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PICC insertion: Caring for your child at home after the procedurePPICC insertion: Caring for your child at home after the procedurePICC insertion: Caring for your child at home after the procedureEnglishOtherChild (0-12 years);Teen (13-18 years)NAVeinsNon-drug treatmentCaregivers Adult (19+)NA2014-02-14T05:00:00ZJoao Amaral, MD;Michelle Côté, RN;Candice Sockett, RN(EC), MN:APN6.0000000000000072.0000000000000399.000000000000Health (A-Z) - ProcedureHealth A-Z<p>This brochure is a guide on how to care for your child at home after a PICC insertion.</p><p>Your child has had a PICC insertion at the Image Guided Therapy (IGT) clinic. This brochure explains how to look after your child at home after the procedure, and when to call for help. </p><h2>Key points</h2> <ul> <li>Keep the PICC site and line as dry as possible. </li> <li>Leave the dressing in place. </li> <li>Your child can have acetaminophen 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>Phone your community care nurse, your specialist, the vascular access resource nurse, Image Guided Therapy (IGT) or go to the nearest Emergency Department right away if your child has any of the following: </p> <ul> <li><a href="/Article?contentid=30&language=English">fever</a> greater than 38°C (100.4°F) </li> <li>swelling or bleeding around the PICC site </li> <li>leakage or drainage at the PICC site </li> <li>noticeable change of color in the arm </li> <li>difficulty breathing </li> <li>funny feeling in your child's heart</li> <li>irregular heart beat, such as skipped beats or fast heartrate </li> <li>noticeable swelling of the arm </li> <li>PICC gets pulled out a little or all the way </li> </ul><h2>At SickKids </h2> <div>If you have any concerns during the 48 hours after the procedure, you can contact the vascular access resource nurse at the Hospital for Sick Children at (416) 813-6986 during working hours, your referring doctor, the IGT clinic nurse at (416) 813-6054, or go to the nearest Emergency Department. For all concerns after 48 hours, please call your family doctor or the vascular access resource nurse at The Hospital for Sick Children at (416) 813-6986.<p></p></div>https://assets.aboutkidshealth.ca/AKHAssets/PICC_insertion_caring_for_child_at_home.jpg
PICC removal: Caring for your child at home after the procedurePPICC removal: Caring for your child at home after the procedurePICC removal: Caring for your child at home after the procedureEnglishOtherChild (0-12 years);Teen (13-18 years)NAVeinsNon-drug treatmentCaregivers Adult (19+)NA2014-03-28T04:00:00ZJoao Amaral, MD;Michelle Côté, RN;Candice Sockett, RN(EC), MN:APN8.3000000000000060.8000000000000367.000000000000Health (A-Z) - ProcedureHealth A-Z<p>This brochure is a guide on how to care for your child at home after a PICC removal.</p><p>Your child has had a PICC removal. This brochure 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 acetaminophen 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>Phone your specialist or Image Guided Therapy (IGT), or go to the nearest Emergency Department right away if your child has any of the following: </p> <ul> <li><a href="/Article?contentid=30&language=English">fever</a> higher than 38°C (100.4°F)</li> <li>pain needing <a href="/Article?contentid=62&language=English">acetaminophen</a> after 48 hours </li> <li>bleeding that does not stop with pressure around the PICC site </li> <li>leakage or drainage at the PICC site </li> </ul><h2>At SickKids</h2> <p>If you have any concerns during the 48 hours after the procedure, you can contact the vascular access resource nurse during working hours at the Hospital for Sick Children at (416) 813-6986, your referring doctor, the IGT clinic at <strong>(416) 813-6054</strong>, or go to the nearest Emergency Department.</p> <p>For all concerns after 48 hours please call your family doctor or the vascular access resource nurse at The Hospital for Sick Children at (416) 813-6986. </p>https://assets.aboutkidshealth.ca/AKHAssets/PICC_removal_caring_for_child_at_home.jpg
PKU transitions in the early yearsPPKU transitions in the early yearsPKU transitions in the early yearsEnglishMetabolicChild (0-12 years);Teen (13-18 years)Stomach;Small Intestine;Large Intestine/ColonDigestive systemNon-drug treatmentCaregivers Adult (19+)NA2009-11-10T05:00:00ZAnnette Feigenbaum, MB, ChB, FRCP;Guidelines designed by:;Elizabeth Kerr, PhD, Cpsych;Karen Sappleton, MSEd, MSW, RSW;with the PKU Team at The Hospital for Sick Children;In memory of Dr. Beverley J. Antle5.2000000000000079.2000000000000763.000000000000Flat ContentHealth A-Z<p>Children growing up with phenylketonuria (PKU) need to incorporate health care into their normal routines. Read about encouraging proper development. </p><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
PKU transitions in the middle yearsPPKU transitions in the middle yearsPKU transitions in the middle yearsEnglishMetabolicChild (0-12 years);Teen (13-18 years)Stomach;Small Intestine;Large Intestine/ColonDigestive systemNon-drug treatmentCaregivers Adult (19+)NA2009-11-10T05:00:00ZAnnette Feigenbaum, MB, ChB, FRCP;Guidelines designed by:;Elizabeth Kerr, PhD, Cpsych;Karen Sappleton, MSEd, MSW, RSW;with the PKU Team at The Hospital for Sick Children;In memory of Dr. Beverley J. Antle5.1000000000000079.5000000000000913.000000000000Flat ContentHealth 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><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
