC can be used right away for your child’s medication or fluids. Your child should not feel any pain when the PICC is being used.</p><h2>Pain relief after the procedure</h2><p>After the procedure, some children may feel pain in the small area where the PICC comes out of the skin. Usually, this pain is mild and will go away within a few hours. If needed, give your child <a href="https://www.aboutkidshealth.ca/Article?contentid=62&language=English">acetaminophen</a> for pain. If your child complains of a lot of pain, call your child’s nurse or doctor and ask if your child can have something to relieve the pain.</p><p>Children often try to protect the arm that has the PICC. Encourage your child to use their arm normally. It is good and safe for your child to move the arm in all directions.</p> | | <h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. You can call and speak to the Vascular Access Service resource nurse at (416) 813-6986 during working hours, or leave a message with the Vascular Access Team. If you have concerns and it is after working hours, please call The Hospital for Sick Children switchboard at 416-813-7500 and ask them to page your child’s doctor on call, or go to the nearest Emergency Department.</p> | | | | | | | piccathome | | https://assets.aboutkidshealth.ca/AKHAssets/PICC_insertion_caring_for_child_at_home.jpg | | Main |
| PICC removal: Caring for your child at home after the procedure | P | PICC removal: Caring for your child at home after the procedure | PICC removal: Caring for your child at home after the procedure | | English | Other | Child (0-12 years);Teen (13-18 years) | NA | Veins | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2020-11-18T05:00:00Z | | | | | | 9.20000000000000 | 62.5000000000000 | 425.000000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn how to care for your child at home after a PICC removal.</p> | <p>Your child has had a <a href="https://www.aboutkidshealth.ca/Article?contentid=1012&language=English">peripherally inserted central catheter (PICC)</a> removal. The information on this page explains how to care for your child at home after the procedure, and when to call for help.</p> | <h2>Key points </h2><ul><li>Leave the dressing in place for 48 hours.</li><li>Your child can have <a href="https://www.aboutkidshealth.ca/Article?contentid=62&language=English">acetaminophen</a> for pain.</li><li>Your child may return to gentle activity 24 hours after the procedure.</li></ul> | | | | | | <h2>When to see a doctor?</h2><p>Call your child’s doctor or go to the nearest Emergency Department right away if your child has any of the following:</p><ul><li>A <a href="https://www.aboutkidshealth.ca/Article?contentid=30&language=English">fever</a> higher than 38°C (100.4°F)</li><li><a href="https://www.aboutkidshealth.ca/pain">Pain</a> requiring <a href="https://www.aboutkidshealth.ca/Article?contentid=62&language=English">acetaminophen</a> after 48 hours</li><li>Bleeding that does not stop with pressure around the old PICC site</li><li>Leakage or drainage at the old PICC site</li></ul> | | | | | | | | | | | <h2>Discharge from the hospital</h2><p>Most children who have a PICC removal go home 30 minutes after the procedure. Some children remain in the hospital to receive additional treatment. The length of time your child remains at the hospital differs depending on the reason for the removal.</p> | | <h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. You can call and speak to the Vascular Access Service resource nurse at (416) 813-6986 during working hours, or leave a message with the Vascular Access Team. If you have concerns and it is after working hours, please call The Hospital for Sick Children switchboard at 416-813-7500 and ask them to page your child’s doctor on call, or go to the nearest Emergency Department.</p> | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/PICC_removal_caring_for_child_at_home.jpg | | Main |
| PKU transitions in the early years | P | PKU transitions in the early years | PKU transitions in the early years | | English | Metabolic | Child (0-12 years);Teen (13-18 years) | Stomach;Small Intestine;Large Intestine/Colon | Digestive system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2009-11-10T05:00:00Z | | | | | | 5.20000000000000 | 79.2000000000000 | 763.000000000000 | | Flat Content | Health A-Z | <p>Children growing up with phenylketonuria (PKU) need to incorporate health care into their normal routines. Read about encouraging proper development. </p> | <h2>What is phenylketonuria (PKU)?</h2><p>Phenylketonuria (PKU) is an absence or deficiency in phenylalanine hydroxylase (PAH), an enzyme involved in metabolizing or converting the amino acid phenylalanine into tyrosine, another amino acid. PAH deficiency results in high levels of blood phenylalanine and an accumulation of phenylketones in the urine.</p><p>Partial deficiency of the enzyme results in hyperphenylalaninemia. In this condition, the child has elevated blood phenylalanine, although it is not quite as high as when there is a complete absence of PAH. In hyperphenylalaninemia, phenylketones do not accumulate.</p><h2>Transition through the years</h2>
<p>Children go through many changes as they grow up, including how they think, what they like, and how they take care of themselves. Big changes are often called transitions.</p><p>A child must go through a transition in health care when they are diagnosed with PKU. The family and the health care team can help them learn good health care habits, the same way they help them learn other life skills. A child who learns good health care habits will probably have good health habits and attitudes all their life. </p><p>This page will help you think about age-appropriate goals for your child. It will give you ideas to help your child become more confident and independent in life and in their health care. It also includes extra goals for children with PKU. </p><p>Each child has different abilities from other children. Your child may surprise you with what they can do. Expect good things from your child and encourage them to expect the best from themselves.</p>
| <h2>Key points</h2>
<ul>
<li>Babies and young children are learning new things every day. Encourage your child's development by playing with them and teaching them. </li>
<li>As your child grows older, they can learn to do more things for themselves. Give them simple chores to do and encourage them to learn new things. </li>
<li>Set up a routine for PKU care, and start teaching your child about "green light" or "go" foods. </li>
</ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/PKU_transitions_early_years.jpg | | Main |
| PKU transitions in the middle years | P | PKU transitions in the middle years | PKU transitions in the middle years | | English | Metabolic | Child (0-12 years);Teen (13-18 years) | Stomach;Small Intestine;Large Intestine/Colon | Digestive system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2009-11-10T05:00:00Z | | | | | | 5.10000000000000 | 79.5000000000000 | 913.000000000000 | | Flat Content | Health A-Z | <p>Children with phenylketonuria (PKU) need to learn how to balance everyday life and health care. Learn ways to encourage your child to manage their PKU. </p> | <h2>What is phenylketonuria (PKU)?</h2><p>Phenylketonuria (PKU) is an absence or deficiency in phenylalanine hydroxylase (PAH), an enzyme involved in metabolizing or converting the amino acid phenylalanine into tyrosine, another amino acid. PAH deficiency results in high levels of blood phenylalanine and an accumulation of phenylketones in the urine.</p><p>Partial deficiency of the enzyme results in hyperphenylalaninemia. In this condition, the child has elevated blood phenylalanine, although it is not quite as high as when there is a complete absence of PAH. In hyperphenylalaninemia, phenylketones do not accumulate.</p><h2>Transition through the years</h2><p>Children go through many changes as they grow up, including how they think, what they like, and how they take care of themselves. Big changes are often called transitions. </p><p>A child must go through a transition in health care when they are diagnosed with PKU. The family and the health care team can help them learn good health care habits, the same way they help them learn other life skills. A child who learns good health care habits will probably have good health habits and attitudes all their life. </p><p>This page will help you think about age-appropriate goals for your child. It will give you ideas to help your child become more confident and independent in life and in their health care. It also includes extra goals for children with PKU. </p><p>Each child has different abilities from other children. Your child may surprise you with what they can do. Expect good things from your child and encourage them to expect the best from themselves. </p> | <h2>Key points</h2>
<ul>
<li>As your child grows older, they can do more things for themselves.</li>
<li>Encourage your child to be responsible for their homework and for some of their PKU care. </li>
<li>Tell your child you are there to help them if they need it. </li>
</ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/PKU_transitions_middle_years.jpg | | Main |
| PKU transitions in the teenage years | P | PKU transitions in the teenage years | PKU transitions in the teenage years | | English | Metabolic | Child (0-12 years);Teen (13-18 years) | Stomach;Small Intestine;Large Intestine/Colon | Digestive system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2009-11-10T05:00:00Z | | | | | | 6.10000000000000 | 73.9000000000000 | 815.000000000000 | | Flat Content | Health A-Z | <p>Teenagers with phenylketonuria (PKU) face the unique challenge of balancing their health with their growing independence. Read about how you can support your teen with PKU.</p> | <h2>What is phenylketonuria (PKU)?</h2><p>Phenylketonuria (PKU) is an absence or deficiency in phenylalanine hydroxylase (PAH), an enzyme involved in metabolizing or converting the amino acid phenylalanine into tyrosine, another amino acid. PAH deficiency results in high levels of blood phenylalanine and an accumulation of phenylketones in the urine.</p><p>Partial deficiency of the enzyme results in hyperphenylalaninemia. In this condition, the child has elevated blood phenylalanine, although it is not quite as high as when there is a complete absence of PAH. In hyperphenylalaninemia, phenylketones do not accumulate.</p><h2>Transition through the years</h2><p>Children go through many changes as they grow up, including how they think, what they like and how they take care of themselves. Big changes are often called transitions. </p><p>A child must go through a transition in health care when they are diagnosed with PKU. The family and the health-care team can help them learn good health-care habits, the same way they help them learn other life skills. A child who learns good health-care habits will probably have good health habits and attitudes all their life. </p><p>This page will help you think about age-appropriate goals for your child. It will give you ideas to help your child become more confident and independent in life and in their health care. It also includes extra goals for children with PKU. </p><p>Each child has different abilities from other children. Your child may surprise you with what they can do. Expect good things from your child and encourage them to expect the best from themselves. </p> | <h2>Key points</h2>
<ul>
<li>As your teen grows older, they should become more confident and independent. They should be able to take on more responsibility. </li>
<li>Encourage your teen to take charge of their own health and life, and to solve problems for themselves. </li>
<li>Let your teen know that you are still there to help and support them.</li>
</ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/PKU_transitions_teenage_years.jpg | | Main |
| Pacemaker surgery | P | Pacemaker surgery | Pacemaker surgery | | English | Cardiology | Child (0-12 years);Teen (13-18 years) | Heart | Heart | Procedures | Caregivers
Adult (19+) | NA | | 2009-11-10T05:00:00Z | | | | | | 7.90000000000000 | 63.6000000000000 | 1693.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Pacemaker surgery is required to put a pacemaker in a child. Learn about what a pacemaker is, how the surgery is done and what happens after surgery.</p> | <h2>What is a pacemaker?</h2>
<p>A pacemaker is a small device that uses electrical impulses to control the speed and rhythm of your child's heartbeat. A pacemaker is surgically placed (implanted) in the body. It has two parts: </p>
<ul>
<li>The pacemaker itself is a metal box with a battery. It delivers electrical impulses to the leads. </li>
<li>The leads are wires connected to the pacemaker. They carry the electrical impulses to the heart muscle. </li>
</ul> | <h2>Key points</h2>
<ul>
<li>A pacemaker is a small device that uses electrical impulses to control the speed and rhythm of your child's heartbeat. Your child will have an operation to implant the pacemaker. </li>
<li>Your child will need to stay in hospital for a few days after the operation. </li>
<li>Members of your child's health-care team will teach you about the pacemaker and what to watch for. </li>
<li>Your child will need regular follow-up appointments to make sure the pacemaker is working well. </li>
</ul> | | | | | | | | | | | | | | | | <h2>A team of professionals will perform the operation at the hospital</h2><p>Your child's surgery will be performed at the hospital, in a special laboratory or operating room. Doctors, nurses and an anaesthetist will all help during the operation. An anaesthetist is a doctor who is specially trained to give anaesthetics, the medicines that keep your child asleep and feeling no pain during the operation.</p><h2>The morning of the operation</h2><p>Your child will be admitted to the Cardiology Inpatient Unit. To get ready for the operation, your child will be given an intravenous (IV) tube. An IV is a small tube put in the vein of an arm or leg so that the doctors can easily give your child medicines.</p><h2>During the operation</h2><p>Your child will be given a general anaesthetic to put your child to sleep during the operation.</p><p>Sticky pads may be placed on your child's chest at the beginning of the operation. If necessary, these pads can be used to maintain your child's steady heart beat during the operation.<br></p><p>During the operation, the doctor will put in a pacemaker or replace your child's current pacemaker. There are two types of pacemakers your child may receive: a transvenous pacemaker, or an epicardial pacemaker.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Pacemaker types</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Pacemakers_MED_ILL_EN.png" alt="A heart with a transvenous pacemaker and a heart with an epicardial pacemaker" />
<figcaption class="asset-image-caption">A transvenous pacemaker lead is passed through a vein to the correct location inside the heart. An epicardial pacemaker lead is stitched to the outside of the heart muscle.</figcaption> </figure>
<h3>Operation to put in a transvenous pacemaker</h3><ul><li>A special catheter may be passed through a vein in the groin if your child needs temporary pacing during the procedure. If used, this catheter will be removed at the end of the operation.<br></li><li>An incision is made in the chest. The doctor makes a pocket between the layers of muscle and inserts the pacemaker into this pocket.</li><li>The pacemaker lead is then passed through a vein near the shoulder to the correct location inside the heart. The doctor uses special X-ray pictures called fluoroscopy to make sure the lead is put in the right place in the heart muscle.</li><li>The doctor then connects the pacemaker to the lead and the chest incision is closed with stitches. Over time, these stitches will dissolve on their own. The incision site is covered with a bandage.</li></ul><h3>Operation to put in an epicardial pacemaker</h3><ul><li>A small incision is made in your child's chest to put the lead(s) on the heart.</li><li>One end of the lead is stitched on the outside surface of the heart muscle and the other end connects to the pacemaker.</li><li>The surgeon makes a pocket between the layers of the chest wall or abdomen muscles and inserts the pacemaker into the pocket.</li><li>The incision is then closed with stitches. Over time, these stitches will dissolve on their own. The incision site is covered with a bandage.</li></ul><h2>How much time the operation will take</h2><p>Your child's surgeon will let you know how long the operation should take. The length of time will depend on what type of pacemaker is used and if there are any complications during the operation.</p> | <h2>After the operation</h2>
<p>After the operation, your child will be moved to a recovery room to wake up from the anaesthetic. It is likely that your child will remain in the recovery room for a couple of hours. Then they will go back to the cardiology inpatient unit. You will be able to visit your child in the recovery area once they are ready. </p>
<p>The doctor will come and talk to you about your child's operation.</p>
<p>Because of the general anaesthetic used during the operation, your child may be very sleepy for several hours. Your child may need to stay in bed for about four hours after the operation. During this time, the nurse will check your child's blood pressure, breathing and incision(s) regularly. </p>
<p>After your child is awake, they will be allowed to drink liquids and slowly begin eating and drinking normally again.</p>
<p>Your child may also have another electrocardiogram and chest X-ray.</p>
<p>Your child will also get antibiotics through the IV tube for about two days following the operation. These medicines fight infection.</p>
<h2>Managing your child's pain</h2>
<p>Your child may be sore around the incision site(s) and will receive pain-relieving medicine.</p>
<p>Your child may also have an upset stomach for a short time after the operation. This is likely due to the anaesthetic. If your child has an upset stomach, your child's nurse will give your child medicine to help. </p>
<h2>Monitoring your child after the operation</h2>
<h3>The incision site(s)</h3>
<p>The doctors and nurses will monitor your child's incision site(s) for bleeding and signs of infection. These signs include fever, redness, swelling and drainage around the incision.</p>
<h3>Checking that the pacemaker is working properly</h3>
<p>Your child's pacemaker will be checked with a small machine called a Holter monitor. The monitor checks your child's heartbeat. Your child will wear the Holter monitor for 12 to 24 hours following the operation. </p>
<p>After the doctors have the results from the Holter monitor, the pacemaker technologist will test your child's pacemaker with a small computer. The test does not hurt. </p> | <h2>Preparing for an operation to put in a pacemaker</h2>
<h3>Speak to your child about what is going to happen</h3>
<p>What, when and how you tell your child about the operation for a pacemaker will depend on how grown up and mature your child is. Talk to your child in a way that they can understand. You can use the information on this page as a start. </p>
<p>A few days before the operation, let your child know that they will be going to the hospital for an operation. It is important to be honest. Your child will feel less anxious and scared when they know what to expect. Children also take their behavioural cues from the adults around them. If you speak to your child in a calm manner without anxiety about the upcoming operation, your child will feel less anxious and scared. </p>
