According to the American Academy of Pediatrics (AAP), pediatrics is a medical specialty that deals with the physical, mental, and social health of children from birth to young adulthood. Pediatrics is also a discipline that deals with the biological, social, environmental, and impact of disease on child development. Children differ from adults anatomically, physiologically, immunologically, psychologically, developmentally, and metabolically. Therefore, the handling of children’s health is also done in a different way.
In order to provide education related to child health, the University of Indonesia Hospital (RSUI) held a webinar, on Friday (28/1), with the theme “Holistic Approach to Management of Pediatric Cases”. The speakers at the event were dr. Cynthia Centuri Sp.A., Dr. dr. Putri Maharani Tristanita Marsubrin Sp.A.(K), and Dr. dr. Irene Yuniar Sp.A.(K) with the moderator dr. Endah Setyaningsih.
According to dr. Cynthia, a child’s growth and development disorders are not only caused by nutritional deficiencies, but also by genes and hormones. Therefore, an approach and screening is needed to determine the cause of the baby experiencing stunting. To find out, the first step that must be done is making a developmental pre-screening questionnaire (KPSP) for children aged 3 months-6 years. Second, a hearing test is conducted every 3 months for infants aged <12 months and every 6 months for infants aged >12 months. Furthermore, the TERA and BERA tests were conducted to determine the hearing and speech abilities of infants and toddlers
breathing or have stopped breathing. In the case of newborns, out of 10 babies there was 1 baby who was resuscitated. Newborns have the golden minute, the first 60 seconds from birth, to re-evaluate and initiate ventilation if necessary. This phase is the most important phase in the success of infant resuscitation. Next, the phase of the first golden hour, which is, she added that breathing in children also needs to be considered because many children are undergoing resuscitation. Resuscitation is the provision of artificial respiration for people who have difficulty the first 60 minutes of a baby’s life. This phase is divided into four stages, namely neonatal resuscitation, post-resuscitation or stabilization care, transportation of sick babies to the NICU, and respiratory and cardiovascular assistance at the start of treatment.
“The neonatal resuscitation process begins with the antenatal counseling process by looking at the data of the mother and the condition of the fetus during the pregnancy phase, preparation of equipment, and division of tasks within the team so that errors during resuscitation can be minimized and the resuscitation process is effective,” explained dr. Putri
Meanwhile, dr. Irene highlighted the phenomenon of shock in children. Shock is a life-threatening circulatory failure caused by inadequate oxygen delivery and tissue metabolism, causing tissue and cellular hypoxia. In the pathophysiology of shock, the amount of oxygen delivered must be balanced with the amount of oxygen consumed. Hypovolemic shock is caused by bleeding, cardiogenic shock is caused by impaired contractility, and obstructive shock is caused by a disturbance in afterload. To deal with it, management of shock is needed and the type of drugs, such as inotropes, vasodilators, inodilators, and vasopressors. In patients with shock, early and adequate hemodynamic support is essential to prevent organ dysfunction and failure. Resuscitation should be initiated immediately even though investigations into the cause of shock are still ongoing. Once the cause of shock is known, it must be corrected quickly, such as control of bleeding, PCI in coronary syndromes, thrombolysis or embolectomy in massive pulmonary embolism, and administration of antibiotics and control of the source of infection in septic shock.