PKU transitions in the teenage yearsPPKU transitions in the teenage yearsPKU transitions in the teenage yearsEnglishMetabolicChild (0-12 years);Teen (13-18 years)Stomach;Small Intestine;Large Intestine/ColonDigestive systemNon-drug treatmentCaregivers Adult (19+)NA2009-11-10T05:00:00ZAnnette Feigenbaum, MB, ChB, FRCP;Guidelines designed by:;Elizabeth Kerr, PhD, Cpsych;Karen Sappleton, MSEd, MSW, RSW;with the PKU Team at The Hospital for Sick Children;In memory of Dr. Beverley J. Antle6.1000000000000073.9000000000000815.000000000000Flat ContentHealth 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><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
Pacemaker surgeryPPacemaker surgeryPacemaker surgeryEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartProceduresCaregivers Adult (19+)NA2009-11-10T05:00:00ZCarrie Morgan, RN, MN;Christine Chiu-Man, MSc7.9000000000000063.60000000000001693.00000000000Health (A-Z) - ProcedureHealth 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
Pacemaker: Caring for your child at homePPacemaker: Caring for your child at homePacemaker: Caring for your child at homeEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartHeartNon-drug treatmentCaregivers Adult (19+)NA2009-12-17T05:00:00ZCarrie Morgan, RN, MNChristine Chiu-Man, MSc9.2000000000000055.10000000000001541.00000000000Health (A-Z) - ProcedureHealth 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.</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> <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 </span> <span class="asset-image-title">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</figcaption> <figcaption class="asset-image-caption"> 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
PainPPainPainpainEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)NANervous systemSymptoms;Conditions and diseasesCaregivers Adult (19+)Pain2019-02-01T05:00:00ZLanding 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>painhttps://assets.aboutkidshealth.ca/AKHAssets/pain_learning_hub.jpg
Pain after an operation: Taking care of your child's pain at homePPain after an operation: Taking care of your child's pain at homePain after an operation: Taking care of your child's pain at homeEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyNervous systemNon-drug treatmentCaregivers Adult (19+)NA2012-04-09T04:00:00ZJanet Ahier, APN;Kimberly Colapinto, RN, BScN, MN;Jo-Anne Marcuz, MScPT;Basem Naser, MBBS, FRCPC6.2000000000000077.70000000000001790.00000000000Health (A-Z) - ProcedureHealth 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
Pain assessmentPPain assessmentPain assessmentEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-15T04:00:00ZLisa Isaac, MD, FRCPC; Jennifer Stinson, RN, PhD, CPNP8.3000000000000063.40000000000001547.00000000000Flat ContentHealth 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>
Pain at home: Taking care of your childPPain at home: Taking care of your childPain at home: Taking care of your childEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyNervous systemNon-drug treatmentCaregivers Adult (19+)NA2010-05-07T04:00:00ZJennifer Tyrrell, RN, MN, CNeph(c)6.0000000000000076.00000000000001250.00000000000Health (A-Z) - ProcedureHealth 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
Pain management after heart surgeryPPain management after heart surgeryPain management after heart surgeryEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemConditions and diseases;Drug treatmentAdult (19+)NA2010-01-15T05:00:00Z5.1000000000000082.30000000000001335.00000000000Flat ContentHealth 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
Pain management for common childhood pain and injuriesPPain management for common childhood pain and injuriesPain management for common childhood pain and injuriesEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-17T04:00:00ZJanet Ahier, RN, MN8.6000000000000060.40000000000001263.00000000000Flat ContentHealth 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>
Pain management in labour and deliveryPPain management in labour and deliveryPain management in labour and deliveryEnglishPregnancyAdult (19+)Body;UterusReproductive systemNAPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC10.300000000000049.90000000000001811.00000000000Flat ContentHealth 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
Pain management planPPain management planPain management planEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-17T04:00:00ZJanet Ahier, RN, MN9.8000000000000057.6000000000000171.000000000000Flat ContentHealth A-Z<p>An overview of the components of a pain management plan for children.</p>
Pain medicinesPPain medicinesPain medicinesEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-21T04:00:00ZAnna Taddio, PhD10.000000000000053.80000000000002098.00000000000Flat ContentHealth 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><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>
Pain reliefPPain reliefPain reliefEnglishNeonatology;Pain/AnaesthesiaPremature;Newborn (0-28 days);Baby (1-12 months)BodyNANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZSharyn Gibbins, NNP, PhD10.800000000000045.70000000000001004.00000000000Flat ContentHealth 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