<p>Let your child know that they may have pain and needles before and after the operation. Comfort your child and let them know that you will be with them as much as you can. Your child should also understand that the operation is needed and that the doctors and nurses are there to help. </p>
<p>Your child will need to stay in the hospital for a few days. You can stay with your child during this time.</p>
<h2>Clinic visit before the operation</h2>
<p>Your child will need to visit the cardiac pre-operative clinic a few days before the operation. During this visit, the nurses will let you and your child know more about the operation. The doctor will also discuss the details of the operation with you, including how the surgery will be done, where the incision (surgical cut) will be made, and the risks of the operation. </p>
<p>Your child may also need one or more of the following tests:</p>
<ul>
<li>an electrocardiogram, also called an ECG, which measures and records the electrical activity in the heart </li>
<li>blood tests </li>
<li>a chest X-ray, which takes a picture of your child's heart </li>
<li>an echocardiogram, which is a type of ultrasound that can take moving pictures of the heart's muscles and valves at work </li>
</ul>
<h2>Eating and drinking before the operation</h2>
<p>Your child must stop eating and drinking several hours before the operation. The table below tells you when your child must stop eating and drinking. The nurse will discuss this with you during your clinic visit to the hospital before the operation. </p>
<h3>What your child can eat and drink before the operation</h3>
<table class="akh-table">
<thead>
<tr><th>Time before procedure</th><th>What you need to know</th></tr>
</thead>
<tbody>
<tr>
<td>Midnight before the procedure</td>
<td><p>No more solid food. This also means no gum or candy.</p>
<p>Your child can still drink liquids such as milk, orange juice and clear liquids. Clear liquids are anything you can see through, such as apple juice, ginger ale or water. </p>
<p>Your child can also eat Jell-O or popsicles.</p></td>
</tr>
<tr>
<td>6 hours</td>
<td>No more milk, formula or liquids you cannot see through, such as milk, orange juice and cola.</td>
</tr>
<tr>
<td>4 hours</td>
<td>Stop breastfeeding your baby.</td>
</tr>
<tr>
<td>2 hours</td>
<td>No more clear liquids. This means no more apple juice, water, ginger ale, Jell-O or popsicles.</td>
</tr>
</tbody>
</table> | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/Pacemakers_MED_ILL_EN.png | | | Main |
| Pacemaker: Caring for your child at home | P | Pacemaker: Caring for your child at home | Pacemaker: Caring for your child at home | | English | Cardiology | Child (0-12 years);Teen (13-18 years) | Heart | Heart | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2009-12-17T05:00:00Z | | | | | | 9.20000000000000 | 55.1000000000000 | 1541.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>A pacemaker is a small device that uses electrical impulses to control the speed and rhythm of your child's heartbeat. Learn how to care for your child with a pacemaker.</p> | <h2>What is a pacemaker?</h2><p>A pacemaker is a small device that uses electrical impulses to control the speed and rhythm of your child's heartbeat.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Pacemaker</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Pacemaker_closeup_EQUIP_ILL_EN.jpg" alt="The activity sensor, battery, circuitry and lead of a pacemaker" />
<figcaption class="asset-image-caption">A pacemaker is very small and light. It is placed under the skin and muscle to help control your child's heartbeat.</figcaption>
</figure><br><br> | <h2>Key points</h2>
<ul>
<li>A pacemaker is a small device that uses electrical impulses to control the speed and rhythm of your child's heartbeat.</li>
<li>Your child should avoid strong electric and magnetic fields, as these can interfere with pacemaker function.</li>
<li>Your child should not play sports where there is a risk of repetitive blows to the pacemaker area.</li>
<li>Regular follow-up appointments with both the cardiologist and the pacemaker clinic are important.</li>
<li>If you are concerned about your child, please seek medical attention. If you have questions about the pacemaker, please call the pacemaker clinic staff.</li>
</ul> | | | | | <h2>Your child should avoid strong electric and magnetic fields</h2><p>Strong magnetic fields will interfere with the pacemaker's ability to sense the heart's activity. When this happens, the pacemaker will respond by sending out its pacing impulses at a fixed rate. It will not turn itself off. Your child needs to take precautions with the following: </p><ul><li>If your child visits the Hydro exhibit at the Ontario Science Centre, they should stay behind the rope because the strong magnet can interfere with the pacemaker.</li><li>If your child has Industrial Arts classes at school or is interested in mechanical hobbies, they should not work with arc welders or alternators.</li><li>Any procedure involving electrical equipment that is used in a doctor's office or an operating room may interfere with the pacemaker's function or change the pacemaker's settings. An example is electrocautery, which uses electricity to burn (cauterize) tissue.<br></li><li>Magnetic resonance imaging (MRI), a procedure done in health care facilities, should not be performed on anyone with a pacemaker. </li><li>Items containing magnets, such as magnetic jewelry, toys with large magnets, and some headphones should be kept at least six inches away from the pacemaker.</li><li>In general, any electronics, particularly those with antennas that transmit electrical signals, should be kept at least six inches away from the pacemaker. An example is a cellphone. </li><li>Your child should walk past anti-theft detectors normally and should not linger between the gates. The pacemaker may activate the alarm but should not be affected by it. </li></ul>
<figure class="asset-c-80"><span class="asset-image-title">Precautions when using a cell phone or tablet</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/Pacemaker_precautions.jpg" alt="Girl using cell phone on side opposite pacemaker device as example of what is ok, boy laying down with phone on chest as example of what not to do, boy with phone in his shirt pocket as example of what not to do" /></figure>
<p>A microwave oven will not interfere with the function of your child's pacemaker.</p> | | | | | | | | | | <h2>Why does my child's heart need a pacemaker to work normally?</h2>
<p>There are several reasons why a child might need a pacemaker. The two main reasons are heart block and sick sinus syndrome.</p>
<ul>
<li>Heart block: With heart block, the electrical impulses do not pass normally between the upper and lower chambers because of a blockage at the AV node. This blockage can exist before birth (congenital heart block) or can result from surgery to repair a cardiac defect. Acquired heart block can result from heart infections (such as endocarditis or myocarditis) or even from certain drugs.</li>
<li>Sick sinus syndrome: In sick sinus syndrome, the sinus node does not work properly. The result is that the heartbeats are too slow or too fast. </li>
</ul>
<h2>How does the pacemaker work?</h2>
<p>The pacemaker has two parts: the pacemaker itself and the lead (wire).</p>
<ol>
<li>The pacemaker: This is a small metal container that holds the battery and electrical circuits. It is very small, weighing less than two ounces. It is placed under the skin and muscle, either near the shoulder or near the stomach area. The pacemaker watches for the natural electrical activity of the heart, and sends electrical impulses to make the heart beat only when necessary. </li>
<li>Leads: The electrical impulse from the pacemaker travels through insulated wires with metal tips called leads that are in contact with your child's heart. Depending on the type of pacemaker, the leads may be attached to the upper chamber of the heart, the lower chamber, or both. <br></li>
</ol> | <h2>What kinds of pacemakers are available?</h2><p>Pacemakers come in many different makes and models. Your child's doctor will decide which kind of pacemaker your child should have. For more information about pacemakers, you can talk to your doctor or the pacemaker clinic staff.</p><h3>Transvenous vs. epicardial pacemaker systems</h3><p>In children, pacemakers can be placed in one of two ways:</p><ul><li>The pacing lead can be attached to the inside surface of the heart and the pacemaker is placed in the shoulder area. This is called a transvenous pacemaker system.</li><li>The pacing lead can be attached on the outside surface of the heart and the pacemaker is placed in the abdomen. This is called an epicardial pacemaker system.</li></ul>
<figure class="asset-c-80"><span class="asset-image-title">Pacemaker types</span><img src="https://assets.aboutkidshealth.ca/akhassets/Pacemakers_MED_ILL_EN.png" alt="Transvenous pacemaker passing through a vein and into the heart and epicardial pacemaker attached to the outside of the heart" /><figcaption class="asset-image-caption">A transvenous pacemaker lead is passed through a vein to the correct location inside the heart. An epicardial pacemaker lead is stitched to the outside of the heart muscle.</figcaption></figure>
<h3>Single vs. dual chamber pacemakers</h3><p>A single chamber pacemaker system has one pacing lead that is placed either in the top (atrium) or the bottom (ventricle) chamber of the heart. A dual chamber pacemaker has two pacing leads, with one lead each in the top and bottom chambers of the heart.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Single vs. dual chamber pacemakers</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Pacemakers_single_vs_dual_MED_ILL_EN.png" alt="A single chamber pacemaker compared to a dual chamber pacemaker, which pass through a vein and into the heart" />
<figcaption class="asset-image-caption">Pacemakers can have one or two leads. A single chamber pacemaker has one lead, usually in the bottom chamber of the heart. A dual chamber pacemaker has one lead in the top chamber and one lead in the bottom chamber.</figcaption></figure>
<h3>Rate-responsive pacemakers</h3><p>Pacemakers can adjust the pacing rate according to the level of the patient's activity. For example, most pacemakers have built-in sensors that can detect body motion such as walking or running and increase the pacing rate in proportion to the patient's activity.</p> | | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/Pacemakers_single_vs_dual_MED_ILL_EN.png | | | Main |
| Pain | P | Pain | Pain | pain | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | NA | Nervous system | Symptoms;Conditions and diseases | Caregivers
Adult (19+) | Pain | | 2019-02-01T05:00:00Z | | | | | | | | | | Landing Page (Overview) | Learning Hub | <p>Find information on acute and chronic pain, from how it is assessed through to how you, your child and the healthcare team can treat and manage it.<br></p> | <p>This learning hub has information on acute and chronic pain, including signs and symptoms, methods of assessment and the 3P approach to pain management. The information has been developed in close collaboration with the Pain Centre at The Hospital for Sick Children and the OUCH (Opportunities to Understand Childhood Hurt) Lab at York University. <br></p><p>The acute and chronic pain sections are organized by age, which is an important factor in how a child's pain is assessed and treated. However, when reading this information, please remember that every child's situation is unique. If you have questions about your own child's care, please speak to your child's doctor.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | pain | | | https://assets.aboutkidshealth.ca/AKHAssets/pain_learning_hub.jpg | Main |
| Pain after an operation: Taking care of your child's pain at home | P | Pain after an operation: Taking care of your child's pain at home | Pain after an operation: Taking care of your child's pain at home | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Nervous system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2012-04-09T04:00:00Z | | | | | | 6.20000000000000 | 77.7000000000000 | 1790.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Most children have at least some pain after an operation, which is called post-operative pain. Learn about relieving a child's post-operative pain at home.</p> | <p>You are taking your child home from the hospital after an operation. Your child will probably feel pain for the first few days at home. This page will give you some information about your child's pain. The brochure will also tell you how to care for your child when they are in pain. </p><h2>Write important information here</h2><p>Name of your child's surgical clinic:</p>
<br>
<p>Phone number:</p>
<br>
<p>Contact person:</p>
<br>
<div class="pdf-page-break"><h2>What you need to know about your child's pain</h2><p>Most children have at least some pain after an operation. This is called post-operative pain. How much pain your child will have, and for how long, will depend on your child and the type of operation your child had. </p><p>
<strong>Here are some things you should know about your child's post-operative pain:</strong></p><ul><li>Your child will probably have pain after their operation.</li><li>Not all children feel pain the same way.</li><li>In the days after an operation, the pain should get better, not worse.<br></li><li>Pain medicine will help your child hurt less.</li><li>Comforting your child will help them
<a href="/Article?contentid=1259&language=English">relax</a> and relieve pain.</li><li>
<a href="/Article?contentid=1259&language=English">Distracting</a> your child can also help relieve pain.</li><li>Comfort and distraction can be as important as giving medicine to your child.</li></ul></div> | <h2>Key points</h2>
<ul>
<li>If your child has had an operation they will probably have some pain for at least several days after the procedure.</li>
<li>You can give pain medicine regularly in the first few days after your child is home to help them to hurt less. After that only give the medicine when your child needs it.</li>
<li>In addition to medicine comforting your child and distraction techniques such as listening to music, playing and blowing bubbles help to reduce pain.</li>
</ul> | | | | | | <h2>When to call your doctor</h2>
<p>If the pain medicine and comforting your child do not work to lessen pain or if your child's pain gets worse, call your doctor's office. </p>
<p>Write down your doctor's name:</p>
<p>Write down your doctor's number:</p> | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pain_after_an_operation_taking_care_of_child_at_home.jpg | | Main |
| Pain and cancer | P | Pain and cancer | Pain and cancer | | English | Oncology | Pre-teen (9-12 years);Teen (13-18 years) | NA | NA | Symptoms | Pre-teen (9-12 years)
Teen (13-18 years) | Pain | | 2019-09-03T04:00:00Z | | | | | | 7.00000000000000 | 70.5000000000000 | 1420.00000000000 | | Flat Content | Health A-Z | <p>Pain can be caused by cancer, procedures, treatments or symptoms of cancer and treatments. Find out how you can manage and how your health-care team can help you.</p> | <h2>What is pain?</h2>
<figure>
<div class="asset-animation">
<iframe src="https://teens.aboutkidshealth.ca/Style%20Library/AKH/animations/How%20We%20Feel%20Pain/AMD_ICCP_how_we_feel_pain_teen_EN.aspx"></iframe>
<br></div></figure>
<p>You feel pain when nerve fibres in your body sense something unpleasant, such as a pin prick or extreme pressure, and send a message to the brain, which reads it as pain. Although pain is unpleasant, it’s actually a really useful warning sign from our bodies that something is wrong.</p><p>People are often most concerned and scared about the pain associated with cancer. You may think that if you have cancer you are bound to have pain and that nothing can be done to relieve it. But this isn’t true. </p><p>Cancer does not have to be painful. With the help of your medical team, cancer pain can be prevented or reduced so that you can do the activities that are important to you. Never think that you are being "weak" to ask for help with pain. Nobody will think you are just complaining. The sooner you speak up about your pain, the easier it is to treat! </p> | <h2>Key points</h2><ul><li>Pain is felt when nerve fibres in the body sense something such as a pin prick or extreme pressure, and then they send a message to the brain, which it reads as pain.</li><li>Cancer does not have to be painful; your health-care team can help you prevent and reduce pain.</li><li>Pain can be caused by a tumour, procedures, treatment side effects, mucositis or nerve damage.</li><li>Pain can be reduced through medications, exercises or stretches, using heat or cold, or through distraction.</li></ul> | | | | | | | | | | | | | | | | | | | | <h2>Additional resources</h2><p>This SPARK Care Recommendation is intended to help inform teens undergoing cancer treatments. Seek the care of a health-care professional if you have any questions regarding SPARK Care Recommendations or your child’s diagnosis or symptoms.</p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/SickKids_Reducing-Pain_Teen.pdf"><figure class="asset-small"><img alt="Download pain from minor procedures PDF for teens" src="https://assets.aboutkidshealth.ca/AKHAssets/SickKids_Reducing-Pain_Teen_DownloadPDF.jpg" /> </figure> </a>
| | | | | | | | | | Teens |
| Pain assessment | P | Pain assessment | Pain assessment | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Central nervous system;Peripheral nervous system;Autonomic nervous system | Symptoms | Caregivers
Adult (19+) | Pain | | 2009-09-15T04:00:00Z | | | | | | 8.30000000000000 | 63.4000000000000 | 1547.00000000000 | | Flat Content | Health A-Z | <p>Learn about the process and goals of pain assessment to provide the information necessary to initiate optimal pain treatment strategies.</p> | <p>An accurate assessment of pain is essential to determine the best pain relief method. In addition to describing the intensity of pain (how much pain and how painful it is), an assessment will tell health care professionals about whether the pain is acute or chronic and the location of the pain. Chronic and acute pain treatment strategies can be different, so it is important to understand what type of pain your child is having. Assessment will also help to distinguish between pain and related feelings of discomfort, fear, and anxiety.</p>
<p>Because of the individual nature of pain, assessment is not easy. Only your child truly knows how the pain feels. Like sadness or fear, only the individual who is experiencing it can tell how intense it is or how much it bothers them. </p>
<p>Pain assessment cannot be absolutely precise. Unlike reading a temperature with a thermometer, there is no objective measure to tell us how much pain someone is in. But using a variety of methods in combination, a reasonably accurate assessment of pain is possible. </p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Pain at home: Taking care of your child | P | Pain at home: Taking care of your child | Pain at home: Taking care of your child | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Nervous system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2010-05-07T04:00:00Z | | | | | | 5.80000000000000 | 77.4000000000000 | 1215.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>This page give advice on how to relieve a child's pain at home. </p> | <p>This brochure gives information on how to care for your child at home when they are in pain. The pain may be because of a cut from a minor fall, sprain, a sore throat, earache or a procedure they had at the hospital, such as resetting a broken bone and applying a cast. </p>
