Pediatrician at your disposal 24 hours a day? If our child is ill we often feel that a pediatric specialist, ready for prompt assistance anytime even on week-ends, holidays or in the middle of the night, would give us safety. In fact the problem is substantial – especially in cases when our febrile infant is crying or we are helpless to soothe our child’s severe, racking cough. Pediatricians of our Svábhegyi Children’s Clinic follow the newest recommendations of their medical specialties with attention and participate in the medical training and specialists’ education. Being a child care institution it is important to us to provide safety to parents that their children are in good hands with us in the course of our assistance in curing and recuperating them.
From newborn to 18 years of age
Fever, vomiting, diarrhea, abdominal cramps, breathing difficulties, persistent coughing, skin rashes… Our infant- and pediatric specialists, having excellent professional knowledge based on decades of hospital experience, are available 24 hours a day (see link of doctors in attendance…). At our specialty clinic (see map…) we are also at your disposal on a pre-scheduled date with our availability of up-to-date diagnostic equipment and laboratory background.
In what cases the child must be seen by the doctor by all means?
Since this is a common question of the parents we would like to give a guide (see footnote no.1.) for information. Fever itself (see footnote no.2.) does not mean a case of emergency except those problems when there is a presence of extreme high fever, febrile convulsions (see footnote no.2.) or feverish condition under the age of three months. Fever itself is not the sign of a serious pediatric disease yet generally it causes panic among family members.
If the child’s body temperature is between 37.4°C and 37.9°C we speak of subfebrility only, while in case of higher temperature we really notice fever. Fever above 39°C may cause older children a serious depressed and fretful condition as well as impatience.
In case of fever caused by infection, the increased body temperature makes the environment for pathogens’ multiplication hostile. In such cases the child’s own immune system is more active too so in order to boost the body defenses moderate fever could be useful. However the management of the fever and fluid replacement is important. Similar is the case when diarrhea (see footnote no.2.) comes with pyrexia. If the child does not want to drink (refusing to drink from glasses or from a nursing bottle) it is worth trying to take liquids in by the help of a smaller spoon.
Daily maintenance fluid requirement in children:
- under the weight of 10 kg 1 liter/day
- between 11 and 20 kg 1000 ml+50x(child’s weight in kg -10) ml, for example a child having 15 kg weight needs 1000 ml +50x(15 kg-10)=1000ml+250 ml=1250 ml, i.e. 1.25 liter
- above 20 kg 1500 ml+20x(child’s weight in kg – 20) ml,
for example a child having 25 kg weight needs 1500 ml+ 20x(25kg-20)=1500 ml+100 ml=1600 ml, i.e. 1.6 liter
In feverish condition a rate of 10% extra fluid daily intake/centigrade must be added to the calculated value.
Most of the dermatological lesions must be seen by the doctor since it is very difficult to characterize these defects without observation.
Wet diapers open the door to bacteria, fungi and other pathogens. If the posterior of the baby is red or we also recognize small, white, protuberant spots of pinpoint size and possibly the epidermis becomes deficient then upon napping owing to the itch and the pain the baby is more fretful, fractious and conflicting.
The case is different for the presence of allergy (see link…) when the baby’s organism hypersensitively reacts to a skin contact or to a kind of food with visible skin symptoms. Since food allergy (see link…) may provoke serious reactions from the organism, these skin defects must be taken seriously and shown to a pediatrician or to a specialist without delay.
This procedure must also be followed in case of certain insect bites (wasp, bee) (see link).
It is worth to describe the typical skin lesions which could be monitored on the different aged children:
Tap: colored deviation of the skin having different sizes which does not protuberate that is cannot be felt by palpation when touching the area of the skin above the deviation in question; tap could be an inflamed area of the skin but also an aneurysm or pigmentation
Papule: a kind of deviation which moderately bulges from the skin with a size of a few millimeters
Plaque: an area taken shape by the fusion of papules
Lump: lesion with size of 0.5-2 cm, moderately bulges from the skin
Tumor: a deviation with size above 2 cm, slightly protuberant, could be well circumscribed by palpation
Hives (nettle-rash): flat elevated pink or reddish lesion with paler centre and fluid like fade; it resembles to the well-known signs on the skin after a nettle-sting
Vesicle: is a small fluid-filled sac with size of less than 0.5 cm; one of the well-known vesicles is for example the herpetic vesicle
Water blister: a fluid-filled sac over 0.5 cm
Purulent vesicle: purulence-filled vesicle with size under 0.5 cm
Flake: loss of the outer layer of skin in scale-like flakes
Cracks: painful crackings on the surface of the skin like the well-known cracks at the mouth-corners
Grooming signs: linear erosion of the skin surface originating from deviations with itching compulsion
Ulcer: disintegration of tissues spreading to the lower layers of the skin