Pain relief: Comfort kitPPain relief: Comfort kitPain relief: Comfort kitEnglishPain/AnaesthesiaBaby (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)BodyNervous systemNon-drug treatmentCaregivers Adult (19+)NA2018-12-18T05:00:00ZKimberly O'Leary, MEd;Amanda English, BA, CCLS;Jane Darch, BA/BEd, CCLS;Jennifer Butterly, MA6.0000000000000074.1000000000000782.000000000000Health (A-Z) - ProcedureHealth 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
Pain treatmentPPain treatmentPain treatmentEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-16T04:00:00ZCarrie Morgan, RN, BScN12.100000000000044.2000000000000512.000000000000Flat ContentHealth 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>
Pain: How to talk to kids about their painPPain: How to talk to kids about their painPain: How to talk to kids about their painEnglishPain/AnaesthesiaBaby (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)BodyNervous systemNon-drug treatmentCaregivers Adult (19+)NA2010-03-05T05:00:00ZKimberly O'Leary, MEd;Amanda English, BA, CCLS;Jane Darch, BABEd, CCLS;Jennifer Butterly, MA;Alexis Shinewald, CCLS, BA, ECE6.0000000000000087.0000000000000860.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about how to talk to your chid 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/ProgramsandServices/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
Palliative and bereavement care teamPPalliative and bereavement care teamPalliative and bereavement care teamEnglishNAChild (0-12 years);Teen (13-18 years)NANAHealth care professionalsAdult (19+) CaregiversNA2009-12-04T05:00:00ZJennifer Russell, MD, FRCPC12.900000000000034.1000000000000382.000000000000Flat ContentHealth A-Z<p> If their condition is life-limiting, children may be seen by members of a palliative and bereavement care team. These health-care professionals can help ensure a child is not in pain and provide bereavement support for families who are grieving.</p><p> This page explains how a palliative and bereavement care team can support children with a life-limiting disease and their families.</p><h2> Key points </h2><ul><li> Members of the palliative and bereavement care team provide support for the physical, emotional, spiritual, and psychological symptoms experienced by a child with a life-limiting disease and their family.</li><li>Members can include nurses, physicians, social workers, chaplains, a bereavement coordinator and other health-care professionals.</li></ul>
Palliative care after a blood and marrow transplantPPalliative care after a blood and marrow transplantPalliative care after a blood and marrow transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemNAAdult (19+)NA2010-03-06T05:00:00ZJohn Doyle, MD, FRCPC, FAAP Christine Armstrong, RN, MScN, NP Peds10.000000000000050.0000000000000312.000000000000Flat ContentHealth A-Z<p>Parents can learn about palliative care, when considering it for their child who has had a blood and marrow transplant (BMT).</p><p>To "palliate" means to relieve. The goal of palliative care is to try to relieve symptoms and make the child feel as comfortable as possible. This happens when it is unlikely that their disease can be cured. </p> <p>Palliative care uses intensive, active care to relieve physical and emotional symptoms. It embraces the child as a whole, and considers the child's physical, emotional, spiritual, and social needs. Palliative care also considers the needs of the family. </p><h2>Key points</h2> <ul><li>The goal of palliative care is to try to relieve symptoms and make the child as comfortable as possible.</li> <li>When considering palliative care for your child, the goal of treatment is no longer focused on curing your child’s illness.</li> <li>End-of-life care will help families discuss difficult subjects, plan home or hospital care, and provide resources for the best care possible.</li></ul>
Palliative care at homePPalliative care at homePalliative care at homeEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemNon-drug treatment;Support, services and resourcesAdult (19+)NA2010-05-19T04:00:00ZLaura Beaune, RNChristine Newman, MD, FRCPC8.0000000000000066.00000000000001921.00000000000Flat ContentHealth A-Z<p>Learn more about what is involved in providing palliative care for your child at home.<br></p><p> This page outlines important factors to consider for families wishing to manage palliative care at home.</p><h2> Key points </h2> <ul><li>In order to receive palliative care at home, your child must be diagnosed with an illness in its terminal stages for which specialized hospital care is no longer beneficial. </li><li>When considering palliative care at home, it is important to think about your child's nutrition, your family's financial resources, community resources, your other children, your child's own preference, your undestanding of your child's condition and their final days and your child's education.</li> <li>To receive palliative care at home, you and your health care team must agree that because of your child’s prognosis, using medications and life-supporting equipment in the event that their heart stops is not be in your child’s best interest.</li></ul>