<p>Parents can help make the best pain relief decisions for their own child because they know their children best. </p>
<h2>What you need to know about your child’s pain</h2>
<ul>
<li>Not all children feel pain the same way.</li>
<li>In the days after a painful event the pain should get better, not worse.<br></li>
<li>Pain medicine will help your child hurt less.</li>
<li>Comforting your child will help them relax and relieve pain.</li>
<li><a href="/Article?contentid=1259&language=English">Distracting your child</a> can help relieve pain.</li>
<li>Comfort and distraction can be as important as giving medicine to your child.</li>
</ul> | <h2>Key points</h2>
<ul>
<li>Children do not all feel pain the same way.</li>
<li>You can find out how much pain your child is in by asking and by observing their behavior.</li>
<li>Your child’s pain can be lowered with pain medicines. Always follow the directions given to you by the nurse, doctor or pharmacist. </li>
<li>Your child’s pain can also be lowered with physical and behavioural methods. </li>
<li>Re-assess your child’s pain. </li>
</ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Pain_at_home_taking_care_of_your_child.jpg | | Main |
| Pain management after heart surgery | P | Pain management after heart surgery | Pain management after heart surgery | | English | Cardiology | Child (0-12 years);Teen (13-18 years) | Heart | Cardiovascular system | Conditions and diseases;Drug treatment | Adult (19+) | NA | | 2010-01-15T05:00:00Z | | | | | | 5.10000000000000 | 82.3000000000000 | 1335.00000000000 | | Flat Content | Health A-Z | <p>Read about pain management for children who have had heart surgery.<br></p> | <p>After heart surgery, your child will likely experience some pain. Here are ways to assess and control your child's pain after surgery.<br></p> | <h2> Key points </h2>
<ul><li>Your child will probably have pain after their operation. </li>
<li>All children do not feel pain the same way. </li>
<li>In the days after an operation, the pain should get better, not worse. </li>
<li>For mild pain, give acetaminophen; for medium pain, give ibuprofen or morphine if necessary; for strong pain, call the hospital or your doctor.</li>
<li>Comfort your child and help her to relax by taking your child’s mind off the pain or operation. This can be as important as giving medicine to your child. </li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pain_management_after_surgery.jpg | | Main |
| Pain management for common childhood pain and injuries | P | Pain management for common childhood pain and injuries | Pain management for common childhood pain and injuries | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Central nervous system;Peripheral nervous system;Autonomic nervous system | Non-drug treatment | Caregivers
Adult (19+) | Pain | | 2009-09-17T04:00:00Z | | | | | | 8.60000000000000 | 60.4000000000000 | 1263.00000000000 | | Flat Content | Health A-Z | <p>Discusses pain management for common childhood pain and injuries such as ear infections, colic, and injections.</p> | <p>Minor injuries are a normal part of growing up for most children. Bumps, scrapes, and burns, if they are not serious, can be easily managed by parents at home. All that is needed is a little knowledge and some loving parental attention.</p><p>What can be more difficult is determining whether an injury or pain requires professional medical attention. If you and your child feel that medical attention is required, you will need to visit your family doctor, or the emergency department of a hospital for more serious injuries or painful episodes. Anyone taking care of your child, such as a babysitter, should also be prepared to do this.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Pain_management_for_common_childhood_pain_and_injuries.jpg | | Main |
| Pain management in labour and delivery | P | Pain management in labour and delivery | Pain management in labour and delivery | | English | Pregnancy | Adult (19+) | Body;Uterus | Reproductive system | NA | Prenatal
Adult (19+) | NA | | 2009-09-11T04:00:00Z | | | | | | 10.3000000000000 | 49.9000000000000 | 1811.00000000000 | | Flat Content | Health A-Z | <p>Read about the various types of medical and non-medical pain management during labour. Analgesics and general anesthesia are discussed.</p> | <p>There are many different types of pain relief that can be given during labour. Your choices for pain relief will depend on what stage of labour you are in, what types of pain management you prefer, your health, and the condition of your unborn baby. </p> | <h2>Key points</h2>
<ul><li>Non-medical pain relief includes relaxation, breathing, walking, water therapy, and distraction.</li>
<li>Medical pain relief includes analgesics, inhalants, local or general anaesthesia, pudendal blocks, epidural blocks and spinal blocks.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pain_management_in_labour.jpg | | Main |
| Pain management plan | P | Pain management plan | Pain management plan | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Central nervous system;Peripheral nervous system;Autonomic nervous system | Symptoms | Caregivers
Adult (19+) | Pain | | 2009-09-17T04:00:00Z | | | | | | 9.80000000000000 | 57.6000000000000 | 171.000000000000 | | Flat Content | Health A-Z | <p>An overview of the components of a pain management plan for children.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Pain medicines | P | Pain medicines | Pain medicines | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Central nervous system;Peripheral nervous system;Autonomic nervous system | Symptoms | Caregivers
Adult (19+) | Pain | | 2009-09-21T04:00:00Z | | | | | | 10.0000000000000 | 53.8000000000000 | 2098.00000000000 | | Flat Content | Health A-Z | <p>Learn about pain relief medication and how to administer it, including patient controlled analgesia.</p> | <p>During the last few decades many new pain relief medications have become available. The decision to use one particular type of medicine over another will depend on the age of your child and the severity and type of pain they experience. Some of these medicines are available without a prescription, while others require a prescription from the doctor.</p> | <h2>Key points</h2>
<ul><li>Common types of pain medication include acetaminophen and NSAIDs, opioids and local anaesthetics.</li><li>Medications can be given through the skin, in a suppository, under the skin and through a vein.</li><li>Follow the medication instructions from your child's health-care team and tell them about any other treatments, including over-the-counter or herbal remedies, that your child may be taking.</li><li>Pain medicines may not relieve all pain but can work well with physical and psychological approaches to reduce pain to an acceptable level.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Pain relief | P | Pain relief | Pain relief | | English | Neonatology;Pain/Anaesthesia | Premature;Newborn (0-28 days);Baby (1-12 months) | Body | NA | NA | Prenatal
Adult (19+) | NA | | 2009-10-31T04:00:00Z | | | | | | 10.8000000000000 | 45.7000000000000 | 1004.00000000000 | | Flat Content | Health A-Z | <p>Read about how pain relief is administered to premature babies. Medications and behavioural and physical methods are all used. </p> | <p>Pain in premature babies is treated in much the same way as in older children and adults. Medications and behavioural and physical methods are all used. Often, parents can participate in the behavioural and physical methods of pain relief. These are discussed further down this page.</p> | <h2>Key points</h2>
<ul><li>Pain in premature babies is treated with medications as well as behavioural and physical methods.</li>
<li>Health-care professionals will try to make the NICU as comfortable as possible for babies and create opportunities for parents to physically comfort their baby.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/preemie_sleeping_peaceful_EN.jpg | | | Main |
| Pain relief: Comfort kit | P | Pain relief: Comfort kit | Pain relief: Comfort kit | | English | Pain/Anaesthesia | Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | Body | Nervous system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2018-12-18T05:00:00Z | | | | | | 6.00000000000000 | 74.1000000000000 | 782.000000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn techniques to help your child manage their pain in the hospital and at home.<br></p> | <p>Children can experience pain from an illness or injury or from hospital procedures or treatments. Each child copes with pain differently. Some children will not talk about their pain, while others will cry loudly. However, being engaged in a fun activity helps ease pain and anxiety for all children.</p><p>A comfort kit contains toys and other items that can help distract your child from their pain. These items will work in the hospital or at home and can be used alongside any pain medication your child may need. As your child gets older, it is a good idea to let them choose a few things that may work best for them to reduce pain.</p><p>Talk to your child's nurse or child life specialist for more ideas.</p>
| <h2>Key points</h2><ul>
<li>When children are involved in an activity they enjoy, their pain and anxiety decreases.</li><li>A comfort kit contains toys and other distracting objects to help your child deal with painful tests or procedures.</li><li>As your child gets older, encourage them to choose what might best distract them from their pain.</li></ul> | | | | | | | | | | | | | | | | <h2>Wand</h2><p>A wand helps your child pay attention to something other than pain and encourages imagination.</p><h3>Ideas for use</h3><ul><li>Use the wand to make the hurt disappear in the same way you might kiss something to make it better.</li><li>Concentrate on the movement of the sparkles.</li><li>Make the wand magic and pretend to travel to a favourite place.</li></ul><h2>Bubbles</h2><p>Bubbles can help teach deep breathing, which can relieve stress and anxiety.</p><h3>Ideas for use</h3><ul><li>Blow with long slow breaths.</li><li>Have the child blow the hurt away.</li><li>Predict where the bubbles will land and pop.</li><li>Have a contest to see who can blow the bubbles the furthest.</li><li>Ask your child how many bubbles they can blow at once.</li></ul><h2>Story and activity books</h2><p>Books and stories can help your child pay attention to something other than the pain and encourage imagination.</p><h3>Ideas for use</h3><ul><li>Books for younger children involve touching various textures, rhymes and pop-ups.</li><li>Books for older children involve mazes, searches and puzzles.</li><li>Pick books that are simple and familiar. A more challenging activity may be frustrating.</li><li>Ask questions about the book that your child cannot answer with just a yes, no or maybe. For example, ask, "What do you think will happen next?"</li></ul><h2>Music</h2><p>Music can help your child relax. It can be useful when a child is not able to do a more engaging activity.</p><h3>Ideas for use</h3><ul><li>Encourage your child to sing or hum along with the music.</li><li>Use soothing music for younger children.</li><li>Consider playing music in the background while focusing on another activity.</li><li>Older children might benefit from music that encourages them to move. If the music is fast-paced, encourage your child to clap, bang their fists or click their tongue to the beat of the music.</li></ul><h2>Virtual reality headset</h2><p>A virtual reality headset provides a highly engaging 3D visual distraction.</p><h3>Ideas for use</h3><ul><li>Have your child choose a slide.</li><li>Let the child tell you what they see.</li><li>Let child create their own story based on what they see.</li></ul><h2>Stress ball</h2><p>A stress ball can give your child a "job" to do or a place to transfer nervous energy.</p><h3>Ideas for use</h3><ul><li>Encourage your child to transfer pain or stress out of their body and onto the ball.</li><li>Count how long you can squeeze the ball without stopping.</li><li>Count while opening and closing your fist around the ball.</li><li>Transfer the ball from one hand to the other.</li></ul><h2>Video games, computer and television</h2><p>These things are usually familiar and can be relaxing.</p><h3>Ideas for use</h3><p>While your child is in the hospital, balance videogames, computer use and TV with more creative and expressive experiences such as dancing or drawing.<br></p> | | | <h2>SickKids comfort kit</h2><p>Each unit has a comfort kit created by the Child Life team. The kits include:</p><ul><li>bubbles</li><li>a squeeze ball</li><li>a light globe</li><li>a ‘search and find’ book</li><li>a breathing sphere (Hoberman)</li><li>a Find-it Tube</li><li>shakers</li><li>I Spy Wonder Tube</li><li>Tube Shaker</li><li>board games.</li></ul><p>The comfort kit items are available for your child to use before and during their needle poke. Once the procedure is finished, we ask that you clean and return all the items you borrowed so another child can use them.</p>
| <h2>Further information</h2><p>For more information about the Comfort Promise bundle of options to reduce the pain of needle pokes, please see the following pages:</p><p><a href="https://www.aboutkidshealth.ca/Article?contentid=989&language=English">Needle pokes: Reducing pain in infants aged up to 18 months</a><br></p><p>
<a href="https://www.aboutkidshealth.ca/Article?contentid=990&language=English">Needle pokes: Reducing pain in children aged 18 months or over</a></p><p>
<a href="https://www.aboutkidshealth.ca/Article?contentid=3627&language=English">Needle pokes: Reducing pain with numbing cream</a><br></p><p>
<a href="https://www.aboutkidshealth.ca/Article?contentid=3628&language=English">Needle pokes: Reducing pain with sucrose or breastfeeding</a></p><p>
<a href="https://www.aboutkidshealth.ca/Article?contentid=3629&language=English">Needle pokes: Reducing pain with comfort positions and distraction</a><br></p> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pain_relief_comfort_kit.jpg | | Main |
| Pain treatment | P | Pain treatment | Pain treatment | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | Body | Central nervous system;Peripheral nervous system;Autonomic nervous system | Symptoms | Caregivers
Adult (19+) | Pain | | 2009-09-16T04:00:00Z | | | | | | 12.1000000000000 | 44.2000000000000 | 512.000000000000 | | Flat Content | Health A-Z | <p>Learn about techniques for pain management and the treatment of pain.</p> | <p>Once a pain assessment has been completed, a pain management plan is developed. The plan will involve a multi-dimensional approach that may include the use of medicines (pharmacology), physical therapies, and psychological strategies that can all help relieve pain in children.</p>
<p>Further pain assessments will be conducted and the course of action will be adjusted or changed according to changing needs. For example, as a child’s injury heals and the pain subsides, the need for strong medications will be reduced. Often, the need for pain relief is short-lived and may only last for a few days. </p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Pain: How to talk to kids about their pain | P | Pain: How to talk to kids about their pain | Pain: How to talk to kids about their pain | | English | Pain/Anaesthesia | Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | Body | Nervous system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2010-03-05T05:00:00Z | | | | | | 5.50000000000000 | 78.6000000000000 | 970.000000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn about how to talk to your child about how much pain they are feeling and some strategies to help them cope with pain.</p> | <h2>Helping your child manage their pain at the hospital</h2>
<p>Most children in hospital have pain. All children should know that pain goes away and that many kids have pain just as they do. </p>
<p>You and your child will work together with the health-care team to manage pain. Feel free to ask questions and talk about your child's pain with the team. </p>
<p>Medication is not the only way to relieve pain. Other ways to manage pain are described here. The following information will also help you learn ways to talk about pain. </p> | <h2>Key points</h2>
<ul>
<li>Most children in hospital will feel some pain.</li>
<li>There are many ways to relieve pain.</li>
<li>Parents and kids can learn different ways to relieve pain.</li>
</ul> | | | | | | | | | | | | | | | | <h2>Ways to measure pain</h2><p>"How does it feel?" "How much does it hurt?" "Where does it hurt?"</p><p>These are some of the questions staff at the hospital may ask to learn more about your child's pain.</p><p>It is important for your child to be able to talk to you or a member of their health-care team about their pain so it can be treated and your child will feel better. Your child knows their own pain best, so we need to find a way to help them describe it. </p><p>The tools most often used to measure a child's pain are a faces scale or a number scale.</p><p>The faces scale is used with younger children who understand pictures better than numbers.</p>
<figure>
<span class="asset-image-title">Faces pain scale</span>
<img alt="Diagrams of cartoon faces in pain, on a scale from zero to ten" src="https://assets.aboutkidshealth.ca/akhassets/PN_faces_scale_MISC_IMG_EN.jpg" />
<figcaption class="asset-image-caption"> Faces Pain Scale - Revised. Copyright © 2001, International Association for the Study of Pain. Reproduced with permission. Source: Hicks CL, von Baeyer CL, Spafford P, van Korlaar I, Goodenough, B. The Faces Pain Scale - Revised: Toward a common metric </figcaption>
</figure>
<h3>The Number Scale</h3><p>The number scale is used with children who are school-age and older because they understand numbers and their values.</p>
<figure>
<span class="asset-image-title">Pain assessment numerical/visual analogue scale</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/PN_painscale_thermom_CHART_IMG_EN.jpg" alt="A thermometer numbered zero to ten, with no hurt marked at the bottom of the thermometer and worse hurt at the top" />
<figcaption class="asset-image-caption">Children are asked to indicate their pain intensity by putting a mark on the scale.</figcaption></figure>
<h3>Creating your own scale</h3><p>If these scales do not work well for your child, pick a theme that they enjoy or can relate to such as colours, animals or shapes. Have your child choose the item that describes their kind of pain. </p><h2>Other signs your child is in pain</h2><p>Sometimes children cannot use a scale to rate their pain. Here are some other signs that you can look for to tell if your child is in pain: </p><ul><li>not playing </li><li>being more quiet than usual </li><li>going back to using younger behaviours such as thumb-sucking or wetting the bed</li></ul> | | | | <h2>Resources</h2><p>Child life specialists find the following books to be helpful:</p><ul><li>
<em>A Child in Pain: How to Help, What to Do </em>by Leora Kuttner</li><li>
<em>Pain, Pain, Go Away: Helping Children with Pain </em>by Patrick J. McGrath, G. Allen Finley, and Judith Ritchie </li><li>
<em>Keys to Parenting your Anxious Child </em>by Katharina Manassis </li></ul><p>These websites have great information for children and families about managing pain:<br></p><ul><li>
<a href="http://www.sickkids.ca/patient-family-resources/Child-Life/index.html" target="_blank">www.sickkids.ca/childlife</a></li><li>
