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WardSpace

Pediatrics · WardSpace

Children are not small adults.

Learn to think through the child, the family, and the changing physiology. The same ward loop as adult medicine, notice, interpret, decide, present, reassess, with the things that make a child different built into every screen: the age band beside every number, the weight beside every decision, the caregiver’s words on the chart.

  • 14 sections
  • 10 children with a chart
  • 13 presentations
  • 3 deteriorating children

Explored here

… of 49 pediatric items

On this device. Material explored, not competence.

Start here

Thinking in pediatrics

Twelve ways a child changes the reasoning, each taught by one decision you make before the principle is stated: age, weight, development, the caregiver, vitals, compensation, feeding, hydration, birth, immunization, safety, confidentiality.

Begin

The age dial

Move the age. Watch what changes.

6 months old

Band
Infant 1 to 12 months
HR 100 to 180 awake · RR 30 to 53
hypotension below 70 systolic · hypothermia below 36.0
Expected weight
about 7.6 kg
WHO median, boys and girls averaged. The real child is weighed; every dose and every fluid is per kilogram.
Development at 6 months
Gross motor: Rolls from tummy to back; leans on hands to support sittingFine motor: Reaches and grasps; brings things to the mouth; transfers toward 7 to 9 monthsLanguage: Squeals; takes turns making sounds; blows raspberriesSocial: Knows familiar people; likes to look at self in a mirror; laughs
Ask: Has she rolled over? Does she reach out for toys?
Vitals by ageGrowthDevelopment

Age changes everything

The same presentation, four ages

Fever

14 days6 months4 years15 years

The younger the child, the less reliable the examination and the higher the chance that a fever without a source is a serious bacterial infection.

Vomiting

3 weeks9 months4 years15 years

Vomiting is a symptom of the whole child: in the newborn it may be obstruction, in the infant a surgical abdomen or a metabolic disease, in the older child a head, a gut or a ketone problem.

Cough and difficulty breathing

6 weeks18 months7 years16 years

Airway calibre, the viruses that circulate, and the diseases that present change with age; the phrase 'difficulty breathing' means bronchiolitis in an infant and asthma in a schoolchild.

Abdominal pain

2 months18 months8 years15 years

The surgical causes of a painful abdomen are almost entirely age-specific, and young children localize pain poorly, so age is the first clue to where to look.

The domain

Every room, in the order you meet a child

Start here

  1. Thinking in pediatrics01 · 12 principlesTwelve ways a child changes the reasoning
  2. Vitals by age02 · 6 age bands · 20 normal-for-age itemsThe age bands, and normal-for-age practice
  3. Age changes everything03 · 7 presentations, four ages eachFever, vomiting, limp, headache, side by side

The child

  1. Presentations04 · 13 presentations by agePresentation-first, by age
  2. Growth05 · WHO chart viewer · 6 trajectoriesThe chart as a reasoning tool
  3. Development06 · 9 ages · 3 practice childrenThe progression, the red flags, how to ask
  4. Newborn07 · History builder · jaundice · infectionThe history before birth, jaundice, infection
  5. Adolescent08 · HEEADSSS · 3-moment interviewThe confidential interview
  6. Specialties09 · 17 divisions · 24 conditionsThe pediatric divisions and their conditions

On the ward

  1. Acute pediatrics10 · 3 deteriorating children · who first?The deteriorating child, frame by frame
  2. Pediatric ward11 · 2 rounds · 3 pages · a night shift · 2 sign-outsRounds, call, the night shift, handover, discharge
  3. Cases12 · 10 longitudinal childrenLongitudinal children with a full chart
  4. Practice13 · 6 judgement drillsWhat matters, what to ask, what to examine
  5. Quick reference14 · Vitals, milestones, growth, labsVitals, development, growth, labs by age

Today in pediatrics

Collapsed during the 400 metres

A 15-year-old runner collapsed mid-race and came round within a minute. Her coach says she 'just fainted'. She has fainted once before, in a swimming pool.

15 years old · 3 steps · fictitious educational patient

See the child

Normal for age?

0/0 · 20 items

18 hoursNewborn finding

Visible jaundice at 18 hours of age

Presentations, by age

FeverCough and respiratory distressVomitingDiarrhea and dehydrationAbdominal painSeizureLimpRash with feverJaundicePoor weight gainAltered level of consciousnessNewborn feverStridor

Specialties

General pediatricsNeonatologyRespiratoryCardiologyGastroenterologyInfectious diseaseNeurologyEndocrineNephrologyHematology and oncologyRheumatologyMusculoskeletalAdolescent medicineDevelopmental pediatricsAcute pediatricsDermatologyOphthalmology

Every range, threshold and score in this domain is a teaching value from a named pediatric reference (PALS 2020, the Canadian Paediatric Society, the AAP, the WHO growth standards), printed the way a textbook prints it so the reasoning can be practised. It is educational, not decision support: real children are managed by your institution’s guidelines, your seniors, and the child in front of you.