Palliative care for brain tumours: Factors to considerPPalliative care for brain tumours: Factors to considerPalliative care for brain tumours: Factors to considerEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCKaren Drybrough, RNLaura Janzen, PhD, CPsych, ABPP-CNUte Bartels, MD8.8000000000000060.30000000000003415.00000000000Flat ContentHealth A-Z<p>An in-depth look at the factors and treatments to consider concerning palliative care. Trusted answers from Canadian Paediatric Hospitals.</p><p>Palliative care is care designed to make a child with a life-limiting condition as comfortable as possible when it's clear that further cancer-directed treatment won't be possible or effective. For brain tumours, palliative care refers to end-of-life treatment, and is provided when death is expected within a period up to six months. Palliative care specifically refers to intensive, active care aimed at the relief of physical and emotional symptoms. To "palliate" means to relieve. </p><h2>Key points</h2> <ul><li>Palliative care enters into your discussion with the doctor when the goal of treatment is no longer focused on curing a condition but on making your child as comfortable as possible. </li> <li>Palliative care can be provided at the same time as cure-directed treatments.</li> <li>The palliative care service at the hospital can offer guidance to help you make decisions about your child's care.</li></ul>
Palliative care for brain tumours: GrievingPPalliative care for brain tumours: GrievingPalliative care for brain tumours: GrievingEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00ZKaren Drybrough, RN, MScNUte Bartels, MDLaura Janzen, PhD, CPsych, ABPP-CN6.7000000000000068.60000000000001711.00000000000Flat ContentHealth A-Z<p>Losing a child is one of the most difficult losses to deal with. In-depth advice on coping with grief and finding help from Canadian Paediatric Hospitals</p><p>You will probably be overwhelmed with a range of emotions. Losing a child is one of the most difficult losses to deal with. No parent expects to outlive their child. You may feel sad one minute and angry the next. You may feel shock, denial, and depression. Sometimes you feel these emotions altogether or one after the other. Often they come without warning. You may also experience a tremendous emotional release if you've been holding your emotions in throughout the course of your child's illness. </p><h2>Key points</h2> <ul><li>Every individual grieves differently and experiences different emotions at different times.</li> <li>It is important to allow time to grieve and remember your child.</li> <li>Get help from bereavement or support groups, or from an individual or a group therapy if you need it.</li></ul>
Palliative care for brain tumours: Managing your child's carePPalliative care for brain tumours: Managing your child's carePalliative care for brain tumours: Managing your child's careEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00ZKaren Drybrough, RN, MScNUte Bartels, MDLaura Janzen, PhD, CPsych, ABPP-CN7.5000000000000066.70000000000001062.00000000000Flat ContentHealth A-Z<p>In-depth information on managing palliative care, from providing comfort to skin care. Answers provided by Canadian Paediatric Hospitals.</p><p>Delivering comfort to your child is the main goal of palliative care. Many children will require pain relief with medications. Non-pharmacological methods such as relaxation, guided imagery, hypnosis, and other techniques are excellent tools for providing comfort and pain relief. </p><h2>Key points</h2> <ul><li>Parents can help care for their children by advocating for them, caring for their skin and preventing pressure ulcers.</li> <li>While you may be able to provide some level of care for your child, you may eventually need to ask for help to make your child as comfortable as possible.</li></ul>
Palliative care for brain tumours: Preparing for the endPPalliative care for brain tumours: Preparing for the endPalliative care for brain tumours: Preparing for the endEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00ZKaren Drybrough, RN, MScNUte Bartels, MDLaura Janzen, PhD, CPsych, ABPP-CN8.3000000000000064.20000000000002300.00000000000Flat ContentHealth A-Z<p>Preparing for the death of a terminally ill child is difficult but important. In-depth information on end-of-life decisions concerning palliative care.</p><h2>How do you say goodbye to your passing child?</h2> <p>A palliative care team member can help you articulate what you want to say to your child. Your child may enjoy listening to you say things like "we all love you and we will think of you always." You may want to repeat this numerous times. Or you may want to simply express your love through touch — snuggling, kisses — or soothing activities, like storytelling or gentle play. You as parents will know what you and your child are comfortable with. </p><h2>Key points</h2> <ul><li>It is difficult to predict exactly when death will occur, even for medical professionals.</li> <li>If you are able to do so, consider making arrangements for when your child dies ahead of time.</li></ul>
Palliative care for brain tumours: Preparing your familyPPalliative care for brain tumours: Preparing your familyPalliative care for brain tumours: Preparing your familyEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemNAAdult (19+)NA2009-07-10T04:00:00ZKaren Drybrough, RN, MScNUte Bartels, MDLaura Janzen, PhD, CPsych, ABPP-CN7.4000000000000066.80000000000002159.00000000000Flat ContentHealth A-Z<p>An in-depth discussion of the many difficulties and issues concerning palliative care. Trusted answers from Canadian Paediatric Hospitals.</p><p>Having such an ill child will affect many people: you, your spouse, to your other children, grandparents, other extended family, and friends. Your primary care team and palliative care team are available to speak to the whole family about what palliative care encompasses. This will open the door to discussions about everyone's fears, worries, needs, and hopes. Each family member may be in a different place when it comes to being able to accept the reality that a relative is dying. It is important to appreciate everyone's viewpoint regarding their role as it pertains to your child. </p><h2>Key points</h2> <ul><li>Try to be honest with your ill child about what is happening without being abrupt or frightening.</li> <li>Seek support for yourself, your family and your other children if and when you need it.</li></ul>