<a href="https://psychologyfoundation.org/Public/Resources/KHST_Download_Resources/Copy_of_Download_Resources.aspx?WebsiteKey=7ec8b7ce-729b-4aff-acd8-2f6b59cd21ab&hkey=0e18b555-9114-49b4-9838-084fab967f0e" target="_blank">www.psychologyfoundation.org/Public/Resources/KHST_Download_Resources/Copy_of_Download_Resources.aspx</a><br></li></ul>
<br> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pain_how_to_talk_to_kids.jpg | | Main |
| Pancreatitis | P | Pancreatitis | Pancreatitis | | English | Gastrointestinal | Child (0-12 years);Teen (13-18 years) | Pancreas | Pancreas | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2014-05-13T04:00:00Z | | | | | | 9.80000000000000 | 46.9000000000000 | 1354.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Learn what causes pancreatitis, what the signs and symptoms are and what treatments are available</p> | <h2>What is pancreatitis?</h2><p>Pancreatitis is an
<a href="/Article?contentid=926&language=English">inflammation</a> of the pancreas. The pancreas is an organ that is part of the gastrointestinal system and is located just behind the stomach. This organ produces
<a href="/Article?contentid=1728&language=English">insulin</a> and glucagon which are hormones that regulate blood sugar levels in the body. But the pancreas also plays a major role in digestion. It produces the necessary enzymes that help digest the food we eat.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Pancreas</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_pancreas_EN.jpg" alt="Digestive enzymes in the pancreas draining into the small intestine" />
<figcaption class="asset-image-caption">The pancreas is part of the gastrointestinal system. It produces enzymes that help digest the food we eat. The enzymes are released into the small intestine.</figcaption>
</figure>
<p>There are two types of pancreatitis: acute and chronic.</p><ul><li>Acute pancreatitis means the condition arises suddenly and usually gets better after a short period of time.<br></li><li>Chronic pancreatitis means that the condition develops gradually and keeps coming back. Chronic pancreatitis is rare in children and is usually part of an inherited condition.</li></ul><p>Specialized cells in the pancreas called acinar cells produce digestive enzymes. These enzymes are normally released into the small intestine. In pancreatitis, an event causes an injury to the acinar cells, which triggers an inflammatory reaction. This inflammation can be strong enough to damage the pancreas.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Pancreatitis</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_pancreatitis_EN.png" alt="Normal enzyme release into duodenum compared to an inflamed pancreas with enzyme accumulation in injured acinar cells" />
<figcaption class="asset-image-caption">Normally the acinar cells in the pancreas release the digestive enzymes into the duodenum, the first part of the small intestine. In pancreatitis, an event causes damage to the acinar cells and may trigger inflammation, which can be strong enough to damage the pancreas.</figcaption>
</figure> | <h2>Key points</h2>
<ul>
<li>Pancreatitis is an inflammation of the pancreas. The condition can either be acute or chronic.</li>
<li>Pancreatitis often causes intense stomach pain, nausea and vomiting.</li>
<li>There is no specific medication to treat pancreatitis. A stay in the hospital may be necessary. Treatments are intended to keep your child hydrated and to minimize pain.</li>
</ul> | <h2>Signs and symptoms</h2>
<h3>Acute pancreatitis</h3>
<p>Some signs and symptoms of pancreatitis are:</p>
<ul>
<li>intense stomach pain (<a href="/Article?contentid=825&language=English">abdominal pain</a>), which is usually in the upper abdomen, just below the sternum (breastbone). The pain may also be felt in the back.</li>
<li>nausea and <a href="/Article?contentid=746&language=English">vomiting</a>, which becomes worse after eating</li>
<li><a href="/Article?contentid=30&language=English">fever</a></li>
<li>loss of appetite</li>
</ul>
<p>Your child may be more comfortable lying on their side because moving increases the pain. Your child may also feel very ill, restless and uncomfortable.</p>
<p>Less common symptoms include:</p>
<ul>
<li>ileus (where the intestines stop contracting and may become blocked)</li>
<li>swollen belly (abdomen)</li>
<li><a href="/Article?contentid=775&language=English">jaundice</a> (condition causing the skin, body tissues and fluids to have a yellowed colour)</li>
<li>fluid build-up in the abdomen</li>
<li>build-up of fluid around the lungs that can make breathing difficult</li>
</ul>
<p>In babies and toddlers, symptoms can be more difficult to recognize. They include:</p>
<ul>
<li>irritability</li>
<li>swollen abdomen</li>
<li>fever</li>
<li>bellyache (abdominal pain)</li>
<li>loss of appetite</li>
</ul>
<h3>Chronic pancreatitis</h3>
<p>Chronic pancreatitis is also an inflammation of the pancreas. Instead of the inflammation getting better as in acute pancreatitis, the inflammation continues in some more susceptible children and causes permanent damage to the pancreas. Genetic and environmental factors may be responsible for one's susceptibility to pancreatitis. Children usually experience signs and symptoms identical to those caused by acute pancreatitis, such as intense abdominal pain that worsens after eating a meal, nausea and vomiting and episodes will be recurrent. </p>
<p>The condition lasts for long periods of time and slowly destroys the functions of the pancreas. For example, the pancreas may lose its ability to produce insulin. As a result, children can develop glucose intolerance. Chronic pancreatitis can also cause weight loss because of poor digestion. Diagnosing chronic pancreatitis relies on changes in diagnostic imaging and <a href="/Article?contentid=36&language=English">blood work</a> in addition to clinical symptoms.</p> | <h2>Causes of pancreatitis</h2>
<h3>Pancreatitis can be due to other conditions</h3>
<p>A number of conditions may trigger pancreatitis; some of these are associated with other conditions.</p>
<ul>
<li>Biliary disease. Ten per cent to 30% of children with pancreatitis may suffer from gallstones. Treating the condition may help restore normal pancreatic function.</li>
<li>Multisystem diseases. Twenty per cent of cases of acute pancreatitis may be due to conditions affecting several organs or organ systems, such as sepsis, <a href="/Article?contentid=934&language=English">hemolytic-uremic syndrome</a> or <a href="/Article?contentid=920&language=English">systemic lupus erythematous</a>.</li>
<li>Metabolic diseases. Metabolic disorders may be responsible for 2% to 7% of acute pancreatitis cases. Examples include errors of metabolism children are born with high lipid levels or high calcium levels.</li>
<li>Infections. Acute pancreatitis is sometimes diagnosed when a child suffers from an infection. However, it is difficult to establish a direct relationship between the two conditions. Some of the infectious diseases that have been linked to pancreatitis include: <a href="/Article?contentid=753&language=English">mumps</a>, <a href="/Article?contentid=758&language=English">rubella</a>, CMV, <a href="/Article?contentid=910&language=English">HIV</a>, adenovirus and coxsackie virus B.</li>
<li>Anatomic abnormalities. Abnormalities in the structure of the pancreas or biliary tract can lead to pancreatitis.</li>
</ul>
<h3>Pancreatitis can be due to medication</h3>
<p>Medications are thought to cause one quarter of the cases of pancreatitis. The most common medications that are thought to cause pancreatitis are <a href="/Article?contentid=258&language=English">valproic acid</a>, L-asparaginase, prednisone and <a href="/Article?contentid=182&language=English">6-mercaptopurine</a>. It is not fully understood why these medications may cause pancreatitis. One reason may be because children treated with these drugs have other conditions that may predispose them to pancreatitis.</p>
<h3>Pancreatitis can be due to trauma</h3>
<p>Another possible cause of pancreatitis is trauma. An injury to the pancreas may provoke acute pancreatitis. This type of injury may happen in a car crash, sports, falls or child abuse.</p>
<h3> Other causes </h3>
<p>Pancreatitis may be hereditary, which means it was passed on by one or both parents. It can be associated with hereditary conditions such as <a href="/Article?contentid=882&language=English">cystic fibrosis</a>. It can also be caused by a genetic mutation that is found in the child but not in the parents.</p>
<p>Finally, there are a large number of cases of pancreatitis where the cause is unknown. This is called idiopathic pancreatitis.</p> | <h2>Diagnosis</h2>
<p>The doctor who examines your child will use the signs and symptoms in addition to lab and imaging tests to diagnose your child.</p>
<p>To determine if the pancreas is working properly, a blood test can measure the levels of the digestive enzymes amylase and lipase. If the levels of these enzymes are high then there is probably something is wrong with the pancreas.</p>
<p>Your child will probably have an <a href="/Article?contentid=1290&language=English">ultrasound</a>, <a href="/Article?contentid=1272&language=English">CT scan</a> (computed tomography scan) or MRCP (magnetic resonance cholangiopancreatography). An ultrasound can help rule out other possible causes of stomach pains, such as appendicitis or gallstones. It also shows if the pancreas has changed in position or size because of swelling.</p> | <h2>Treatment</h2>
<h3>Treatment of acute pancreatitis</h3>
<p>Your child may need to stay in the hospital for monitoring and to receive appropriate care and fluids for hydration. Usually, children get better in two to four days.</p>
<p>There are no specific medications to treat pancreatitis. The initial part of treatment is pancreatic rest. This means your child will eat nothing by mouth. Your child will likely have an intravenous (IV) line inserted in the vein of an arm or leg. Your child will get fluids, anti-nausea medicines and pain medication.</p>
<h3>Treatment of chronic pancreatitis</h3>
<p>Children with chronic pancreatitis may have episodes of acute pancreatitis that would be treated as described above. Management of chronic pancreatitis requires a long term-plan.</p>
<p>Your child's doctor will try and identify the cause of the condition. They will help manage the pain. They will monitor pancreatic functions over the long-term to make sure they detect any pancreas-related digestive problem and diabetes as early as possible.</p>
<p>Your child may be given antibiotics in case of infection. Also, it is recommended to avoid alcohol and smoking because it may worsen the condition. Your child's doctor will talk to you about what other treatment options are best for your child's situation.</p> | <h2>Complications</h2>
<p>Complications of acute pancreatitis are uncommon in children. The most common complication is a collection of fluid that forms around the pancreas. This is called a pseudocyst. A pseudocyst can become infected, bleed or rupture. The fluid may go away on its own with time. However, if the fluid collection is large or if it is causing symptoms, then your doctor might suggest draining the fluid to avoid further complications.</p> | <h2>When to see a doctor</h2><h3>See a doctor if your child has the following symptoms:</h3><ul><li>severe pain in the upper part of the belly</li><li>nausea and vomiting</li><li>loss of appetite</li><li>jaundice</li></ul><p>Your child may show physical changes when their condition is serious or when their condition gets worse. Parents and caregivers can learn how to
<a href="https://www.healthcareexcellence.ca/media/s3bbk5nv/20221216_signsmaterialsqr_en.pdf">spot these signs</a> in order to seek help from a health-care provider.</p> | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/IMD_pancreatitis_EN.png | | | Main |
| Parental advocacy for pain management | P | Parental advocacy for pain management | Parental advocacy for pain management | | English | Neonatology;Pain/Anaesthesia | Premature;Newborn (0-28 days);Baby (1-12 months) | NA | NA | NA | Prenatal
Adult (19+) | NA | | 2009-10-31T04:00:00Z | | | | | | 10.4000000000000 | 50.9000000000000 | 433.000000000000 | | Flat Content | Health A-Z | <p>Read about the role that parents can play in easing their baby's pain. Parents should always ask how they can help relieve their baby's pain.</p> | <p>Parents are in an ideal position to act as advocates for their premature baby’s pain relief. In most cases, parental advocacy means being aware of the infant’s condition and communicating that information to health care professionals in a timely manner. </p> | <h2>Key points</h2>
<ul><li>It is important for parents to not only provide physical comfort for their baby, but to communicate with their health-care providers and advocate for their baby.</li>
<li>Parents should be aware of the challenges of pain management and try to have realistic expectations about pain relief.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/parental_advocacy_for_pain_management.jpg | | Main |
| Parenting & life skills | P | Parenting & life skills | Parenting & life skills | parenting | English | NA | Child (0-12 years);Teen (13-18 years) | NA | NA | Healthy living and prevention | Caregivers
Adult (19+) | NA | | | | | | | | | | | | Landing Page | Learning Hub | <p>Learn about attachment, and the social and emotional development of babies. Explore topics such as bullying, anger management, resilience, puberty, sexuality and sleep.</p> | <p>Having a baby and starting a family is a wonderful experience, but it will also introduce a lot of changes into your life. Learn about attachment, and the social and emotional development of babies. Explore resources about topics such as bullying, anger management, general life skills such as resilience, puberty, sexuality and sleep.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | parenting | | | https://assets.aboutkidshealth.ca/AKHAssets/parenting_life_skills_landing-page.jpg | Main |
| Parenting a child with leukemia | P | Parenting a child with leukemia | Parenting a child with leukemia | | English | Oncology | Child (0-12 years);Teen (13-18 years) | Body | Skeletal system | Conditions and diseases | Adult (19+) | NA | | 2018-03-06T05:00:00Z | | | | | | 7.20000000000000 | 69.1000000000000 | 774.000000000000 | | Flat Content | Health A-Z | <p> Learn about ways you can manage the stress of parenting your child with leukemia.</p> | <p>Your child’s treatment can affect the entire family. Numerous visits to the hospital and concerns about your child’s health may cause you to feel more anxious and fatigued. </p>
<p>The combination of sadness, guilt, and anger that your child feels may build up as treatment continues. Your family dynamic may change after your child is diagnosed. </p> | <h2> Key points </h2>
<ul><li>Ways to cope with parenting a child with leukemia include being knowledgeable about their disease, maintaining a positive attitude, setting a routine, being patient, accepting help, taking care of yourself, and finding a balance between overprotecting and overindulging.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Parenting your child with a blood and marrow transplant | P | Parenting your child with a blood and marrow transplant | Parenting your child with a blood and marrow transplant | | English | Haematology;Immunology;Oncology | Child (0-12 years);Teen (13-18 years) | Body | Immune system | NA | Adult (19+) | NA | | 2009-11-30T05:00:00Z | | | | | | 6.60000000000000 | 73.9000000000000 | 654.000000000000 | | Flat Content | Health A-Z | <p>Learn tips on how you can cope, after your child's blood and marrow transplant (BMT).</p> | <p>Waiting in the hospital after your child's blood and marrow transplant (BMT) is a challenging time for many parents. Learning about your child's daily routine such as medicines, tests and possible complications can be overwhelming. You also may feel anxious about the strict precautions you have to take until your child's immune system recovers.</p><p>To be a good caregiver to your child, it is important that you take care of yourself. Find someone you can talk to, who is a good listener and lets you talk about how you feel. You may find certain friends or a small circle of friends very helpful. Or you might take comfort in the families of other transplant patients. Professional counseling or talking with clergy may also help.</p><p>Here are some tips that can help you cope while your child is in the hospital:</p> | <h2>Key points</h2>
<ul><li>It is important for parents and caregivers to maintain a positive attitude around their child, stay informed, and advocate for their child.</li>
<li>In order to be an effective caregiver, you must take time for yourself and accept help when you can.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/parenting_your_child_with%20_a_blood_and_marrow_transplant.jpg | | Main |
| Partial epilepsy syndromes | P | Partial epilepsy syndromes | Partial epilepsy syndromes | | English | Neurology | Child (0-12 years);Teen (13-18 years) | Brain | Nervous system | Conditions and diseases | Caregivers
Adult (19+)
Educators | NA | | 2010-02-04T05:00:00Z | | | | | | 10.0000000000000 | 49.7000000000000 | 824.000000000000 | | Flat Content | Health A-Z | <p>Read about the causes, symptoms and treatments for partial epilepsy syndromes.</p> | <p>Partial or focal epilepsy syndromes are described in terms of the part of the brain they involve (the seizure focus). Many partial seizures arise in the temporal lobe. However, seizures can also arise in other lobes of the brain. These are called extratemporal seizures. Symptomatic seizures are most common, but others include idiopathic and cryptogenic seizures.<br></p> | <h2>Key points</h2><ul><li>Partial epilepsy syndromes are described in terms of the part of the brain they involve, for example frontal lobe epilepsy, parietal lobe epilepsy or occipital lobe epilepsy.</li><li>The two most common causes of seizures outside the temporal lobe are brain tumours and malformations at or around birth.</li><li>Depending on the cause of the seizures, a child may be treated with anti-epilepsy medications or surgery.<br></li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Participating in a clinical trial | P | Participating in a clinical trial | Participating in a clinical trial | | English | Neonatology | Premature;Newborn (0-28 days);Baby (1-12 months) | NA | NA | NA | Prenatal
Adult (19+) | NA | | 2009-10-31T04:00:00Z | | | | | | 9.20000000000000 | 53.8000000000000 | 838.000000000000 | | Flat Content | Health A-Z | <p>Learn about a difficult decision some parents face: whether to agree to allow their premature baby to participate in a clinical trial. </p> | <p>It can be a difficult decision deciding whether to allow your premature baby to participate in a clinical trial. Before making any decision, make sure the doctor or research nurse addresses all your questions and worries. Consider the advantages and disadvantages of clinical trials.</p> | <h2>Key points</h2>
<ul><li>There are several questions you should ask before allowing your premature baby to participate in a clinical trial so that you can understand the advantages and disadvantages for your baby.</li>
<li>Saying no to a clinical trial or other research will not have any negative impact on the care or treatment your baby receives.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Parvovirus infection (fifth disease, erythema infectiosum) | P | Parvovirus infection (fifth disease, erythema infectiosum) | Parvovirus infection (fifth disease, erythema infectiosum) | | English | Infectious Diseases | School age child (5-8 years);Pre-teen (9-12 years);Teen (13-15 years) | Skin | Immune system | Conditions and diseases | Caregivers
