PULLMAN & ASSOCIATES PEDIATRICS
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Emergency Contact Details

1/27/2019

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Hospitals
Washington, D.C.
  • Children's National Medical Center
    • ​Address: 111 Michigan Avenue, NW, Washington, DC 20010 
    • Phone: 1-888-884-2327
  • ​Medstar Georgetown University Hospital
    • ​Address: 3800 Reservoir Road NW, Washington, DC 20007
    • Phone: 202-444-2000
Northern Virginia
  • Inova Fairfax Hospital
    • ​3300 Gallows Road, Falls Church, Virginia 22042
    • Phone: 703-776-4001
  •  Virginia Hospital Center
    • ​Address: 1701 North George Mason Drive, Arlington, Virginia 22205
    • Phone: 703-558-5000
  • Inova Alexandria Hospital
    • Address: 4320 Seminary Road, Alexandria, Virginia 22304
    • Phone: 703-504-3000
Maryland
  • Holy Cross Hospital
    • ​Address: 1500 Forest Glen Road, Silver Spring, Maryland 20910
    • Phone: 301-754-7000
  • ​Suburban Hospital
    • ​Address: 8600 Old Georgetown Road, Bethesda, Maryland 20814
    • Phone: 301-896-3100
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​Poison Control Center

Phone: 1-800-222-1222
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Poison Exposure or Ingestion?

1/27/2019

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Do you suspect that your child has been exposed to or ingested something poisonous (including household agents, medications, or plants)?
Call the Poison Control Center (1-800-222-1222​) immediately.
They will give you exact instructions about the necessary steps to follow.

Call to update us after you have carried out the Poison Center’s instructions.
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Decongestants and Cough Medicines

1/27/2019

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We discourage the use of all cough medicines in children under the age of 6 years.

For children over the age of 6 years, if the cough is disrupting sleep and an over-the counter cough medicine or decongestant is effective, try to limit its use to once in the a.m. and once in the p.m.
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Fever Care

1/27/2019

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In order to diagnose a fever, first check your child's temperature (Is It a Fever?).

For children ages 2-12 years, you may follow the instructions on the bottle. However, the best method of dosing for all children under 80 pounds, and especially for babies, is to dose based on weight.

When dealing with a high fever, it is always best to use the full dose for weight, as it will be more effective than a small dose. For medication dosing, fever is generally considered any temperature greater than 101.4°F (38°C).


​In order to clinically evaluate your child, it is important to get the fever down by administering the proper dose of Tylenol or Motrin. Do not give Tylenol before two months of age unless directed to do so by your doctor. Give only Tylenol at 15 mg/kg body weight between 2 and 6 months of age, every four hours. After 6 months of age, you may give either Tylenol at 15 mg per kilo of body weight every 4 hours or Motrin 10 mg/kg of body weight, every 6-8 hours. It is ordinarily not necessary to alternate Tylenol and Motrin.

  • Acetaminophen (Tylenol)
    • May be used in babies over 2 months of age.
    • Use 15 mg per kg of body weight. (One kg= 2.2 lbs, so a 22 lb child weighs 10 kg).
    • Give acetaminophen every 4 hours.
    • Infant acetaminophen is 80 mg per 0.8 ml (one dropper is 0.8 ml) but Tylenol brand is 160 mg/ 5 ml.
    • Children’s Acetaminophen is 160 mg per 5ml (1 teaspoon= 5ml).
    • So an 8 kg baby would get 1 1/2 droppers of infant acetaminophen or 3.75ml of children’s acetaminophen.
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  • Ibuprofen (Motrin, Advil)
    • May be used in babies over 6 months of age.
    • Use 10 Mg per kg of body weight (One kg= 2.2 lbs, so a 22 lb child weighs 10 kg).
    • Infant Ibuprofen is 50 mg per 1.25 ml (1 teaspoon= 5ml).
    • Children’s ibuprofen is 100 mg per 5 ml (1 teaspoon= 5ml).
    • So a 10 kg baby would get 2.5 ml of infant or 5 ml of children’s Motrin.