Palliative care for children with leukemiaPPalliative care for children with leukemiaPalliative Care for Children with LeukemiaEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseases;Non-drug treatmentAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth A-Z<p> Learn when palliative care would be introduced for children with leukemia.</p><p>To "palliate" means to relieve. The goal of palliative care is to maximize quality of life and comfort for your child.</p> <p>Palliative care uses intensive, active care to relieve physical and emotional symptoms. It embraces the child as a whole, and considers the child's physical, emotional, spiritual, and social needs. Palliative care also considers the needs of the family.</p><h2> Key points </h2> <ul><li> Palliative care is usually introduced when the goal of treatment is no longer curing your child’s leukemia, but making your child feel as comfortable as possible.</li> <li> Your child's health care team and the hospital's palliative care service generally coordinate palliative care.</li></ul>
Palliative care for congenital heart conditionsPPalliative care for congenital heart conditionsPalliative care for congenital heart conditionsEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemNon-drug treatmentAdult (19+)NA2010-05-19T04:00:00ZLaura Beaune, RNChristine Newman, MD, FRCPC11.000000000000049.00000000000000Flat ContentHealth A-Z<p> Read how palliative care is designed to make a child with a life-limiting condition comfortable when cardiac intervention won't be effective.</p><p>To "palliate" means to relieve. Palliative care is a form of intensive, active care aimed at the relief of physical and emotional symptoms. It is intended to help a child with a life-limiting condition to live as comfortably and free of symptoms as possible. </p> <p>Historically, palliative care has been thought of as end-of-life treatment, and this section chiefly addresses end-of-life care. However, palliative care can be beneficial to the child and family from the time of diagnosis of a life-limiting illness. </p> <p>Palliative care embraces the child and family as a whole, taking into consideration physical, emotional, spiritual, and social needs. A variety of professionals, including nurses, doctors, and social workers, have expertise in palliative care. </p><h2> Key points </h2> <ul><li> Surgical palliation is used when a heart defect cannot be fully corrected but can be modified to improve a condition.</li><li> Palliative care has generally been considered as an end-of-life treatment but can also be provided at the same time as cure-directed treatments.</li> <li> Palliative care has generally been considered as an end-of-life treatment but can also be provided at the same time as cure-directed treatments.</li> <li> You can continue to keep your child in hospital to receive palliative care, or you can take them home or to a hospice. </li></ul>
Palliative care for congenital heart conditions: Preparing your familyPPalliative care for congenital heart conditions: Preparing your familyPalliative care for congenital heart conditions: Preparing your familyEnglishCardiologyChild (0-12 years);Teen (13-18 years)HeartCardiovascular systemNon-drug treatment;Support, services and resourcesAdult (19+)NA2010-05-19T04:00:00ZLaura Beaune, RNChristine Newman, MD, FRCPC7.7000000000000064.00000000000001632.00000000000Flat ContentHealth A-Z<p>Palliative care affects the whole family. Learn about discussing death and dying with your child and your family.<br></p><p>The death of a sick child will affect everyone in your family, from your spouse, to your other children, to grandparents and other extended family. Someone from the palliative care service is available to speak to your whole family if requested. This will open the door to discussions about everyone's fears and concerns. It's important to be aware that each family member may be in a different place when it comes to being able to accept the reality that a relative is dying. </p> <p>As much as possible, families need to focus on the time that they have with their child and make the most out of that time.</p> <p>It is important for information to be shared with all family members, taking into account the age of siblings, for example, and the desire for information. </p><h2> Key points </h2> <ul><li>Ill children should be involved as much as possible in decisions about their treatment. </li> <li>Ill children may minimize their pain and fear. </li> <li> Healthy siblings may feel forgotten family members and need to understand why their parents are absent more than usual.</li> <li>Children grieve as intensely as adults, but show it differently.</li> <li>Palliative care team members and chaplains can provide emotional support. </li></ul>