Adult (19+) | Fever;Headache;Rash | | 2020-09-02T04:00:00Z | | | | | | 7.70000000000000 | 59.1000000000000 | 509.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Parvovirus B19 is a virus that causes fifth disease (slapped cheek syndrome). Learn about the symptoms, causes and treatment of Parvovirus B19.</p> | <h2>What is Parvovirus B19?</h2>
<p>Parvovirus B19 is a virus that causes fifth disease or erythema infectiosum. Fifth disease is also known as "slapped cheek syndrome." This is because it causes a red rash on the cheeks. Parvovirus B19 can spread from person to person. It spreads through droplets in the air or on surfaces we touch. </p> | <h2>Key points</h2>
<ul>
<li>Parvovirus B19 infection is a viral infection that is usually mild.</li>
<li>People with blood disorders and pregnant women are at risk of complications.</li>
<li>Once the rash appears, the child is no longer contagious.</li>
</ul> | <h2>Signs and symptoms of Parvovirus B19<br></h2>
<ul>
<li><a href="/Article?contentid=30&language=English">mild fever</a>, chills, headaches and other flu-like symptoms (these usually appear four to 14 days after the virus enters the body, and can last up to three weeks)<br></li>
<li>rash that starts after seven to 10 days of symptoms. The rash typically starts on the cheeks, then spreads to the torso and looks red, blotchy and lace-like. The rash then spreads to the arms and the rest of the body<br></li>
<li>the rash can be more well-defined after a warm bath (it can be itchy and last from seven to 21 days)</li>
<li>joint pain or swelling</li>
</ul> | | | <h2>How to help your child with Parvovirus B19<br></h2><p>Offer your child fluids often. This helps to avoid dehydration. Treat fever or pain with
<a href="/Article?contentid=62&language=English">acetaminophen</a> or
<a href="/Article?contentid=153&language=English">ibuprofen</a>. </p><p>Because Parvovirus B19 is caused by a virus, antibiotics will not work. There is no effective lotion or medication for the rash. </p><p>Children who are otherwise healthy usually get better after a few weeks. </p> | <h2>Complications</h2>
<p>Parvovirus B19 can make children with immune system problems or blood disorders such as <a href="/Article?contentid=745&language=English">sickle cell disease</a> or <a href="/Article?contentid=840&language=English">thalassemia</a> more sick. </p>
<p>The virus can spread from a pregnant woman to her unborn child. If this happens, it can lead to severe and life-threatening conditions in the unborn baby.<br></p> | <h2>When to seek medical assistance</h2><p>Call your child's regular doctor if: </p><ul><li>your child has a blood disorder or a weakened immune system and you are concerned they may have Parvovirus B19 or have been in contact with someone with Parvovirus B19<br></li></ul><p>Call your doctor if:</p><ul><li>you are pregnant and have been in contact with someone with Parvovirus B19<br></li></ul><p>Go to the nearest Emergency Department or call 911 if your child:</p><ul><li>is unable to drink or eat and is becoming dehydrated</li><li>has trouble breathing</li><li>becomes very pale, tired or weak</li></ul> | | | | | | | | | | | | | | | | | | | | parvovirus | | https://assets.aboutkidshealth.ca/AKHAssets/fifth_disease.jpg | | Main |
| Pasteurized food and babies | P | Pasteurized food and babies | Pasteurized food and babies | | English | Nutrition | Child (0-12 years);Teen (13-18 years) | NA | NA | Healthy living and prevention | Caregivers
Adult (19+)
Educators
Hospital healthcare providers
Community healthcare providers
Remote populations
First nations | NA | | 2013-09-27T04:00:00Z | | | | | | 8.70000000000000 | 59.0000000000000 | 533.000000000000 | | Flat Content | Health A-Z | <p>Learn the difference between pasteurized and unpasteurized foods so you can safely feed your baby solids.</p> | <p>When you
<a href="/Article?contentid=497&language=English">introduce solids</a> into your baby's diet, you will need to know the difference between pasteurized and unpasteurized food. Knowing which foods are safe for your baby will help to keep them healthy.</p>
<br> | <h2>Key points</h2>
<ul><li>Pasteurization uses heat to remove harmful bacteria from food without destroying nutrients.</li>
<li>It is important to feed a baby only pasteurized food while their immune system is still developing.</li>
<li>Some soft cheeses are not pasteurized. Always read the label to check.</li>
<li>Never give honey to any baby under 12 months of age. Even if it has been pasteurized, honey can give a baby <em>Listeria</em>.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pasturized_food_babies.jpg | | Main |
| Patent ductus arteriosus (PDA) | P | Patent ductus arteriosus (PDA) | Patent ductus arteriosus (PDA) | | English | Cardiology | Child (0-12 years) | Heart | Cardiovascular system | Conditions and diseases | Adult (19+) | NA | | 2009-12-04T05:00:00Z | | | | | | 9.30000000000000 | 52.5000000000000 | 484.000000000000 | | Flat Content | Health A-Z | <p>Learn about patent ductus arteriosus (PDA). This condition involves the ductus arteriosus remaining open. For some children, this condition is beneficial.</p> | <p> Patent ductus arteriosus (PDA) is when the ductus arteriosus remains open after birth.</p> | <h2> Key points </h2>
<ul><li>Patent ductus arteriosus (PDA) is the name for a ductus arteriosus that remains open after birth, allowing for oxygen-rich blood to reach the lungs.</li>
<li> When the opening is large, babies can experience congestive heart failure.</li>
<li>If the ductus arteriosus does not close on its own, treatment can be drugs or cardiac catheterization.</li>
<li>In the majority of cases, children who have a PDA repaired can be considered "cured."</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Patent ductus arteriosus (PDA): Closure in the heart catheterization lab | P | Patent ductus arteriosus (PDA): Closure in the heart catheterization lab | Patent ductus arteriosus (PDA): Closure in the heart catheterization lab | | English | Cardiology | Baby (1-12 months);Toddler (13-24 months) | Heart | Heart | Procedures | Caregivers
Adult (19+) | NA | | 2009-11-10T05:00:00Z | | | | | | 7.00000000000000 | 70.6000000000000 | 908.000000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Patent ductus arteriosus (PDA) is when the ductus arteriosus does not close properly after birth. Learn about the operation to correct PDA and recovery.</p> | <h2>What is a patent ductus arteriosus?</h2><p>In the womb, baby's oxygen comes from the mother. Since there is no need for blood to pass through the lungs of the fetus, the blood is diverted away from the lungs, to the rest of the body, by an artery called the ductus arteriosus.</p><p>Once a baby is born and takes their first breath, the ductus arteriosus is no longer needed and begins to close. Under normal circumstances, the ductus arteriosus is completely closed in a few weeks.</p><p>With some babies, this process of closure either does not happen at all or does not happen completely, leaving a small opening. As a result, normal blood flow is affected. This condition is called patent ductus arteriosus (PDA). Patent, in this context, means open.</p><p>Sometimes, the body just needs a little extra time for the PDA to close. Certain medications can also be used to encourage a PDA to close. If time or medications do not close the PDA, heart catheterization or surgery may be used. This information describes what happens during heart catheterization to close a PDA.</p>
<figure class="asset-c-100">
<span class="asset-image-title">PDA closure with catheterization</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Patent_ductus_closure_MED_ILL_EN.png" alt="A heart with patent ductus arteriosus and a heart with a catheter and plug inserted to close the PDA" />
<figcaption class="asset-image-caption">A catheter is threaded through a blood vessel in the body up to the heart. A closure device is threaded through the catheter and placed into the PDA. Once the device is in place, the catheter is taken out.</figcaption>
</figure>
<h2>What is heart catheterization?</h2><p>During
<a href="/Article?contentid=59&language=English">heart catheterization</a>, the doctor carefully puts a long, thin tube called a catheter into a vein or artery in your child's neck or groin. The groin is the area at the top of the leg. Then, the catheter is threaded through the vein or artery to your child's heart.</p><p>The doctor who does the procedure is a cardiologist, which means a doctor who works on the heart and blood vessels. This may not be your child's regular cardiologist.</p> | <h2>Key points</h2>
<ul>
<li>If a PDA does not close on its own, a small closure device can be placed in the heart catheterization lab. </li>
<li>Your child will need a general anaesthetic for the procedure. </li>
<li>Although there are some risks, serious problems are rare. </li>
<li>Most children can go home on the same day as the procedure. </li>
</ul> | | | | | | | | | | | | | | | | <h2>What does the closure device look like and how does it stay in place?</h2>
<p>The closure device is made of metal and mesh material. It looks like a short tube with different-sized discs (circles) on either end. Before it is put in, the discs are folded so the device will fit in the catheter. When it is in the right place, one disc opens up as the device is moved out of the catheter. The tube portion plugs the PDA, and the other disc opens up on the opposite side. The PDA is now closed, with the device acting as a plug. This stops the blood from flowing through the PDA. </p>
<h2>What happens during the procedure</h2>
<p>The procedure is performed while your child is under a general anaesthetic. This means that your child will be asleep during the procedure. </p>
<p>During the procedure, the doctor inserts a catheter into a blood vessel in the groin at the top of your child's leg. The catheter is moved up the blood vessel into the heart and into the PDA. An X-ray picture is then taken of the PDA. A closure device is threaded through the catheter and placed into the PDA. </p>
<p>Once the device is in place, the doctor takes out the catheter and covers the cut on your child's leg with a bandage.</p>
<h2>The procedure takes about one to three hours</h2>
<p>The procedure usually takes one to three hours. After the procedure, your child will go to the recovery room for one to six hours to wake up from the anaesthesia. </p> | <h2>After the procedure</h2>
<p>The cardiologist will let you know when your child can go home. Your child will stay in the hospital for at least four to six hours <a href="/Article?contentid=1214&language=English">after the procedure</a>. Most children can go home on the same day as the procedure. </p>
<p>If your child needs to stay overnight, they will be transferred to the inpatient unit.</p>
<p>Your child will need to have an X-ray the morning after the procedure to make sure the closure device has not moved. If your child goes home overnight, you will need to bring your child back in the morning to have the X-ray. </p> | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/Patent_ductus_closure_MED_ILL_EN.png | | | Main |
| Patient-controlled and nurse-controlled analgesia | P | Patient-controlled and nurse-controlled analgesia | Patient-controlled and nurse-controlled analgesia | | English | Pain/Anaesthesia | Child (0-12 years);Teen (13-18 years) | NA | NA | Drug treatment | Caregivers
Adult (19+) | NA | | 2017-03-17T04:00:00Z | | | | | | 9.10000000000000 | 58.2000000000000 | 1523.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Find out how PCA and NCA help your child get relief from severe, short-term pain in the hospital. </p> | <h2>What is analgesia?</h2><p>Analgesia is another name for pain relief. While your child recovers from surgery in the hospital, they may be given
opioid medication such as
<a href="/Article?contentid=194&language=English">morphine</a>, hydromorphone or
<a href="/Article?contentid=135&language=English">fentanyl</a> to relieve severe, acute (short-term) pain. These drugs are usually used for a limited time.</p>
<figure>
<img alt="A machine with a hand-held button to provide pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_PCA-NCA_Machine_EN.jpg" />
<figcaption class="asset-image-caption">A machine with a hand-held button to provide pain medicine.</figcaption> </figure> | <h2>Key points</h2>
<ul>
<li>Patient-controlled analgesia (PCA) and nurse-controlled analgesia (NCA) allow a child to receive opioid medication to relieve severe pain in hospital.</li>
<li>PCA allows the patient to decide when and how much medication they receive. NCA is used if a patient cannot deliver their own medication.</li>
<li>For safety reasons, only the patient should press the PCA button and only a nurse should press the NCA button.</li>
<li>Sometimes, medications in PCA and NCA pumps can cause nausea, vomiting, constipation and drowsiness. Your child’s nurse will monitor your child closely to check for any side effects and make sure the medication is working properly.</li>
</ul> | | | | | | | | | | | | | | | | <h2>How do PCA and NCA work?</h2><p>For both PCA and NCA, medication is delivered through a special pump that is connected to an intravenous line (IV). This is a small tube put into a vein in your child’s arm or leg to give medicine or fluids. When a button attached to the pump is pressed, your child receives a small dose of medication through the IV line.</p><p>Usually your child will get pain relief right away, but other times it may take a few minutes for the medication to take effect.</p><p>The pump provides opioid medication in “as needed” doses, but it can also be programmed to provide a constant infusion, or flow, of opioid medication. You can ask your child’s nurse or a healthcare provider from your hospital’s pain service how your child’s pump is set up.</p><h2>How safe are PCA and NCA?</h2><p>When used properly, PCA and NCA therapy are very safe forms of pain relief. Two safety features built into the pump prevent your child from ever receiving too much medication.</p><ul><li>A lock-out period gives the medication time to work and prevents it from being delivered even if the button is pressed repeatedly.</li><li>A maximum dose setting (decided by your child’s health-care team) limits the total amount of medication your child receives.</li></ul><h2>How do I make sure my child uses PCA or NCA properly?</h2><h3>Patient-controlled analgesia</h3><ul><li>Only the patient (your child) decides when they need pain relief and pushes the button on the pump to deliver the medication. This is very important for safety reasons.</li><li>Your child should always be able to easily reach the button on their pump.</li><li>Your child can press the button before a painful activity or procedure, such as coughing, walking, physical therapy or dressing changes.</li><li>If, after one button push, the pain is not relieved in a few minutes, your child can press the button again.</li><li>If your child’s pain is not relieved after a few pushes, you or your child should let the nurse know.</li></ul>
<figure>
<img alt="A patient using a machine with a hand-held button to receive pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_PatientControlledA_EN.jpg" />
<figcaption class="asset-image-caption">A patient using patient-controlled analgesia to receive pain medicine.</figcaption> </figure>
<h3>Nurse-controlled analgesia</h3><ul><li>Only your child’s nurse pushes the button on the pump. This allows the nurse to monitor your child closely.</li></ul><h2>How effective are PCA and NCA?</h2><p>PCA and NCA offer fast and effective pain relief when they are used as instructed and for the exact pain for which they were prescribed.</p><p>Remember that they may not be helpful for other pains. For instance, the opioid medication in a PCA or NCA pump might not ease pain from a non-surgical headache or from stomach pain due to nausea or gas.</p><h3>Other options for pain relief</h3>
<figure>
<img alt="A nurse using a machine with a hand-held button to give a patient pain medicine." src="https://assets.aboutkidshealth.ca/akhassets/PMD_NurseControlledA_EN.jpg" />
<figcaption class="asset-image-caption">A nurse using nurse-controlled analgesia to provide pain medicine to a patient.</figcaption> </figure>
<p>If your child experiences new or different pains, they may be prescribed other medications such as
<a href="/Article?contentid=62&language=English">acetaminophen</a>, ketorolac (an intravenous anti-inflammatory medication) or
<a href="/Article?contentid=153&language=English">ibuprofen</a>. If used correctly, these medications may help reduce the amount of opioid medication that your child needs.</p> | | | <h2>At SickKids</h2>
<p>The Acute Pain Service (APS) is a team of pain specialists that looks after all patients with PCA and NCA and provides care to many other hospital patients who have pain. </p>
<p>The service includes anaesthesiologists (doctors who provide sleep medicine and control pain for surgery, procedures and certain illnesses), advanced practice nurses and a psychiatrist. They work closely with other members of your child’s healthcare team to make sure your child’s pain is managed effectively.</p>
<p>If you are using PCA or NCA, you can expect a daily visit from the APS. The team also has an anaesthesiologist on-call overnight to deal with any urgent concerns.</p> | | | | | | | | | | | Main |
| Pavlik harness | P | Pavlik harness | Pavlik harness | | English | Orthopaedics/Musculoskeletal | Newborn (0-28 days);Baby (1-12 months) | Hip | Skeletal system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2022-10-17T04:00:00Z | | | | | | 6.80000000000000 | 74.8000000000000 | 1494.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn how to care for your baby and use the Pavlik harness orthosis.</p> | <h2>Why does my baby need a Pavlik harness?</h2><p>The health-care team may recommend the Pavlik harness for your baby when either one or both hips are
<a href="/article?contentid=944&language=english">dysplastic or even dislocated</a>. Even if only one hip is affected, it is important to have both legs in the harness to ensure that the affected hip is stabilized. </p><h2>What is the Pavlik harness?</h2><p>The Pavlik harness orthosis is used to correct
<a href="/article?contentid=944&language=english">developmental dysplasia of the hip (DDH)</a>. It is a set of soft straps that help to keep your baby’s legs in a hip-healthy position with the legs bent up and apart and gently falling out to the sides. This helps to keep your baby’s hip in the socket to allow for normal hip development. It is usually used to treat newborn babies as old as six months. </p>
<figure class="asset-c-80"><span class="asset-image-title">Pavlik harness orthosis</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/Pavlik_harness.jpg" alt="Identification of shoulder strap, chest strap, abduction strap, flexion strap and bootie strap on a Pavlik harness on a baby" /><figcaption class="asset-image-caption">The Pavlik harness is used to correct developmental dysplasia of the hip joints.</figcaption></figure> | <h2>Key points</h2><ul><li>The Pavlik harness is an orthosis to help correct developmental dysplasia of the hip by supporting your baby's hip joints in the correct position. </li><li>The harness will be adjusted as your baby grows. Watch your baby for signs of skin irritation or a trapped nerve (femoral nerve palsy).</li><li>If you have any questions or concerns, contact the Baby Hip Clinic team.