For high fevers over 103°F, we may suggest that you alternate Tylenol and Motrin for 24 hours. When alternating them, the same dosages are used. Each is given every 6 hours, so that medication is being given every three hours: 12PM Tylenol, 3PM Motrin, 6PM Tylenol, 9PM Motrin, etc.
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How to: Armpit Temperature

1/27/2019

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There are two important parts of taking your child's temperature. Knowing how to take it (click here for Is It a Fever and What to Do), and knowing what it means (click here for What Temperature is a Fever?).
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Step 1:
Place the tip of the thermometer in a dry armpit.

Step 2:
Close the armpit by holding the elbow against the chest until the thermometer beeps.

Step 3:
If you’re uncertain about the result, check it with a rectal temperature.
​
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What Temperature is Cause for Concern?

1/27/2019

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Make sure to use the appropriate method for taking your child's temperature depending on their age (click here to find out Is [It] a Fever and What to Do?).

Rectal temperature
  • Under 2 months of age: Over 100.4°F if under 2 months of age
  • Between 2 and 4 months of age: Over 101.4°F

Oral or Eardrum
Older babies and toddlers may have temperatures between 103° and 105°F.


Your child has a fever if any of the following apply:
  • Rectal temperature over 100.4° F for babies less than 2 months old.
  • Rectal temperature over 101.4° F for babies older than 2 months old.
  • Oral temperature over 101 ° F for kids over 5 years of age

The body’s average rectal temperature is 98.6 °F, but it normally fluctuates during the day, tending to rise toward the end of the day. Fever is a symptom, not a disease. Fever is the body’s normal response to infections and plays a role in fighting them.

The usual fevers (100° to 104° F) that all children get are usually not harmful in themselves.

Does your child have a fever? Apply appropriate Fever Care to look after your child.
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How to: Eardrum Temperature

1/27/2019

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There are two important parts of taking your child's temperature. Knowing how to take it (click here for Is It a Fever and What to Do), and knowing what it means (click here for What Temperature is a Fever?).

Step 1:

B

Step 2:
B
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How to: Oral Temperature

1/27/2019

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There are two important parts of taking your child's temperature. Knowing how to take it (click here for Is It a Fever and What to Do), and knowing what it means (click here for What Temperature is a Fever?).

Step 1:
Use a flexible digital thermometer. Do not use a mercury thermometer.

Step 2:
Be sure your child has not taken a cold or hot drink within the last 30 min.


Step 3:
Place the tip of the thermometer under one side of the tongue and toward the back. Note: An accurate temperature depends on proper placement.

Step 4:
Have your child hold it in place with the lips and fingers and breathe through the nose, keeping the mouth closed.

Step 5:
Leave it inside the mouth until the thermometer beeps.
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How to: Rectal Temperature

1/27/2019

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There are two important parts of taking your child's temperature. Knowing how to take it (click here for Is It a Fever and What to Do), and knowing what it means (click here for What Temperature is a Fever?).

Step 1:
​
Have your child lie stomach down on your lap.


Step 2:
Before you insert the thermometer, apply some petroleum lubricating jelly (such as Vaseline) to the end and to the opening of the anus.

Step 3:
Gently insert the thermometer into the rectum about to 1 inch. Never try to force it past any resistance.

Step 4:
Hold your child still while the thermometer is in.

Step 5:
Leave the thermometer in your child’s rectum until it beeps.
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Is it a Fever and What to Do?

1/27/2019

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How to Take a Temperature
We recommend using a digital thermometer to quickly and accurately take your child's temperature.

Please Note: The most effective method for taking your child's temperature may depend on their age.


Rectal Temperatures (How to: Rectal Temperature)
  • Accuracy: The most accurate
  • Age: Under 2 years. Particularly important for infants 3 months of age or younger

Oral / Eardrum Temperatures (How to:  Oral Temperature and How to: Eardrum Temperature)
  • Accuracy: Accurate if done properly and can be more convenient.
  • Age: For children 5 years old or older, take the temperature by mouth.