Palliative care for newborn babiesPPalliative care for newborn babiesPalliative care for newborn babiesEnglishNeonatologyNewborn (0-28 days)NANASupport, services and resourcesAdult (19+)NA2009-10-28T04:00:00ZChristine Newman, MD, FRCPC9.1000000000000057.20000000000002121.00000000000Flat ContentHealth A-Z<p>Read about palliative care, and what a family goes through when their child needs palliative care. Coping with the dying process is also discussed.</p><p>To palliate means to relieve. Palliative care is care designed to make a baby with a life-limiting condition as comfortable and symptom-free as possible when it is clear that further treatment aimed at cure is neither possible nor effective. Historically, palliative care has been thought of as end-of-life treatment. However, this form of intensive, active care aimed at the relief of physical and emotional discomfort can be beneficial to the baby and family from the time of diagnosis of a life-limiting illness. </p><h2>Key points</h2> <ul><li>Palliative care enters into your discussion with the doctor when the goal of treatment is no longer focused on curing a condition but on making your baby as comfortable as possible.</li> <li>Support your baby by being there, creating positive memories and holding and touching your baby as much as possible.</li> <li>Prepare your family and other children for what will happen and seek counselling to help you cope.</li></ul>https://assets.aboutkidshealth.ca/akhassets/LIB_bereavementpic_14_EN.jpg
Palliative care for premature babiesPPalliative care for premature babiesPalliative care for premature babiesEnglishOtherPremature;Newborn (0-28 days);Baby (1-12 months)NANASupport, services and resourcesPrenatal Adult (19+)NA2009-10-31T04:00:00ZChristine Newman, MD, FRCPCLori A. Ives-Baine, RN, BScN12.000000000000032.0000000000000300.000000000000Flat ContentHealth A-Z<p>Read about palliative care, which considers physical, emotional, spiritual, and social needs, along with the needs of a baby's family.</p><p>To "palliate" means to relieve. Palliative care is care designed to make a baby with a life-limiting condition as comfortable and symptom-free as possible when it's clear that further treatment aimed at cure is neither possible nor effective. </p><h2>Key points</h2> <ul><li>Palliative care is designed to make a baby with a life-limiting condition as comfortable and symptom-free as possible when further treatment aimed at cure is neither possible nor effective.</li> <li>In many cases, babies will remain in the NICU during palliative care, while some may be moved to a community hospital or sent home with their family.</li> <li>Palliative care is generally organized by a hospital's palliative care service.</li></ul>https://assets.aboutkidshealth.ca/akhassets/LIB_bereavementpic_17_EN.jpg
Palliative care for premature babies: Managing your baby's carePPalliative care for premature babies: Managing your baby's carePalliative care for premature babies: Managing your baby's careEnglishOtherPremature;Newborn (0-28 days);Baby (1-12 months)NANASupport, services and resourcesPrenatal Adult (19+)NA2009-10-31T04:00:00ZChristine Newman, MD, FRCPC Lori A. Ives-Baine, RN, BScN8.7000000000000060.90000000000001479.00000000000Flat ContentHealth A-Z<p>Learn about health-care teams that work hard to manage any symptoms babies experience. They focus on relieving pain and ease breathing difficulties. </p><p>During palliative care, a team of health-care professionals will work hard to manage and relieve any symptoms your baby experiences. They will also answer questions you may have and provide support.</p><h2>Key points</h2> <ul><li>A team of health-care professionals will work hard to relieve any symptoms your baby is experiencing including pain and difficulty breathing.</li> <li>The palliative care team will provide support to you while your baby is in their care as well as after.</li></ul>https://assets.aboutkidshealth.ca/akhassets/LIB_bereavementpic_14_EN.jpg
Palliative care for premature babies: Preparing your familyPPalliative care for premature babies: Preparing your familyPalliative care for premature babies: Preparing your familyEnglishOtherPremature;Newborn (0-28 days);Baby (1-12 months)NANASupport, services and resourcesPrenatal Adult (19+)NA2009-10-31T04:00:00ZChristine Newman, MD, FRCPCLori A. Ives-Baine, RN, BScN10.000000000000056.0000000000000450.000000000000Flat ContentHealth A-Z<p>Read about how an entire family is affected by the decision of palliative care. Read about easing the transition both for a premature baby and their family.</p><p>The death of a premature baby will affect everyone in your family, from your spouse, to your other children, to grandparents and other extended family. Someone from the palliative care service is available to speak to your whole family if requested. This will open the door to discussions about everyone's fears and concerns. It's important to be aware that each family member may be in a different place when it comes to being able to accept the reality that a baby is dying. </p><h2>Key points</h2> <ul><li>Each family member will grieve in a different way and may be in a different place when it comes to being able to accept the reality that a baby is dying.</li> <li>Your other children need to have accurate information that is appropriate for their developmental level.</li></ul>https://assets.aboutkidshealth.ca/akhassets/LIB_bereavementpic_18_EN.jpg