</li></ul> | | | | | | | | | | | | | | | | <h2>Application</h2><p>The Pavlik harness is applied by the orthotist at your appointment and the straps are adjusted and marked at the correct length. Your baby will be required to wear the Pavlik harness 24 hours per day at the beginning of treatment. Once the health-care team confirms your baby’s hips have been stable in the harness for a certain amount of time, you can remove the harness for one hour a day until the end of treatment.</p><h2>How to correctly put a Pavlik harness on your baby:</h2><ol><li>Open all the straps and lay your baby face up on the harness with the chest strap across the chest.</li><li>Fasten the chest strap. The top of the chest strap should be at the nipple line.</li><li>You should be able to fit two of your fingers underneath the chest strap when it is fastened. This will ensure your baby can breathe properly in the harness.</li><li>Fasten the shoulder straps to the chest strap. You should be able to fit one of your fingers underneath the shoulder straps when they are fastened. </li><li>Place your baby's legs into the leg portion of the harness (booties) so that the toes are in the "socks."</li><li>Secure the leg straps snugly, but not too tightly.</li><li>Thread the front and back straps through the leg portion of the harness and secure them. The leg straps have colour-coded tabs: Red-Red, Blue-Blue. The blue tabs will be on the left leg and the red tabs will be on the right leg. </li></ol><p>The straps on the harness will be marked to help you fasten them. As your baby grows, the tightness of the leg straps can be adjusted when needed. Your orthotist will help with adjustments when necessary. Do not adjust any of the straps on the harness without first speaking with your health-care team. A video showing the correct procedure to apply the Pavlik harness is shown below. </p><p>A video showing the correct procedure to apply the Pavlik harness is shown below.</p><div class="asset-video">
<iframe src="https://www.youtube.com/embed/C0WbnQwS920?rel=0" frameborder="0"></iframe>
</div> | | | <h2>Baby Hip Clinic</h2> For SickKids patients seen at the
<a href="https://www.sickkids.ca/en/care-services/clinics/baby-hip-clinic/">Baby Hip Clinic</a>, contact the clinic team with any questions or concerns at
<a href="mailto:babyhip.clinic@sickkids.ca">babyhip.clinic@sickkids.ca</a>.<p></p> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Pavlik_harness.jpg | | | Main |
| Peanut allergy | P | Peanut allergy | Peanut allergy | | English | Allergy | Child (0-12 years);Teen (13-18 years) | Body | Immune system | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2021-03-08T05:00:00Z | | | | | | 9.40000000000000 | 56.3000000000000 | 1168.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>A peanut allergy is a life-long reaction to the proteins in found peanuts. Find out how to help your child manage it.<br></p> | <h2>What is a peanut allergy?</h2><p>A peanut allergy occurs when the body reacts to the proteins in peanuts. This allergy is treated separately from other
<a href="/Article?contentid=812&language=English">nut allergies</a>. While other nuts grow on trees, peanuts (like beans, peas and lentils) belong to the legume family and grow underground.</p><h2>How serious is a peanut allergy?</h2><p>Peanut allergy reactions are different for each child, but they usually happen soon after exposure to peanuts. A peanut allergy carries the risk of
<a href="/Article?contentid=781&language=English">anaphylaxis</a>, a severe and life-threatening allergic reaction.</p><p>Some children are so sensitive to peanuts that inhaling a small amount of peanut protein (for example, a tiny amount of shelled peanut released in the air by deep frying peanuts) can trigger a reaction. However, a person with a peanut allergy will not develop symptoms when exposed to the smell of peanuts, for example in peanut butter. The smell may trigger a response in a child with a peanut allergy because of their fear of peanuts, but this is not the same as physical allergic symptoms.</p><h2>Peanut and tree nut allergies</h2><p>Some children who have peanut allergies also have <a href="/Article?contentid=812&language=English">tree nut allergies</a>. Peanuts are not tree nuts; they are actually legumes (like peas and lentils), but the proteins in peanuts are similar to the ones in tree nuts. This is why some children are allergic to both.</p> | <h2>Key points</h2>
<ul>
<li>A peanut allergy can be life long and carries the risk of anaphylaxis, a severe and sometimes life-threatening allergic reaction. </li>
<li>Peanuts are treated as a separate allergen from tree nuts because they are part of the legume family.</li>
<li>Many different products contain peanuts, including baked goods, curries, egg rolls, cereals, chocolate, sauces and hydrolyzed plant or vegetable protein.</li>
<li>To prevent an allergic reaction, always read food product labels, avoid foods if you are not sure of the ingredients and avoid using utensils or containers that might have come in contact with peanuts.</li>
<li>If your child's diet is limited because of a peanut, a registered dietitian can offer advice on getting a balanced diet.</li>
</ul> | | <h2>Possible sources of peanuts</h2><p>Peanuts are used in a range of dishes, packaged food and snacks. Below is a list of some of the many food products that contain peanuts.</p><table class="akh-table"><tbody><tr><td>African, Chinese, Indonesian, Mexican, Thai and Vietnamese dishes, for example curries, chilies, egg rolls or satays</td><td>Artificial nuts (peanuts that have been altered to look and taste like almonds, pecans and walnuts), such as mandelona or Nu-Nuts</td></tr><tr><td>Baked goods and baking mixes</td><td>Cereals and muesli</td></tr><tr><td>Chocolate and other snack foods</td><td>Desserts</td></tr><tr><td>Fried foods</td><td>Hydrolyzed plant protein/vegetable protein (source may be peanut)</td></tr><tr><td>Nut meats, nut butter</td><td>Peanut oil</td></tr><tr><td>Soup, sauces and gravy</td><td></td></tr></tbody></table> | | <h2>What do I do if my child has a peanut allergy?</h2><p>Your child should see an allergist (a doctor who specializes in diagnosing and treating allergies) who can discuss the peanut allergy with you in more detail. Children who have a peanut allergy should avoid all products that may contain peanut.</p><p>Your child’s doctor will also prescribe a medication called an <a href="https://www.aboutkidshealth.ca/Article?contentid=130&language=English">epinephrine auto-injector</a>, which can be used to treat allergic reactions, in case your child accidentally eats a food containing peanut.</p><h2>If my child has an allergy to peanuts, must they avoid all other nuts?</h2><p>People who are allergic to peanuts might not have an allergy to tree nuts. However, a person can be allergic to both. Your child does not need to avoid tree nuts unless your child has had an allergic reaction to tree nuts or they have been advised to do so by their allergist. If your child is eating tree nuts, you should be aware of the risk of cross-contamination (see below).</p><h2>Reducing the risk of cross-contamination</h2><p>Cross-contamination occurs when one substance unintentionally comes in contact with another substance, for example a potential allergen. If the substances mix together, one substance taints the other substance, making it unsafe to eat.</p><p>Food allergens can contaminate other foods when, for example, the same containers, utensils or frying pans hold a range of foods.</p><p>Bulk food containers pose a high risk of cross-contamination because they are often used for different products.</p><p>Be sure to avoid using utensils or containers that may have come in contact with allergy-causing foods and ask about possible cross-contamination when eating out.</p><h2>How can my child get the right mix of nutrients if they must avoid peanuts?</h2><p>The main nutrients in peanuts include <a href="https://www.aboutkidshealth.ca/Article?contentid=1444&language=English">protein</a>, omega-3 fats, fibre, <a href="https://www.aboutkidshealth.ca/Article?contentid=1451&language=English">magnesium</a>, phosphorus, potassium, <a href="https://www.aboutkidshealth.ca/Article?contentid=1449&language=English">folate</a> and vitamin E. Your child can still get these nutrients even if they must avoid peanuts.</p><h3>Nutrients in peanuts that are found in other foods</h3><table class="akh-table"><thead><tr><th>Nutrient</th><th>Where to find it</th></tr></thead><tbody><tr><td>Protein</td><td>Meat, fish, poultry, eggs, cheese, milk, beans, soy</td></tr><tr><td>Omega 3</td><td>Salmon, tuna, mackerel, flaxseed oil, walnuts, edamame (soy beans), radish seeds, omega-3 eggs fortified with DHA</td></tr><tr><td>Fibre</td><td>Vegetables, fruit, whole grains</td></tr><tr><td>Magnesium</td><td>Wheat germ, peas, pumpkin, squash or sesame seeds</td></tr><tr><td>Phosphorus</td><td>Wheat germ, rice bran, wheat bran, cheese, beans, sardines, tempeh</td></tr><tr><td>Potassium</td><td>Bananas, papaya, sweet potato, leafy green vegetables, milk, yogurt, beans (navy, pinto, black), lentils, chickpeas, beef, pork, fish</td></tr><tr><td>Folate</td><td>Leafy green vegetables, beans (navy, pinto, kidney, garbanzo), lentils</td></tr><tr><td>Vitamin E</td><td>Spinach, red pepper, Swiss chard, wheat germ cereal, egg, sunflower seeds</td></tr></tbody></table> | | <h2>When to go the emergency room</h2><p>If your child is having a severe allergic reaction to peanut, call 911 or go to your nearest emergency department immediately. If your child’s doctor prescribed them an epinephrine autoinjector, administer this medication to your child right away. See <a href="https://www.aboutkidshealth.ca/Article?contentid=781&language=English">Anaphylaxis: How to recognize and respond to a severe allergic reaction</a> for more information.</p> | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/peanut_allergy.jpg | | Main |
| Pedestrian safety for children | P | Pedestrian safety for children | Pedestrian safety for children | | English | Prevention | Child (0-12 years);Teen (13-18 years) | NA | NA | Healthy living and prevention | Caregivers
Adult (19+) | NA | | 2021-10-03T04:00:00Z | | | | | | 9.10000000000000 | 59.8000000000000 | 682.000000000000 | | Flat Content | Health A-Z | <p>Find out how to help make walking to school (or anywhere else) a safe routine for your child.</p> | <p>As your child settles into the school year, one item that might be missing from their checklist is a discussion about getting to school safely.</p><p>According to Parachute, the national organization dedicated to preventing injuries, an average of 16 child pedestrians are killed and 1,300 are seriously injured on Canada's roads every year.</p> | <h2>Key points</h2><ul><li>Before allowing your child to walk outside without you, teach them about walking only on the sidewalk, holding hands and never running into the road, even for a favourite toy.</li><li>With older children, use situations such as changing weather or planning a route to teach more about pedestrian safety.</li>
<li>Remind your child to pay attention to other road users and not text or listen to loud music while walking. </li><li>Make sure your child can choose and use a safe crossing route, accurately estimate a vehicle's speed and judge safe gaps in traffic before allowing them to walk alone.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | pedestriansafety | | https://assets.aboutkidshealth.ca/AKHAssets/pedestrian_safety.jpg | | Main |
| Performing grooming and personal care activities with arm and hand differences | P | Performing grooming and personal care activities with arm and hand differences | Performing grooming and personal care activities with arm and hand differences | | English | Adolescent | Teen (13-18 years) | Arm;Neck | NA | Healthy living and prevention | Teen (13-18 years) | NA | | 2021-12-20T05:00:00Z | | | | | | 9.80000000000000 | 57.9000000000000 | 672.000000000000 | | Flat Content | Health A-Z | <p>Learn from young people with arm and hand differences about how they perform hygiene, hair and personal care activities in their own way.</p> | <h2>Hygiene, hair and personal care</h2><p>Many young people with arm and hand differences use adaptive strategies and aids to help them perform personal care tasks.</p> | <h2>Key points</h2><ul><li>There are a variety of adaptive techniques and aids you can use to help you to keep objects steady and/or perform tasks with one or two limbs when grooming and caring for your hygiene.</li><li>There are many ways you can adapt to performing different personal care tasks. Find what works best for you!</li></ul> | | | | | | | | | | | | | | | | | | | <h2>At SickKids</h2><p>
<strong>SickKids Plastic and Reconstructive Surgery Clinic</strong><br><a href="https://www.sickkids.ca/en/care-services/clinical-departments/plastic-reconstructive-surgery/#programs">https://www.sickkids.ca/en/care-services/clinical-departments/plastic-reconstructive-surgery/#programs</a></p><ul><li>Congenital Upper Limb Differences Program</li><li>Brachial Plexus Palsy and Nerve injuries clinic</li></ul><p>For more information on the Embracing Our Differences series, email:
<a href="mailto:hand.arm@sickkids.ca">hand.arm@sickkids.ca</a>.</p> | <h2>Resources</h2><p>
<strong>The CHAMP Program</strong><br>
<a href="https://www.waramps.ca/ways-we-help/child-amputees/">https://www.waramps.ca/ways-we-help/child-amputees/</a></p><p>The Child Amputee (CHAMP) Program offers comprehensive services to child amputees and their families, including financial assistance, regional seminars and peer support.</p><p>
<strong>Holland Bloorview Kids Rehabilitation Prosthetic Department</strong><br>
<a href="https://hollandbloorview.ca/our-services/about-your-visit/virtual-tour/prosthetic-services">https://hollandbloorview.ca/our-services/about-your-visit/virtual-tour/prosthetic-services</a></p><p>The Holland Bloorview Prosthetic Services Department provide custom-fitted devices and innovative solutions for clients who were born without a limb or who have lost a limb due to injury or health conditions. They offer a full range of services, including assessment, prescription, custom manufacturing, training and repair of prosthetic devices.</p> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/AKH%20Social%20Media/Teens_Brachial%20Plexus_Grooming%20Activities.jpg | | Teens |
| Performing kitchen activities with arm and hand differences | P | Performing kitchen activities with arm and hand differences | Performing kitchen activities with arm and hand differences | | English | Adolescent | Teen (13-18 years) | Arm;Neck | NA | Healthy living and prevention | Teen (13-18 years) | NA | | 2021-12-20T05:00:00Z | | | | | | 10.4000000000000 | 57.0000000000000 | 580.000000000000 | | Flat Content | Health A-Z | <p>Learn from young people with arm and hand differences about how they perform meal preparation and dining activities in their own way.</p> | <h2>Meal preparation and cooking</h2><p>Many young people with arm and hand differences use adaptive strategies and aids in the kitchen to help them prepare meals, cook and dine-in or out.</p> | <h2>Key points</h2><ul><li>There are a variety of adaptive techniques and aids you can use in the kitchen to help you to keep objects steady and/or perform tasks with one or two limbs.</li><li>There are many ways you can adapt to performing different tasks in the kitchen. Find what works best for you!</li></ul> | | | | | | | | | | | | | | | | | | | <h2>At SickKids</h2><p>
<strong>SickKids Plastic and Reconstructive Surgery Clinic</strong><br><a href="https://www.sickkids.ca/en/care-services/clinical-departments/plastic-reconstructive-surgery/#programs">https://www.sickkids.ca/en/care-services/clinical-departments/plastic-reconstructive-surgery/#programs</a></p><ul><li>Congenital Upper Limb Differences Program</li><li>Brachial Plexus Palsy and Nerve injuries clinic</li></ul><p>For more information on the Embracing Our Differences series, email:
<a href="mailto:hand.arm@sickkids.ca">hand.arm@sickkids.ca</a>.</p> | <h2>Resources<br></h2><p>
<strong>The CHAMP Program</strong><br><a href="https://www.waramps.ca/ways-we-help/child-amputees/">https://www.waramps.ca/ways-we-help/child-amputees/</a></p><p>The Child Amputee (CHAMP) Program offers comprehensive services to child amputees and their families, including financial assistance, regional seminars and peer support.</p><p>
<strong>Holland Bloorview Kids Rehabilitation Prosthetic Department</strong><br><a href="https://hollandbloorview.ca/our-services/about-your-visit/virtual-tour/prosthetic-services">https://hollandbloorview.ca/our-services/about-your-visit/virtual-tour/prosthetic-services</a></p><p>The Holland Bloorview Prosthetic Services Department provide custom-fitted devices and innovative solutions for clients who were born without a limb or who have lost a limb due to injury or health conditions. They offer a full range of services, including assessment, prescription, custom manufacturing, training and repair of prosthetic devices.</p> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Brachial%20Plexus%20Teen%20Kitchen%20Activities.jpg | | Teens |
| Performing school, work, and computer-based activities with arm and hand differences | P | Performing school, work, and computer-based activities with arm and hand differences | Performing school, work, and computer-based activities with arm and hand differences | | English | Adolescent | Teen (13-18 years) | Arm;Neck | NA | Healthy living and prevention | Teen (13-18 years) | NA | | 2021-12-20T05:00:00Z | | | | | | 11.0000000000000 | 56.1000000000000 | 557.000000000000 | | Flat Content | Health A-Z | <p>Learn from young people with arm and hand differences about how they perform school, work, and computer-based work in their own way.</p> | <h2>School, office and computer-based tasks</h2><p>Many young people with arm and hand differences use adaptive strategies and aids to help them complete tasks at school, work, and at home.</p> | <h2>Key points</h2><ul><li>There are a variety of aids you can use at school, work, and at home to help you to keep objects steady and/or perform academic and workplace tasks with one or two limbs.</li><li>There are many ways you can adapt to performing different school, office and computer-based, and job-related tasks. Find what works best for you!</li></ul> | | | | | | | | | | | | | | | | | | | <h2>At SickKids</h2><p>
<strong>SickKids Plastic and Reconstructive Surgery Clinic</strong><br><a href="https://www.sickkids.ca/en/care-services/clinical-departments/plastic-reconstructive-surgery/#programs">https://www.sickkids.ca/en/care-services/clinical-departments/plastic-reconstructive-surgery/#programs</a></p><ul><li>Congenital Upper Limb Differences Program</li><li>Brachial Plexus Palsy and Nerve injuries clinic</li></ul><p>For more information on the Embracing Our Differences series, email:
<a href="mailto:hand.arm@sickkids.ca">hand.arm@sickkids.ca</a>.</p> | <h2>Resources</h2><p>
<strong>The CHAMP Program</strong><br><a href="https://www.waramps.ca/ways-we-help/child-amputees/">https://www.waramps.ca/ways-we-help/child-amputees/</a></p><p>The Child Amputee (CHAMP) Program offers comprehensive services to child amputees and their families, including financial assistance, regional seminars and peer support.</p><p>
<strong>Holland Bloorview Kids Rehabilitation Prosthetic Department</strong><br><a href="https://hollandbloorview.ca/our-services/about-your-visit/virtual-tour/prosthetic-services">https://hollandbloorview.ca/our-services/about-your-visit/virtual-tour/prosthetic-services</a></p><p>The Holland Bloorview Prosthetic Services Department provide custom-fitted devices and innovative solutions for clients who were born without a limb or who have lost a limb due to injury or health conditions. They offer a full range of services, including assessment, prescription, custom manufacturing, training and repair of prosthetic devices.</p> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Brachial%20Plexus%20Teen%20Performing%20school_work_computerbased%20activities.jpg | | Teens |
