American Academy of Pediatrics T EXTBOOK OF P C EDIATRIC ARE 000i-000l_FrontMatter_AAP-TxtbkPi i 9/5/08 10:07:35 PM 000i-000l_FrontMatter_AAP-TxtbkPii ii 9/5/08 10:07:35 PM American Academy of Pediatrics T EXTBOOK OF P C EDIATRIC ARE Thomas K. McInerny, MD, FAAP Editor in Chief Professor and Associate Chair for Clinical Affairs, Department of Pediatrics University of Rochester School of Medicine and Dentistry Rochester, New York Co-editors Henry M. Adam, MD, FAAP Professor of Clinical Pediatrics, Albert Einstein College of Medicine Children’s Hospital at Montefi ore Bronx, New York Deborah E. Campbell, MD, FAAP Professor of Clinical Pediatrics, Albert Einstein College of Medicine Director, Division of Neonatology, Children’s Hospital at Montefi ore Bronx, New York Deepak M. Kamat, MD, PhD, FAAP Professor of Pediatrics, Wayne State University Vice Chair of Education Director, Institute of Medical Education, The Carman and Ann Adams Department of Pediatrics Children’s Hospital of Michigan Detroit, Michigan Kelly J. Kelleher, MD, MPH, FAAP Professor of Pediatrics and Psychiatry, Colleges of Medicine and Public Health Director, Center for Innovation in Pediatric Practice Vice President for Health Services Research Columbus Children’s Research Institute Columbus, Ohio Robert A. Hoekelman, MD, FAAP ExOffi cio 000i-000l_FrontMatter_AAP-TxtbkPiii iii 9/5/08 10:07:35 PM Director, Department of Marketing and Publications: Maureen DeRosa, MPA Director, Division of Product Development: Mark Grimes Senior Developmental Editor: Martha Cook, MS Editorial Assistant: Carrie Peters Director, Division of Publishing and Production Services: Sandi King, MS Manager, Editorial Production: Theresa Wiener Director, Division of Marketing: Jill Ferguson Manager, Clinical and Professional Publications Marketing: Linda Smessaert Director, Division of Sales: Robert Herling Cover Design: Linda Diamond Internal Designer and Project Manager: Dana Peick, Cadmus Communications Production Editor: Janice Massey, Cadmus Communications Library of Congress Control Number: 2007925935 ISBN-13: 978-1-58110-268-0 MA0402 The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. Every effort has been made to ensure that the drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. It is the responsibility of the health care provider to check the package insert of each drug for any change in indications and dosage and for added warnings and precautions. The mention of product names in this publication is for informational purposes only and does not imply endorsement by the American Academy of Pediatrics. The publishers have made every effort to trace the copyright holders for borrowed material. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the fi rst opportunity. Copyright © 2009 American Academy of Pediatrics. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without prior written permission from the publisher. Printed in the United States of America. Publisher’s Cataloging-In-Publication Data (Prepared by The Donohue Group, Inc.) Textbook of pediatric care / Thomas K. McInerny, editor in chief; co-editors: Henry M. Adam, Deborah E. Campbell, Deepak M. Kamat, Kelly J. Kelleher. p. : ill., charts ; cm. Includes bibliographical references and index. ISBN: 978-1-58110-268-0 1. Pediatrics—Textbooks. I. McInerny, Thomas K. II. Adam, Henry M. III. American Academy of Pediatrics. RJ45 .T59 2009 618.92 2007925935 Suggested Citation: McInerny TK, Adam HM, Campbell DE, Kamat DM, Kelleher KJ, eds. American Academy of Pediatrics Textbook of Pediatric Care. Elk Grove Village, IL: American Academy of Pediatrics; 2009. 9-210/0908 1 2 3 4 5 6 7 8 9 10 000i-000l_FrontMatter_AAP-TxtbkPiv iv 9/15/08 8:51:37 PM D EDICATION W e dedicate this fi rst edition to Robert Hoekelman, MD, whose legacy of excellence, commitment to quality health care for children, and dedication to education in pediatrics are refl ected in these pages. 000i-000l_FrontMatter_AAP-TxtbkPv v 9/5/08 10:07:36 PM 000i-000l_FrontMatter_AAP-TxtbkPvi vi 9/5/08 10:07:36 PM Foreword T he American Academy of Pediatrics (AAP) McInerny, MD, FAAP. Featuring contributions from and our member pediatricians dedicate ourselves to experienced clinicians worldwide, this textbook ad- the health, safety, and well-being of infants, children, dresses clinical issues faced by physicians who care for adolescents, and young adults. An important aspect children: screening, diagnosis, treatment, and man- of our work is creating the educational materials agement for both common and uncommon diseases. necessary to provide appropriate, equitable, and Priorities for the 21st century, including the practice of high-quality pediatric care. To this end, the AAP has evidence-based medicine, electronic health records, capitalized on its extensive knowledge and resources fi nance, and continuous quality improvement, are to create the AAP Textbook of Pediatric Care. also addressed. The AAP is the leading publisher in the fi eld of Because the practice of pediatrics is constantly pediatrics, offering more than 500 publications, changing and because we have a need for infor- both print and electronic, for pediatricians and mation accessible in multiple ways, we also offer other health