PancreatitisPPancreatitisPancreatitisEnglishGastrointestinalChild (0-12 years);Teen (13-18 years)PancreasPancreasConditions and diseasesCaregivers Adult (19+)NA2014-05-13T04:00:00ZElly Berger, BA, MD, FRCPC, FAAP, MHPE;Shawna Silver, MD, FRCPC, FAAP, PEng9.8000000000000046.90000000000001354.00000000000Health (A-Z) - ConditionsHealth 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>https://assets.aboutkidshealth.ca/akhassets/IMD_pancreatitis_EN.png
Parental advocacy for pain managementPParental advocacy for pain managementParental advocacy for pain managementEnglishNeonatology;Pain/AnaesthesiaPremature;Newborn (0-28 days);Baby (1-12 months)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZSharyn Gibbins, NNP, PhD10.400000000000050.9000000000000433.000000000000Flat ContentHealth 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
Parenting & life skillsPParenting & life skillsParenting & life skillsparentingEnglishNAChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NALanding PageLearning 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>parentinghttps://assets.aboutkidshealth.ca/AKHAssets/parenting_life_skills_landing-page.jpg
Parenting a child with leukemiaPParenting a child with leukemiaParenting a child with leukemiaEnglishOncologyChild (0-12 years);Teen (13-18 years)BodySkeletal systemConditions and diseasesAdult (19+)NA2018-03-06T05:00:00ZOussama Abla, MDDanielle Weidman, MDKarin Landenberg, MD000Flat ContentHealth 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>
Parenting your child with a blood and marrow transplantPParenting your child with a blood and marrow transplantParenting your child with a blood and marrow transplantEnglishHaematology;Immunology;OncologyChild (0-12 years);Teen (13-18 years)BodyImmune systemNAAdult (19+)NA2009-11-30T05:00:00ZJohn Doyle, MD, FRCPC, FAAPChristine Armstrong, RN, MScN, NP Peds7.0000000000000074.0000000000000658.000000000000Flat ContentHealth 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
Partial epilepsy syndromesPPartial epilepsy syndromesPartial epilepsy syndromesEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00ZElizabeth J. Donner, MD, FRCPC11.000000000000042.0000000000000772.000000000000Flat ContentHealth 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>
Participating in a clinical trialPParticipating in a clinical trialParticipating in a clinical trialEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZJonathan Hellmann, MBBCh, MHSc, FCP(SA), FRCPC9.0000000000000055.0000000000000763.000000000000Flat ContentHealth 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>
Pasteurized food and babiesPPasteurized food and babiesPasteurized food and babiesEnglishNutritionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+) Educators Hospital healthcare providers Community healthcare providers Remote populations First nationsNA2013-09-27T04:00:00ZStephanie Gladman, RD, MHSc.;Elly Berger, BA, MD, FRCPC, FAAP, MHPE000Flat ContentHealth 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
Patent ductus arteriosus (PDA)PPatent ductus arteriosus (PDA)Patent ductus arteriosus (PDA)EnglishCardiologyChild (0-12 years)HeartCardiovascular systemConditions and diseasesAdult (19+)NA2009-12-04T05:00:00ZFraser Golding, MD, FRCPC9.3000000000000052.5000000000000484.000000000000Flat ContentHealth 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>
Patent ductus arteriosus (PDA): Closure in the heart catheterization labPPatent ductus arteriosus (PDA): Closure in the heart catheterization labPatent ductus arteriosus (PDA): Closure in the heart catheterization labEnglishCardiologyBaby (1-12 months);Toddler (13-24 months)HeartHeartProceduresCaregivers Adult (19+)NA2009-11-10T05:00:00ZLee Benson, MD, FRCP(C), FACC, FSCAI;Carrie Morgan, RN, MN;Cindy Wasyliw, RN, BNSc7.0000000000000070.6000000000000908.000000000000Health (A-Z) - ProcedureHealth 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
Patient-controlled and nurse-controlled analgesiaPPatient-controlled and nurse-controlled analgesiaPatient-controlled and nurse-controlled analgesiaEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)NANADrug treatmentCaregivers Adult (19+)NA2017-03-17T04:00:00ZJacqueline Hanley, RN, MN​​9.0000000000000059.00000000000001394.00000000000Health (A-Z) - ProcedureHealth 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 <a>opioid</a> 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>
Pavlik harness orthosisPPavlik harness orthosisPavlik harness orthosisEnglishOrthopaedics/MusculoskeletalNewborn (0-28 days);Baby (1-12 months)HipSkeletal systemNon-drug treatmentCaregivers Adult (19+)NA2009-12-29T05:00:00ZThe Certified Orthotists at the Centre for Orthotics and Medical Devices6.3000000000000073.30000000000001280.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how to care for your baby and use the Pavlik harness orthosis.</p><p>Your baby will be using the Pavlik harness orthosis (say: or-THOE-siss). Carefully read these instructions twice. If you have any questions, ask your orthotist right away. It is very important that you understand these instructions and follow them closely.</p><p>The Pavlik harness orthosis is used to correct <a href="/Article?contentid=944&language=English">developmental dysplasia</a> of the hip. It is a set of soft straps that hold your baby's legs apart with the knees bent. The Pavlik harness holds your baby's hips in the correct position.