| Periodic fever adenitis pharyngitis aphthous ulcer (PFAPA) syndrome | P | Periodic fever adenitis pharyngitis aphthous ulcer (PFAPA) syndrome | Periodic fever adenitis pharyngitis aphthous ulcer (PFAPA) syndrome | | English | Rheumatology | Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years) | Mouth;Neck | Immune system | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2019-06-05T04:00:00Z | | | | | | 7.80000000000000 | 60.0000000000000 | 954.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Information about the symptoms, causes, diagnosis and treatment of periodic fever adenitis pharyngitis aphthous ulcer (PFAPA) syndrome.</p> | <h2>What is periodic fever adenitis pharyngitis aphthous ulcer (PFAPA) syndrome?</h2>
<p>Periodic fever adenitis pharyngitis aphthous ulcer (PFAPA) syndrome causes sudden attacks of high fever. These attacks occur on a regular basis. Children with PFAPA can also have swollen neck glands, sore throat and/or sores in the mouth. Fever that occurs on a regular basis is called periodic fever. Swollen glands are called adenitis. Sore throat is called pharyngitis. Sores in the mouth are called aphthous ulcers.</p>
<p>Sometimes children do not complain of these other symptoms. A doctor should check whether these symptoms are present with the fever.</p> | <h2>Key points</h2>
<ul>
<li>PFAPA is a disease that causes regular attacks of fever.</li>
<li>The attacks are usually accompanied by swollen neck glands, sore throat and/or sores in the mouth.</li>
<li>PFAPA can be treated with medications or removal of the tonsils.</li>
<li>PFAPA will go away in almost all children by the early teen years.</li>
</ul> | <h2>Symptoms of PFAPA</h2><p>The major symptom of PFAPA is fever. The episodes of fever occur every three to six weeks, while the fever itself usually lasts about three to five days. Children may complain of pain in the throat and they may find it hard to swallow because of this pain. They may also complain of pain in the mouth because of mouth ulcers. The glands in the neck may be enlarged. Children seem quite ill during attacks. However, they recover completely between attacks.</p><p>The attacks eventually stop by late childhood. There are no long-term effects. Children with PFAPA grow and develop normally.</p>
<br> | <h2>Causes of PFAPA</h2>
<p>The cause of PFAPA is not yet known. For reasons that are not yet understood, the body’s inflammation system becomes active, leading to the symptoms of PFAPA.</p>
<p>PFAPA is not caused by an infection that we know about. Children are not contagious when they have a fever from PFAPA. PFAPA is not hereditary. It is not common for more than one child in a family to have it.</p> | <h2>Diagnosis of PFAPA</h2>
<p>It takes time to diagnose PFAPA. Usually infection is suspected at first. Antibiotics are often prescribed with the first few attacks. After a while, the frequency of the attacks and the similarity of the episodes make the physician and the parents suspect that infection is not the cause.</p>
<p>There are no specific tests to diagnose PFAPA. However, many tests are often done to exclude other causes of fevers. Blood tests should be done both when the child has fever and when the child is well. In a child who has PFAPA, the test results should come back to normal between attacks.</p> | <h2>Treatment of PFAPA</h2>
<p>Although PFAPA does not have any long-term consequences, most children (and families) are quite disturbed by the frequency of episodes and by how badly the children feel during the attacks. Antibiotics do not work at all. The fevers are only partly controlled with medications like <a href="/Article?contentid=62&language=English">acetaminophen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>. The fever responds better to ibuprofen than acetaminophen. Fever medication does not shorten the length of the attacks.</p>
<p>There is no medication that can cure PFAPA. Steroids like prednisone given at the start of an attack can shorten the length of the attack quite a bit. Sometime two doses, 24 hours apart, are needed. However, the attacks may happen a little more often if steroids have been used. Seeing how children do with steroid treatment does help confirm the diagnosis of PFAPA.</p>
<p>A newer medicine, anakinra, given once per day by injection into the skin is also very effective. It is only given during the episode until the fever stops.</p>
<p>Cimetidine, a drug given twice a day, may work in some patients. The same is true for colchicine, a medication used in other forms of periodic fever.<br></p>
<p><a href="/Article?contentid=193&language=English">Montelukast</a>, a drug for <a href="/Article?contentid=785&language=English">asthma</a> given once a day, may also work in some children.</p>
<p>Another treatment that has been successful is removal of tonsils and adenoids. It is not clear why this works.</p>
<p>In some children, attacks may return after several years.</p> | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/Periodic_fever_adenitis_pharyngitis_aphthous_ulcer_PFAPA_syndrome.jpg | | Main |
| Peripherally inserted central catheter (PICC) insertion using image guidance | P | Peripherally inserted central catheter (PICC) insertion using image guidance | Peripherally inserted central catheter (PICC) insertion using image guidance | | English | Other | Child (0-12 years);Teen (13-18 years) | NA | Cardiovascular system | Procedures | Caregivers
Adult (19+) | NA | | 2019-07-25T04:00:00Z | | | | | | 9.00000000000000 | 61.5000000000000 | 1293.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Children's veins may become damaged by frequent, painful needle insertions. A PICC may be the best way for some children to receive medicines and IV fluids or to have blood samples taken. Learn about this procedure and how to care for the PICC.</p> | <h2>What is a PICC?</h2><p>A peripherally inserted central catheter (PICC) is a special intravenous (IV) line. A PICC is a long, soft, thin, flexible tube that is inserted into a vein in the arm and guided through the veins until it is positioned in a large vein just above the heart. For babies, a PICC might be put into a vein in the leg instead.</p>
<figure class="asset-c-80"><span class="asset-image-title">PICC</span><img src="https://assets.aboutkidshealth.ca/akhassets/PICC_Line_MED_ILL_EN.jpg" alt="A catheter inserted into the vein of a child’s arm with a clamp and access cap on the outside" /><figcaption class="asset-image-caption">A peripherally inserted central catheter (PICC line) is used for patients who need long-term frequent IV therapy. It is inserted into a vein in the arm and ends in a large vein above the heart.</figcaption></figure> | <h2>Key points</h2><ul><li>A PICC is a long, soft, thin, flexible tube that is inserted into a vein in the arm and guided to the large vein just above the heart. For babies, a PICC might be inserted into a vein in the leg.</li><li>A PICC may be the best way for some children to receive IV medications, nutrition and fluids.</li><li>A PICC can stay in for weeks or months.<br></li></ul> | | | | | | | | | | | | | | | | <h2>On the day of the PICC insertion</h2><h3>Your child will have medicine for pain<br></h3><p>It is important that your child is as comfortable as possible for the procedure. Depending on your child’s age and medical condition, they might be awake during the procedure, slightly sedated (relaxed) or receive general anaesthesia.</p><p>Many children only receive a <a href="/Article?contentid=3001&language=English">local anaesthetic</a> when the PICC is inserted. Local anaesthetic is medication that numbs the area of the arm where the PICC will be inserted. This medication is usually given by a needle into the skin. Once the medication has had time to work, your child should not feel any pain.</p><p>Sometimes, children are given <a href="/Article?contentid=1260&language=English">sedation</a> or a <a href="/Article?contentid=1261&language=English">general anaesthetic</a>.</p><ul><li>If your child receives sedation, they may fall asleep or be sleepy during the procedure. Often, your child will not remember everything that happened during the procedure. Your child will be given a local anaesthetic as well.</li><li>If your child receives general anesthetic, they will not hear or feel anything during the procedure.</li></ul><p>During the procedure, you will be asked to wait in the waiting area.</p> | <h2>After the PICC insertion</h2><p>Once the PICC is inserted, the doctor, nurse or technologist will come and speak with you about the details of the procedure.</p><p>The PICC can be used right away for your child’s medication or fluids. Your child should not feel any pain when the PICC is being used.</p> | <h2>Preparing for a PICC insertion</h2><p>If your child is already in the hospital, you will meet a nurse from the Vascular Access Service who will explain the procedure and answer your questions. If your child is an outpatient, the health-care team looking after your child will explain the procedure to you.</p><p>If your child requires a general anaesthetic for the PICC insertion, you will meet the anaesthetist before the procedure. This is the doctor who will give your child the medicine to sleep during the procedure.</p><h3>Giving consent before the procedure</h3><p>Before the procedure, a member of the interventional radiology team will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks and will help you weigh the benefits against them. It is important that you understand all of these potential risks and benefits of the PICC insertion and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h3>How to prepare your child for the procedure</h3><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to them to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h3>Food, drink, and medicines before the procedure</h3><ul><li>Your child’s stomach must be empty prior and during sedation or anaesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure.<br></li><ul></ul></ul><p>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by your child’s doctor and the interventional radiologist.</p> | <h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html">Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT)</a>. You can call and speak to the Vascular Access Service resource nurse at (416) 813-6986 during working hours, or leave a message with the Vascular Access Team. If you have concerns and it is after working hours, please call The Hospital for Sick Children switchboard at 416-813-7500 and ask them to page your child’s doctor on call, or go to the nearest Emergency Department.</p><p>For more information on fasting, see “<a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Eating and drinking before surgery</a>.”</p><p>For more information on preparing your child for their procedure, see “<a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Coming for surgery</a>.”</p> | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/PICC_Line_MED_ILL_EN.jpg | | | Main |
| Peritoneal dialysis for a child | P | Peritoneal dialysis for a child | Peritoneal dialysis for a child | | English | Nephrology | Child (0-12 years);Teen (13-18 years) | Kidneys | Cardiovascular system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2014-07-30T04:00:00Z | | | | | | 10.7000000000000 | 46.5000000000000 | 931.000000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn what is involved in peritoneal dialysis and how it can benefit your child.</p> | <p>Peritoneal dialysis (PD) is a type of dialysis that occurs inside the body. It uses the peritoneal membrane, a thin lining around the abdomen (tummy), to filter the blood. The lining is semi-permeable, meaning that it allows some small particles to pass through it. In this way, it removes waste products and unwanted fluid from the blood.</p>
<p>Before your child can start peritoneal dialysis, they will have surgery (an operation) to insert a peritoneal dialysis catheter, or tube, into the space inside the peritoneal membrane. This space is called the peritoneal cavity.</p> | <h2>Key points</h2>
<ul>
<li>Peritoneal dialysis cleans the blood using the peritoneal membrane, a thin lining around the abdomen, and a machine called a cycler.</li>
<li>Before peritoneal dialysis, your child will need surgery to insert a catheter (tube) into the space inside the peritoneal membrane.</li>
<li>Peritoneal dialysis allows more independence and flexibility in caring for your child, requires fewer absences from school and lets your child eat a wider range of food than with in-hospital hemodialysis.</li>
<li>Before your child can start peritoneal dialysis, they must have a healthy abdominal wall.</li>
<li>You must be physically able to operate the equipment and commit time to training, performing the dialysis properly and solving any problems that might occur at home.</li>
</ul> | | | | | | | | | | | | | | | <h2>What happens during peritoneal dialysis?</h2><p>Your child will usually be offered automated peritoneal dialysis (APD). This uses a machine called a cycler, which automatically starts the dialysis.</p><p>Automated peritoneal dialysis involves three main phases:</p><ul><li>fill</li><li>dwell</li><li>drain</li></ul><h3>Fill</h3><p>The peritoneal dialysis catheter fills the peritoneal cavity with a sterile dialysis solution called dialysate. This solution contains glucose (sugar).</p><h3>Dwell</h3><p>The solution stays in the peritoneal cavity for a short time.</p><h3>Drain</h3><p>Any waste products and unwanted fluid from the blood are filtered across the peritoneal membrane into the dialysis solution. The wastes and fluids then drain from the abdomen.<br></p>
<figure class="asset-c-80"><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_Hemodialysis_peritoneal_schematic_EN.jpg" alt="The peritoneal cavity filled with solution, solution dwelling in the cavity, and solution being drained from the cavity" /><figcaption class="asset-image-caption">Simple illustration of peritoneal hemodialysis</figcaption> </figure>
<h2>How peritoneal dialysis works</h2><p>Like hemodialysis, peritoneal dialysis works on two principles:</p><ul><li>osmosis</li><li>diffusion</li></ul><p>Osmosis is the ability of water to pass through the wall of the semi-permeable membrane. The higher the concentration of glucose in the dialysis solution, the greater the amount of fluid that will move through the membrane.</p><p>Diffusion is the natural movement of particles from an area with many particles to an area with fewer particles. During peritoneal dialysis, waste products, which are highly concentrated in the blood, will filter across the peritoneal membrane into the dialysis solution, an area with no waste products.</p> | <h2>Things to consider when deciding about peritoneal dialysis</h2>
<p>To help you decide if peritoneal dialysis (PD) is suitable for your child, please consider the following points.</p>
<h3>Your child's suitability for peritoneal dialysis</h3>
<ul>
<li>Your child must have a healthy abdominal wall. PD cannot be done if any defects have been diagnosed.</li>
</ul>
<h3>Your ability and time to perform peritoneal dialysis</h3>
<ul>
<li>As a caregiver, you must be able to understand and read English.</li>
<li>You must be physically able to perform the therapy. This includes having the fine motor skills (for example being able to control the small muscles in your hands) to safely operate the equipment and handle the tubing.</li>
<li>You and your child (if they are old enough) must attend and complete training.</li>
<li>You and your child must attend the peritoneal dialysis clinic every month or as needed.</li>
<li>You must stick to the treatment plan and be flexible to deal with any health care issues that occur.</li>
<li>You will need to be committed to dialysis long-term, actively involved in decisions about your child's health and able to solve problems as they happen.</li>
<li>You will need to have a reliable back-up person to help with dialysis if you are not available.</li>
</ul>
<h3>Your home's suitability for peritoneal dialysis</h3>
<ul>
<li>Your home must be suitable for storing and using the equipment and supplies.</li>
</ul>
<h2>How peritoneal dialysis is done at home</h2>
<p>Peritoneal dialysis can be done safely and easily in the home. You and your child will be supported and guided by the home dialysis team.</p>
<p>Most peritoneal dialysis treatments will happen at night while your child is sleeping. The three phases of fill, dwell and drain continue through the night based on the dialysis instructions that are programmed into the cycler.</p> | | <h2>Are all homes suitable for peritoneal dialysis?</h2>
<p>Before you can start this dialysis, someone will visit you or ask you questions to check if your home is suitable for storing and using the dialysis equipment and supplies.</p>
<p>If it is suitable, a small, portable machine and all the supplies you need will be delivered to your home. Your provincial health plan will cover the costs.</p> | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/IMD_Hemodialysis_peritoneal_schematic_EN.jpg | | | Main |
| Peritonitis related to G tubes and GJ tubes | P | Peritonitis related to G tubes and GJ tubes | Peritonitis related to G tubes and GJ tubes | | English | Gastrointestinal;Other | Child (0-12 years);Teen (13-18 years) | Stomach;Abdomen | Digestive system | Conditions and diseases | Adult (19+)
Caregivers | NA | | 2018-11-30T05:00:00Z | | | | | | 10.2000000000000 | 51.1000000000000 | 838.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Peritonitis is a rare but serious complication related to G or GJ tube insertion. Find out what causes peritonitis related to G and GJ tubes, the signs and symptoms, and how it’s treated.</p> | <p>Gastrostomy tubes (G tubes) and gastrojejunostomy tubes (GJ tubes) are <a href="/tubefeeding">feeding devices</a> that support children who are unable to safely or adequately eat or drink by mouth. A G tube provides liquid nutrition, medication and other fluids directly into the stomach. A GJ tube gives liquid nutrition, medication and other fluids past the stomach directly into the second part of the small bowel, called the jejunum. Both G tubes and GJ tubes are placed through a small, surgical opening in your child’s tummy (abdomen) called a stoma. The tunnel from the outside of the body into the stomach is called the tract.</p><p>A G or GJ tube is easily managed by families and caregivers. However, there can be complications related to G or GJ tube insertion or exchanges.</p><p>Peritonitis is one of the possible complications related to G or GJ tube insertion or exchange. Peritonitis is a very uncommon but serious condition that requires immediate medical attention.<br></p> | <h2>Key points</h2><ul><li>Peritonitis is a rare complication of G or GJ tube insertion.</li><li>Peritonitis is the inflammation of the inner lining of the abdominal wall, which covers all the organs within the abdomen.</li><li>Risk for developing peritonitis is highest in the first few days after tube insertion. It can also happen after a tube exchange if the newly exchanged tube is misplaced and feeds are given outside the stomach.</li><li>If you have any concerns that your child may have peritonitis, do not use your child’s tube for feeds, fluids or medications. Do not feed your child by mouth. Visit the nearest emergency department immediately. </li></ul> | <h2>What are the signs and symptoms of peritonitis? </h2><p>A child with peritonitis may show one or more of the following.</p><ul><li>Irritability</li><li>Abdominal pain or tenderness</li><li>Abdominal distention (swollen belly)</li><li>Fever</li><li>Vomiting/feed intolerance</li><li>Firm/tense/rigid abdomen</li><li>Fast heart beat (tachycardia)</li><li>Difficulty breathing (fast breathing, nostrils flaring)</li></ul><p>If you suspect that your child may have peritonitis,
