Search

Home > Portable Practical Pediatrics > New Era of Minimal Treatment (Pedcast)


	Podcast:		Portable Practical Pediatrics
	Episode:		New Era of Minimal Treatment (Pedcast)
	Category:		Kids & family
	Duration:		00:00:00
	Publish Date:		2016-04-04 19:27:17
	Description:		Topic Introduction The other day I was thinking about how recommended therapies, also known as the "standard of care", have changed during my pediatric career for routine illness. It struck me that we have entered an era of minimalism with regards to treatment. It seems to me that medicine has aged into middle age, no longer eager to "treat" every condition with a therapy, assuming that medical science was smarter than mother nature. I think that concept is passe. No, we have entered an era where interventionism is out and natural healing is in. Hence the rise of integrated medicine, homeopathic medicines, nutritional and aroma therapies. Let me give you a few examples of how previously recommended treatments have changed during my pediatric career and I think you will see what I am talking about. Let's start with a short list of health problems pediatricians are frequently consulted about and I think you will see what I am talking about. Musical Introduction Changing Approaches to Health Problems in Children Infant Colic- this is a condition originally thought to be cause by an upset tummy in an infant (hence the name colic which refers to intermittent crampy pain in the stomach). When I started in pediatrics, the standard treatment for a colicy baby was some type of depressant medication, usually morphine drops called paregoric or some other brain depressant like barbiturates or alcohol. In fact I recall that when I arrived in Charlotte in 1982, one pediatric group sent every newborn home with a prescription for paregoric. Morphine for every child? Not in today's world. In fact, none of these sedative-depressants are used anymore except in the most extreme cases of colic. Colds and Cough- We certainly have backed away from the old days here. These medications are now not recommended for any child under 12 years of age. I'll bet your childhood was full of cough and cold medications. Remember Robitussin, Dimetapp, Actifed, Cheratussin, Vicks, Hycodan, Tussianex, and Delsym, names from our childhood? It turns out that not only were these medications of dubious value but unfortunately, hundreds of children overdosed on them each year, some even dying. Bye bye cough and cold medications. If you want to hear more about this subject, check out these archived docsmo.com episodes. I have talked about this topic extensively over the past few years. http://www.docsmo.com/less-cold-and-cough-medicine-in-children-means-fewer-ed-visits-article/ http://www.docsmo.com/doc-smo-spicy-feet-the-latest-recommendations-regarding-cough-and-cold-medicines-for-young-children-from-fda-and-moms/ http://www.docsmo.com/from-the-desk-of-docsmo-more-on-otc-coldcough-medicines-article/ http://www.docsmo.com/from-the-desk-of-doc-smo-honey-a-great-cough-med-article-edited/ http://www.docsmo.com/medicines-help-or-harm-pedcast/ Fever- In the era of meningitis and other serious blood stream infections in children, before the 1980's, fever often meant serious, serious disease in a child. It still does at times, but rarely in today's vaccine era. In the meningitis era, pediatricians believed that response or lack of response to anti fever medications could be helpful in sorting out which febrile child had a serious life threatening illness and which just had a self limiting viral illness. Response to fever treatment was an important tool pediatricians used to distinguish non serious, self limited viral illness from serious life threatening sickness. You can see why treating fever was such an obsession in those days. But not today. It turns out that lowering a child's body temperature during a routine viral illness often prolongs the illness in terms of the illnesses total duration. In today's world of minimalist treatments, fever reduction is often just a way to make a child more comfortable, not part of therapy or diagnosis of septic illness. Ironically, in today’s world of pediatrics,
	Total Play:		0