</p><p>Your orthopaedic surgeon will tell you how long your baby should wear the orthosis.</p> <figure class="asset-c-80"> <span class="asset-image-title">Pavlik harness orthosis</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pavlik_harness_EQUIP_ILL_EN.jpg" alt="Identification of shoulder strap, chest strap, abduction strap, flexion strap and leg 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>Your baby needs to wear a Pavlik harness orthosis to correct developmental dysplasia of the hip. The Pavlik harness works by keeping your baby's hip joints in the right position.</li> <li>Your baby will need a few days to get used to the harness.</li> <li>The harness should be adjusted as your baby grows.</li> <li>Watch your baby for signs of skin irritation or femoral nerve palsy.</li> <li>If you have any questions or concerns, call your orthotist.</li> </ul><h2>Femoral nerve palsy</h2> <p>Femoral nerve palsy is a rare condition that sometimes occurs in babies who use a Pavlik harness. This condition does not last forever, but your baby needs medical attention right away if it does happen. </p> <p>It will look as if your baby's leg has fallen asleep. Your baby will not kick their leg or move their toes when tickled.</p> <p>If this happens, take off the harness and call the orthopaedic clinic or the orthopaedic resident on call.</p><h2>Putting the orthosis on</h2> <ol> <li>Open all the straps and lay your baby 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 so that the toes are in the "socks."</li> <li>Secure the leg straps snugly, but not too tightly.</li> <li>Finally, thread the flexion and abduction 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.</p> <p>As your baby grows, the tightness of the leg straps can be adjusted when needed. The toe part of the "socks" can also be snipped off as your baby's feet grow. Your orthotist can help with adjustments when necessary. Do not adjust any of the straps on the harness without speaking with your physician or orthotist. </p>https://assets.aboutkidshealth.ca/akhassets/Pavlik_harness_EQUIP_ILL_EN.jpg
Peanut allergyPPeanut allergyPeanut allergyEnglishAllergyChild (0-12 years);Teen (13-18 years)BodyImmune systemConditions and diseasesCaregivers Adult (19+)NA2014-12-18T05:00:00ZVy Kim, MD, FRCPC;Anna Kasprzak, RN​9.2000000000000057.7000000000000885.000000000000Health (A-Z) - ConditionsHealth A-Z<p>A peanut allergy is a life-long reaction to the proteins in 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.<br></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.</p><h2>How serious is a peanut allergy?</h2><p>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 in the air) 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>Will my child always have a peanut allergy?</h2><p>Yes, a peanut allergy can be severe and life-long.</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>Reducing the risk of cross-contamination</h2> <p>Cross-contamination occurs when a harmless substance comes in contact with a harmful substance, for example a potential allergen or harmful bacteria. If the substances mix together, the harmful 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 protein, omega-3 fats, fibre, magnesium, phosphorus, potassium, folate 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>Nut​rie​nt</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 see a dietitian for a peanut allergy</h2> <p>If you have removed many foods from your child's diet because of a peanut or tree nut allergy, it may be a good idea to speak to a registered dietitian. The dietitian can review the foods your child still eats to decide if they are getting enough nutrients. If necessary, they can also recommend alternative foods that your child can eat safely.</p>https://assets.aboutkidshealth.ca/AKHAssets/peanut_allergy.jpg
Pedestrian safety for childrenPPedestrian safety for childrenPedestrian safety for childrenEnglishPreventionChild (0-12 years);Teen (13-18 years)NANAHealthy living and preventionCaregivers Adult (19+)NA2013-11-04T05:00:00ZElly Berger, BA, MD, FRCPC, FAAP, MHPE​9.0000000000000060.0000000000000645.000000000000Flat ContentHealth 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, more than 30 child pedestrians are killed and 2,400 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>https://assets.aboutkidshealth.ca/AKHAssets/pedestrian_safety.jpg
Pens and cartridgesPPens and cartridgesPens and cartridgesEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor, RN, MN, HonBSc;Vanita Pais, RD, CDE;Jennifer Harrington​, MBBS, PhD​8.1000000000000061.8000000000000672.000000000000Flat ContentHealth A-Z<p>Many people prefer insulin pens to syringes. Find out why they are preferred and what the advantages and disadvantages are.<br></p><p>People often prefer <a href="/Article?contentid=1728&language=English">insulin​</a> pens to syringes because they require less steps to prepare the insulin. Insulin pens also use smaller and thinner needles to deliver insulin. Insulin pens can only give a single type of insulin at one time.<br></p><h2>Key points</h2><ul><li>Insulin pens require fewer steps to prepare the insulin than syringes do.</li><li>Insulin pens are designed to only give a single type of insulin at a time.</li><li>For those who require two types of insulin, they will need to use a syringe, or receive the two types in two different pens.<br></li></ul>

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