professionals who care for children. this information as part of our new Web-based re- This kind of leadership saves lives, improves source, Pediatric Care Online. Please see www.pedi- children’s health, and supports the high quality of atriccareonline.org for updates to the textbook and the profession of pediatrics. the latest news in pediatric health care. The AAP Textbook of Pediatric Care was created Renée R. Jenkins, MD, FAAP by a distinguished editorial team led by Thomas K. President, American Academy of Pediatrics, 2007–2008 Foreword vii 000i-000l_FrontMatter_AAP-TxtbkPvii vii 9/5/08 10:07:36 PM 000i-000l_FrontMatter_AAP-TxtbkPviii viii 9/5/08 10:07:37 PM Introduction M edical experts and patients alike increas- physician, we created a supplement to the text, the ingly recognize the value of the medical home and AAP Textbook of Pediatric Care: Tools for Practice, pediatric primary care. Adding to the complexity which provides the reader with copies of many of of the practice of pediatrics within the framework the hundreds of screening questionnaires, forms, of the medical home is that physicians who care tables, and other implementation tools collected by for children do so in various settings: community the editors and authors. This supplement also offers health clinics, private group practices, solo prac- a short summary of pediatric basic life support and tices, and hospitals, as well as in rural, urban, and helpful guidance with pictures of the most common suburban communities. The American Academy of procedures performed by pediatricians. Pediatrics Textbook of Pediatric Care provides in- Most exciting is the delivery of the text and as- formation for physicians who care for children no sociated tools in an electronic format. Pediatric matter the setting, with an emphasis on the medical Care Online (www.pediatriccareonline.org) brings home as the ideal. This fi rst edition, created on the together this text and other leading pediatric re- basis of the fourth edition of Primary Pediatric Care, sources into one integrated site. In addition to on- edited by Robert Hoekelman, MD, provides the lat- line access to the AAP Textbook of Pediatric Care, est evidence-based recommendations for the diag- Pediatric Care Online includes Red Book content; nosis and treatment of children cared for by pedia- Bright Futures; an interactive periodicity schedule; tricians, family physicians, and nurse practitioners. and a topical quick reference guide, as well as tools, The American Academy of Pediatrics (AAP) and its patient education materials, calculators, and timely extensive resources were instrumental in ensuring clinical updates. the completeness and accuracy of this textbook. We Part 1, Delivering Pediatric Health Care, dis- particularly appreciate the efforts by the AAP com- cusses health care delivery and fi nance, as well as mittees and sections in reviewing the chapters rel- organizational issues for pediatric practices in- evant to their areas of expertise. cluding the use of electronic health records, Web- Some of the key topic areas of the textbook of based resources, evidence-based medicine, and which we are most proud include the unique sec- quality improvement methodologies. Chapters on tion on developing well-functioning systems of child health supervision, the medical home, family- care and continuous quality improvement in prac- centered care (including caring for families new to tice patterns. In addition, because pediatricians are the United States), and community-wide approaches increasingly on the front lines in providing mental to promote child health are also offered. This part health care, we increased the emphasis on devel- concludes with a chapter on ethical and legal issues. opmental, behavioral, and psychosocial health care. Part 2, Evaluation and Communication, address- The section on neonatology provides the informa- es the elements of history taking, physical exami- tion necessary to care for high-risk and healthy nation, imaging, and discussing the diagnosis with newborns in areas without ready access to tertiary patients and families. Because the population of care hospitals. children in the United States is becoming increas- We include the helpful “When to Refer” and ingly more diverse and systems of medical care are “When to Admit” guidance at the end of each chap- evolving, chapters on cultural issues in primary pe- ter, and after each chapter is a summary of the most diatric care, the art of referral consultation and col- highly regarded implementation materials. These laborative management, and hospital care are also materials include links to resources for engaging provided. patients and families, medical decision support, Part 3, Principles of Patient Care, has been reor- practice management and care coordination, and ganized into 6 sections: Health Promotion, Disease community advocacy and coordination, as well as Prevention, Screening and Case Finding, Treatment related Web sites, AAP policy statements, and sug- of Disease, Care of the Child With Special Health gested readings. To make things easier for the busy Care Needs, and Palliative and End-of-Life Care. Introduction ix 000i-000l_FrontMatter_AAP-TxtbkPix ix 9/5/08 10:07:38 PM