<strong>do not use your child's tube for feeds, fluids or medications</strong>. Do not feed your child by mouth. Visit the nearest emergency department immediately and let them know that your child has recently had a tube insertion or exchange.</p><p>Peritonitis is a serious condition that can lead to significant problems and, in severe, untreated cases, death.</p> | <h2>Risk factors for peritonitis</h2><p>The risk of peritonitis is highest at these times: </p><ul><li>Within the first few days after the primary insertion of a G or GJ tube. The risk of peritonitis after the primary insertion is 1-3%. </li><li>After using a G tube that has just been exchanged, for feeds, medication or fluids without first <a href="/Article?contentid=2908&language=English">confirming the tube is properly placed in the stomach</a>.</li><li>After using a temporary tube, such as a Foley catheter, for feeds, medication or fluids without first confirming the tube is properly placed in the stomach. </li></ul> | <h2>Diagnosis of peritonitis</h2><p>When your child arrives at the hospital, they will need to be assessed to determine if they have peritonitis.</p><p>The assessment may include the following.</p><ul><li>A physical examination of your child’s abdomen to determine if their abdomen is distended, tender or has absent bowel sounds assessed using a stethoscope to the abdomen</li><li>Blood tests</li><li>X-rays</li><li>Ultrasounds</li><li>A check of the G or GJ tube placement</li></ul> | <h2>Treatment of peritonitis</h2><p>Multiple antibiotics are usually given to treat peritonitis. The type of antibiotics will depend on the severity of the peritonitis.</p><p>Your child’s feeds may need to be stopped for a few days while they get better. Your child will need to be admitted for the treatment of peritonitis.</p><p>On rare occasions, a surgery may be needed to clean out the infection in the abdomen.</p> | | | | | | | | | | | | | | | <p>Contact your G tube specialist if you have any questions or concerns about your child’s feeding tube or about peritonitis. If you suspect your child has peritonitis, take your child to the <a href="http://www.sickkids.ca/VisitingSickKids/emergency/index.html">Emergency Department</a> right away.</p> | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/Peritonitis_EN.jpg | | | Main |
| Periventricular leucomalacia (PVL) | P | Periventricular leucomalacia (PVL) | Periventricular leucomalacia (PVL) | | English | Neonatology;Neurology | Premature;Newborn (0-28 days);Baby (1-12 months) | Brain | Nervous system | Conditions and diseases | Prenatal
Adult (19+) | NA | | 2009-10-31T04:00:00Z | | | | | | 11.2000000000000 | 46.2000000000000 | 374.000000000000 | | Flat Content | Health A-Z | <p>Read about periventricular leucomalacia (PVL), which kills brain tissues. PVL can lead to motor disorders, such as cerebral palsy.</p> | <p>Periventricular leucomalacia (PVL) is a condition in which decreased blood flow to brain tissue causes it to soften up and eventually die, leaving behind cysts filled with fluid. Over time, these cysts may fuse together or collapse altogether. The affected brain tissue and the nerve fibers that run through it help to control body movement; their loss will have an impact on this ability. </p> | <h2>Key points</h2>
<ul><li>Periventricular leucomalacia (PVL) is a condition in which decreased blood flow to brain tissue causes it to soften up and die, leaving behind fluid-filled cysts.</li>
<li>Risk factors include moderate and severe IVH, infections within the womb, asphyxia and a lengthy resuscitation following birth.</li>
<li>Most premature babies diagnosed with PVL will go on to have some form of disability, however mild cases of PVL may have no lasting disability.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Main |
| Personal care after scoliosis surgery | P | Personal care after scoliosis surgery | Personal care after your scoliosis surgery | | English | Orthopaedics/Musculoskeletal | Child (0-12 years);Teen (13-18 years) | Vertebrae;Spine | Muscular system;Skeletal system | Conditions and diseases | Teen (13-18 years) | NA | | 2008-06-01T04:00:00Z | | | | | | 6.00000000000000 | 76.0000000000000 | 1073.00000000000 | | Flat Content | Health A-Z | <p>After scoliosis surgery, there are some personal care issues you may be faced with. Read the experiences of other teens that also had scoliosis surgery.</p> | <h3>
<a href="#menstrual">Your menstrual period</a> </h3><h3>
<a href="#backdressing">Your back dressing</a> </h3><h3>
<a href="#diet">Your diet</a> </h3><h3>
<a href="#bowelbladder">Bowel and bladder function</a> </h3><h3>
<a href="#standsitwalk">Standing, sitting, and walking</a> </h3><h3>
<a href="#paincontrol">Pain control</a> </h3><h3>
<a href="#breathingexercises">Coughing and deep breathing exercises</a></h3> | <h2>Key points</h2><ul><li>Most girls get their menstrual period around the time of surgery. This is a normal response to stress.</li><li>Stitches will close the incision on your back. After about two days, you will get a smaller bandage on your back, which will be removed before you go home and replaced with Steri-Strips.</li><li>You will work up to a full diet before going home.</li><li>A Foley catheter stays in your bladder for about three to four days after surgery.</li><li>You will not have a bowel movement for four to five days due to the anaesthesia and pain medication, but will need to have a bowel movement before you can go home.</li><li>It is important you drinks fluids to prevent bladder infections and constipation.</li><li>Painkillers should be taken in response to back pain rather than abdominal discomfort.</li><li>You need to be able to manage pain through oral medication rather than an IV before you can go home.</li><li>You should try to take deep breaths occasionally and cough to open up and clear airways.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/personal_care_after_scoliosis_surgery.jpg | | Teens |
| Personal stories | P | Personal stories | Personal stories about scoliosis surgery | | English | Orthopaedics/Musculoskeletal | Child (0-12 years);Teen (13-18 years) | Vertebrae;Spine | Muscular system;Skeletal system | Conditions and diseases | Teen (13-18 years) | NA | | 2008-06-01T04:00:00Z | | | | | | 6.00000000000000 | 75.0000000000000 | 138.000000000000 | | Flat Content | Health A-Z | <p>Here are the personal stories of four teens that have gone through scoliosis surgery. They share what they felt about surgery and how they coped.</p> | <p>Sometimes it can really help to hear what someone else has been through. In this section, we have included a few personal stories from teens who decided to do scoliosis surgery. They had their ups and downs. They had fears about surgery just like you. Some became upset when they saw the operating room for the first time. They all felt the pain and the flurry of emotions after surgery. Some even got mad at the nurses for making them walk so soon after surgery, but eventually they realized how important that was. And they all had to build back their strength over time.</p><p>Some of these teens had great people to rely on. Others felt let down by the people they expected to be there. We hope that these stories will make you feel a bit less alone.</p> | <h2>Key points</h2><ul><li>It can be really helpful to hear what someone else has been through to know that you are not alone.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/scoliosis_personal_stories_overview.jpg | | Teens |
| Pertussis (whooping cough) | P | Pertussis (whooping cough) | Pertussis (whooping cough) | | English | Respiratory | Child (0-12 years);Teen (13-18 years) | Trachea;Lungs | Trachea;Lungs | Conditions and diseases | Caregivers
Adult (19+) | Cough;Fever;Runny nose;Vomiting | | 2014-06-17T04:00:00Z | | | | | | 7.30000000000000 | 65.5000000000000 | 933.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Read about the symptoms and treatment of whooping cough, a bacterial infection affecting the lungs. </p> | <p>Pertussis, also known as whooping cough, is a sudden-onset bacterial infection of the lungs and upper respiratory tract.</p><p>Pertussis can be a very serious illness in babies because their airways are small. Babies under three months or older babies with difficulty breathing, eating or drinking may need to be admitted to hospital to support their breathing and nutrition.</p>
| <h2>Key points</h2>
<ul>
<li>Whooping cough can be a serious bacterial infection in children.</li>
<li>You can prevent pertussis by having your child vaccinated and getting a booster shot if needed. Ask your health-care provider for advice.</li>
<li>Whooping cough can be treated with antibiotics. People who come in close contact with your child will need to take medication.</li>
<li>See your doctor if your child's cough gets worse or occurs in clusters. Call 911 if your child's cough makes breathing difficult or causes your child's face to turn blue or if your child has a seizure.</li>
</ul> | <h2>Signs and symptoms of pertussis</h2>
<p>Common symptoms include:</p>
<ul>
<li>persistent, severe coughing that occurs in clusters</li>
<li>a cough followed by <a href="/Article?contentid=746&language=English">vomiting</a> of milk, food or mucus</li>
<li>a change in the colour of the face when coughing</li>
<li>a high-pitched whoop sound when breathing in.</li>
</ul>
<p>Symptoms start seven to 14 days after a child is exposed to the infection.</p> | <h2>Causes of pertussis</h2>
<p>This illness is caused by the bacteria (germ) Bordetella pertussis. You can almost always prevent pertussis by having your child vaccinated.</p>
<p>If you or your child has been vaccinated, the immunity (protection) offered by the vaccine can decrease over time. This is why it is important to get a booster vaccine. Adolescents and adults who do not get a booster vaccine can become infected and pass the infection to children. Babies who have not received their complete vaccination for pertussis are also at risk for getting the infection. They can get sick very quickly when exposed to others who have it.</p> | <h2>How pertussis is diagnosed</h2>
<p>If the doctor thinks your child has pertussis, they will take a swab of the secretions (mucus) from your child's nose for testing. It may take five to seven days for your doctor to get the results.</p> | <h2>How pertussis is treated</h2>
<p>Your child will need to take antibiotics to fight the bacteria that cause pertussis. If your doctor thinks it is very likely that your child has pertussis, they will suggest that your child start the antibiotic even before their test results are confirmed. The antibiotics are most effective if started within three days of the start of illness.</p>
<p>Make sure your child completes the full course of antibiotics, even if their symptoms seem to improve. People in close contact with your child may be asked to take an antibiotic so the infection does not spread.</p> | <h2>Complications of pertussis</h2>
<p>Pertussis can be harmful, especially for babies. Complications may include <a href="/Article?contentid=784&language=English">pneumonia</a>, apnea (breaks in breathing), <a href="/Article?contentid=1773&language=English">seizures</a> and death.</p> | <h2>When to see a doctor</h2><p>Call your child's regular doctor if:</p><ul><li>your child's cough is persistent, getting worse or occurring in clusters</li><li>your child has had contact with someone who has pertussis.</li></ul><p>Go to your nearest Emergency Department or call 911 if:</p><ul><li>coughing causes your child's face to turn blue or your child to stop breathing</li><li>coughing makes breathing difficult or fast</li><li>your child is not responding to you or seems lethargic (sluggish)</li><li>your child has a seizure (persistent shaking of the body that cannot be stopped)</li><li>your child is vomiting or not drinking and is getting
<a href="/Article?contentid=776&language=English">dehydrated</a>.</li></ul><p>Your child may show physical changes when their condition is serious or when their condition gets worse. Parents and caregivers can learn how to
<a href="https://www.healthcareexcellence.ca/media/s3bbk5nv/20221216_signsmaterialsqr_en.pdf">spot these signs</a> in order to seek help from a health-care provider.</p> | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pertussis_whooping_cough.jpg | | Main |
| Pet scan and cancer diagnosis | P | Pet scan and cancer diagnosis | Pet scan and cancer diagnosis | | English | Oncology | Pre-teen (9-12 years);Teen (13-18 years) | Body | NA | Tests | Pre-teen (9-12 years)
Teen (13-18 years) | NA | | 2019-09-03T04:00:00Z | | | | | | 6.60000000000000 | 76.8000000000000 | 430.000000000000 | | Flat Content | Health A-Z | <p>A PET scan is a diagnostic test that shows where cancer cells are in the body. Find out how PET scans are done, what to expect during the scan and when you get your results.</p> | <h2>What is a PET scan?</h2><p>PET (positron emission tomography) scans take a picture that shows parts of the body where cells are burning lots of energy. Cancer cells use lots of energy to divide very fast, so they will show up easily on a PET scan. </p><p>Many times, you will have a CT scan on the same day as your PET scan. A computer puts the pictures from the two scans together to make a very detailed picture that shows both the inside of your body and where the cells are most active.</p><p>The amount of radioactivity injected for a PET scan is very small. It is gone from your body in a few hours. If you or your family have questions or are worried about the radioactivity from a PET scan, talk to your doctor or nurse.</p> | <h2>Key points</h2><ul><li>A PET scan shows parts of the body where cells are burning a lot of energy because they are dividing quickly, which usually means they are cancerous.</li><li>You may be asked not to eat or drink for 6 hours before the PET scan; 1 hour before you will be given glucose by IV.</li><li>The PET scan takes between 1-2 hours and you will need to lie very still while the computer takes the pictures.</li><li>Your doctor will review the results of the scan with you.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/PMD_PET_scan_EN.jpg | | | Teens |
| Pharmacist | P | Pharmacist | Pharmacist | | English | NA | Child (0-12 years);Teen (13-18 years) | NA | NA | Support, services and resources | Caregivers
Adult (19+) | NA | | 2014-08-05T04:00:00Z | | | | | | 9.90000000000000 | 52.6000000000000 | 514.000000000000 | | Flat Content | Health A-Z | <p>Pharmacists are trained health professionals who are medication experts. Learn about the role they play in the health-care team.</p> | <p>A pharmacist is a medication expert who is trained in university and must pass a national licensing exam before they can practise.</p>
<p>Pharmacists who work in a hospital have usually completed extra training in a hospital environment and often specialize in one area of medicine.</p> | <h2>Key points</h2>
<ul>
<li>A pharmacist confirms that your child is taking the appropriate type and dose of medication, adjusts medications as your child's condition changes, teaches you about your child's medications and helps you and your child follow a medication schedule.</li>
<li>You can meet with your pharmacist if you have questions about your child's medications.</li>
</ul> | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/pharmacist.jpg | | Main |
| Pharmacogenetics: Using precision medicine to find the right medication at the right dose | P | Pharmacogenetics: Using precision medicine to find the right medication at the right dose | Pharmacogenetics: Using precision medicine to find the right medication at the right dose | | English | Pharmacy | Child (0-12 years);Teen (13-18 years) | NA | NA | Tests | Adult (19+)
Caregivers | NA | | 2021-10-04T04:00:00Z | | | | | | 11.0000000000000 | 45.1000000000000 | 826.000000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Pharmacogenetics is an example of precision medicine that uses a person’s genetic make-up to predict medication response.</p> | <h2>Precision medicine and how it relates to a patient’s medications</h2><p>Medications are usually prescribed at a set standard dose based on the indication, age and weight of a child. This is called the “one size fits all” model. However, some people respond differently to the same medication at the same dose. Precision medicine can be used to precisely (or specifically) tailor medication choice and dosing for people. This allows medications to be safer and more effective for patients.</p>
<p>An example of precision medicine is the use of pharmacogenetics (PGx) testing. PGx is the study of how differences (variants) in our genetic make-up affect our individual responses to certain medications. PGx can increase the chance of safely getting the benefits of a medication while lowering the risk of side effects.</p><p>We all carry genetic variants that affect our body’s response to a variety of medications. More than 400 medications now include PGx information on their labels. This information gives guidance about precision dosing and caution about potential side effects. The goal with PGx testing is to try to find the most effective medication and tailor the optimal dose for each person.</p> | <h2>Key points</h2><ul><li>Pharmacogenetics (PGx) is the study of how differences in our genetic make-up affect each person’s response to a certain medication.</li><li>PGx testing helps us predict how a person will process a medication and provides caution about potential side effects.</li><li>Having PGx testing done means that results can be used to help guide optimal medication selection and dosing.</li></ul>
| | | | | | | | | | | | | | | <h2>PGx and the science behind precision medication dosing</h2><p>Genes are the instructions that our bodies use to develop, grow and function throughout our lives. Humans have between 20,000 and 25,000 genes that make up their genetic blueprint. Everyone has a full set of genes in every cell of their body. The information or “sequence” that makes up our genes differs slightly from one person to the next. There can be many different versions of the same gene among the human population. When the sequence of a gene is changed, it is called a genetic variant. The presence of genetic variants explains why we are all genetically unique.</p><p>Some genes provide instructions for how the body breaks down (metabolizes), activates or responds to certain medications. PGx testing will look for genetic variants in these genes to try to prevent side effects from happening and to increase therapeutic success.</p><p>A person’s genetic information does not change over time but our understanding of genetics does as we learn more. This means as we learn more, PGx testing may be repeated to test for even more genes that can help further explain our response to medications.</p><h2>Why is PGx testing helpful?</h2><p>PGx testing can provide answers as to why a medication may or may not be working for someone. Some people’s PGx results may indicate that increased monitoring for side effects or specific dose adjustments may be needed for safer and more effective medication treatment. Sometimes, completely avoiding certain medications may be recommended. This is because some genetic variants can contribute to an increased risk of serious side effects or a failure of a medication to work. PGx testing is helpful because results can predict if a person will experience an unusual reaction to a medication compared to the average population. Testing can also recommend other medications that may be predicted to work better. Additionally, PGx test results can help to reassure that changes to medication treatment may not be needed based on the genetic variants a person is carrying.</p><p>Check out <a href="https://www.youtube.com/watch?v=4532ns1MqsI">this video</a> to see how pharmacogenetic testing can be helpful to guide medication treatment based on a person’s test results.</p> | <h2>How is the PGx test performed?</h2><p>The inside of a person’s cheek is swabbed (buccal swab) to collect a sample of cells that contain DNA. A blood sample is only collected when several buccal swab attempts are unsuccessful and if your health-care team thinks it is necessary. This sample will be used to run the PGx test. The PGx test only looks at specific genetic variants that impact how a person processes certain medications.</p><h2>The difference between pre-emptive and reactive PGx testing</h2><p><strong>Pre-emptive testing</strong> is done before a doctor prescribes a medication. The doctor then has the patient’s PGx information available when they are prescribing a medication before an unexplained side effect occurs. Pre-emptive testing tries to tailor medications for a patient before they need medication therapy. This means the patient will have better medication choices and prevention of specific side effects.</p><p><strong>Reactive PGx testing</strong> is done to understand why certain medications have not been effective or why a side effect may have occurred. It is also done to prevent a treatment failure from happening again.</p> | | | <p>To learn more about PGx at SickKids go the <a href="https://www.sickkids.ca/en/care-services/clinical-departments/clinical-pharmacology-toxicology/pharmacogenetics/">Pharmacogenetics</a> page on SickKids.ca.</p> | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/iStock-484324248.jpg | | Main |
