when it is really necessary to call him and get him home (avoiding DIY) – time.news

by time news
from Chiara Daina

The arrival of the specialist reassures the parents, however it is not always the most convenient choice for the little patient. Better to follow the doctor’s telephone instructions

High fever, sore throat, difficulty breathing: when should you worry about the baby’s symptoms and call the pediatrician? In which cases can the indications given on the telephone by the doctor suffice? When, on the other hand, a check-up in your clinic or a home visit is essential? There are many doubts of parents, especially the first child and it is not uncommon that, a little bewildered and frightened, they run in vain to the emergency room or contact the private specialist for a fee. Renato Turra, a free choice pediatrician in the province of Turin and national vice president of the Italian Society of Pediatrics (Sip), clarifies the procedures for intervention and first of all recommends that you trust the opinion of your doctor.

What does the National Collective Agreement provide?

Mam e pap they can call us whenever they have a doubt but they have to cooperate with us, following our advice as much as possible he says. clear that we we visit the child at home only if we deem it necessary. In principle, as established in the National Collective Agreement of Pediatricians, in cases where the clinical conditions do not allow the transferability of the patient. So when the child is bedridden, perhaps with a major fracture, in a wheelchair, or immunosuppressed (exposure to external environments in fact would put his health at risk).

When is the doctor available?

The pediatrician of free choice usually available remotely from 8 to 20 from Monday to Friday and Saturday from 8 to 10. And it should satisfy the demand for white and green codes, avoiding improper access in the pediatric age to the emergency room. If the general condition of the child does not change, if he plays and eats normally, reactive, he interacts with others as usual, there is no need to visit him and by telephone we explain to the parent what to do he declares Antonio D’Avino, who works in a group practice in Naples and holds the role of national vice president of the Italian Federation of pediatricians (Fimp).

What if the child has a fever or has fallen?

A few examples. In the presence of fever we recommend that you check your temperature every four hours and give an antifebrile, paracetamol or ibuprofen, in case of joint pain and headache. If the child has vomiting and diarrhea we ask you to let us know if after oral rehydration he can retain fluids. If the symptoms persist, drowsy and not very alert, we evaluate the clinical status in the clinic: dryness of the mucous membranes of the tongue, inadequate response to tactile and auditory stimuli, possible referral to the emergency room to replenish the mineral salts lost through a drip. Following a fall, joint sprain, trauma (without extensive wounds and unconsciousness): The baby should be kept under observation. If you feel nauseous, dizzy, have difficulty moving then we will perform a check in presence. In any case
never give your child antibiotics without first consulting your doctor. Administering them when they are not needed, for the treatment of non-bacterial infections, is harmful to the health of the child and the whole community (because in this way the development of microbial resistance to antibiotics is favored).

What to do when the doctors’ offices are closed?

During the hours when the doctors’ offices are closed and for situations that cannot be postponed to the next day You can contact the Continuity Assistance service (from 8pm to 8am every day and from 10am on Saturdays, or before holidays, until 8am on Monday). In some Regions (but not in all the relevant healthcare companies) it has been activated also specifically pediatric continuity of care in the days before holidays and holidays: in Puglia, Sicily, Emilia Romagna, Lazio, Lombardy, Campania, Piedmont, Veneto, Tuscany and the province of Bolzano, according to a survey by the Fimp.

If you go to the clinic, do you have to respect a waiting list?

There are no waiting lists. If the pediatrician thinks he can see the baby right away make an appointment the same day, or at another time if not urgent D’Avino continues. The outpatient service usually provided to diagnose with a swab the presence of a bacterial infection, such as otitis and tonsillitis and, in the positive case, to prescribe the antibiotic and every time a sudden change in the child’s habits and behaviorsuch as frequent crying, whining, short temper, refusal to eat and drink for no apparent cause. It is better for the child to be seen in the clinic rather than at home, because it is here the pediatrician may have tools to help him in the diagnosis: from the leukocytometer, for the count of white blood cells in the blood, to the test for VES, to identify the presence of inflammation, and finally that for the C-reactive protein, useful for detecting an infection, observes D’Avino. While thehe rush to the emergency room for non-emergencies should be avoided: The family risks long waits, subtracting assistance from the most complex cases. In that environment, with other patients, there is also the danger of contracting infections.

How does the pediatrician behave in case of Covid?

Home visits, if deemed necessary by paediatrics, as a rule, they must be carried out within the same day if the request arrives before 10 am, after that time they must be done by 12 noon of the following day. Who is eligible? In particular, as already mentioned, non-ambulatory and non-transportable children, and those very fragile, with immunodeficiency, who could suffer damage if exposed to pathogens from the external environment. They are also provided scheduled visits to the chronically ill (with respiratory, neurological problems, renal insufficiency) and whenever the pediatrician intends to verify the family and life conditions of his patient, if we suspect physical abuse, neglect, poor hygiene conditions, D’Avino specifies. In the case of Covid, or symptoms attributable to the infection, remember, even for the little ones, the Usca (special unit of continuity assistance) is activated at home, directly by the pediatrician.

When to call the emergency number 112/118?

The number 118 or 112 (the single European number for emergencies) must be called if the child is seriously ill, for example, experiences a sudden loss of consciousness, a respiratory crisis or life threatening. For all other emergencies, such as intoxication, severe burns, obvious fracture of the bones, large wound to be saturated as soon as possible, repeated vomiting and inability to take therapy by mouth, fever plus urinary infection symptoms and important signs of malaise, must be transported to the hospital immediately. Today for, comments Gian Vincenzo Zuccotti, director of Pediatrics and the emergency room of the Buzzi hospital in Milan and dean of Medicine at the State University, 90% of access to the emergency room represented by white and green codes that could be managed in the area. Often the parents did not contact the family pediatrician first or they tried to contact him but he was busy. How to solve the problem? If the attivit of territorial pediatrics were dispensed in associative form, with more pediatricians who shift during the day and share the same patients, there would be greater availability of assistance. I hope that the model of the Community House envisaged by the National Post-Covid Recovery and Resilience Plan will promote group pediatrics, suggests Zuccotti.

October 10, 2021 (change October 10, 2021 | 16:10)

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