Axillary (armpit) temperatures (How to: Armpit Temperature)
  • Accuracy: The least accurate
  • Better than no measurement, can be used for screening if done correctly
  • Recommend using one of the other methods listed above ​

What is considered a temperature?

[What does this mean?]
The expected time course of most fevers due to viral illnesses is 3 to 4 days. The height of the fever does not necessarily relate to the seriousness of the illness.

The recommended home care management of fevers includes:
  • Treat all fevers with extra fluids and less clothing.
  • Use acetaminophen (Tylenol) or ibuprofen (Motrin) for reducing fever (see dosing chart) it is best to use your child’s weight when figuring out the right dose.
  • Never use aspirin due to the risk of Reyes syndrome, a dangerous complication of ingesting aspirin during certain viral infections such as chicken pox.

Call our emergency hotline (+1 (202) ###-####) immediately if:
  • Your child is less than 2 months of age with a temperature over 100.4 °F or less than 4 months old with a temperature greater than 101.4°F.
  • Your child’s temperature is over 105°F.
  • Your child looks or acts very sick and you can’t bring the temperature down with the appropriate dose of antipyretic.
  • Your child looks or acts very sick regardless of the temperature.

Call our office (+1 (202) 466-5350) during regular hours if:
  • Your child is 2 to 6 months old with temperature greater than 101.4°F and without an obvious cause or location of infection.
  • The fever is between 104° and 105 °F, especially if your child is less than 2 years old.
  • Your child has had a fever more than 3 days.
  • Your child is uncomfortable and refuses to drink.
  • The fever went away for more than 24 hours and then returned.
  • Your have other concerns or questions.

Many preparations come in an infant formulation as well as a children’s formulation. The infant formulation is more concentrated. You must check the concentration on the label.
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What to Keep in the Medicine Cabinet

1/27/2019

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The following is a list of general over-the-counter medicines and supplies that can be included in a medicine cabinet:

  • Medication​
    All medications should have child-proof caps and be kept out of reach of children. Remember,  Always check the expiration date on the medicine first. Never give your child medicine made for adult.
    • Acetaminophen (Tylenol) Infant Drops or Syrup.
    • Ibuprofen (Motrin, Advil) Drops or Syrup.
    • Saline nose drops (refer to Upper Respiratory Illness in Common Illnesses below for recipe).
    • Antihistamine (Benadryl 12.5 mg per 5 cc).
    • Mucolytic/Expectorants (Guaifenesin) May use after the age of 2 years.
    • Decongestant (Dimetapp or Sudafed) May use after the age of 6 years—discuss with provider.
    • Babylax suppositories
  • First Aid Kit
    • Rubbing alcohol for umbilical cord
    • Hydrogen peroxide
    • Betadine
    • Petroleum jelly (Vaseline)
    • Sterile gauze pads, adhesive tape, and bandages
    • Cotton balls, cotton swabs
    • Antibacterial ointment (Neosporin).
  • Supplies
    • Digital thermometer (refer to Fever and How to Take a Temperature below).
    • Bulb syringe.
    • Sunblock (PABA-free, fragrance-free) Try Neutrogena or Kiehl’s SPF 30 or greater.
    • Mosquito repellents (natural: Cutter lemon eucalyptus, with DEET: Cutter Skinsations 7.0% DEET).
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Is it a medical emergency?

1/26/2019

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As parents, we want to protect our children from harm. Sometimes, that means overreacting to non-emergencies. We've all done it. The "better safe than sorry" mentality can drive a parent crazy.
Knowing what to look for and how to determine if something is an emergency is critical to help you decide what action to take. Please use this post as a reference.

Here are some life-threatening emergencies that warrant immediate action:
  • Choking
  • Difficulty breathing that has not responded to a nebulizer treatment
  • Unresponsive
  • Significant bleeding that won’t stop
  • Blue color
  • Sudden Infant Death Syndrome (SIDS)​
What do you do in an emergency? Call 911
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    The staff of Panda Pediatrics, located in Washington, D.C.

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Washington, DC 20037

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