How Are Pediatricians Saving Lives Today? (Pedcast)

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Introduction

Child death from an infectious disease like pneumonia was all too common in America just a hundred years ago. If you read descriptions of life in the 19th century, you quickly realize that children suffering from infectious diseases was common and often devastating.  Thank goodness those days are gone. Good riddance.  To demonstrate that point, just take a look at the most common causes of death in older infants and children during the turn of the century era.  Study of childhood deaths year 1900

#1 Pneumonia secondary to influenza

#2 Tuberculosis

#3 Acute Gastroenteritis

Notice, all of the big three causes of child death have one thing in common; they are all infectious diseases. Have you ever known any children who have succumbed to any of these diseases? Probably not because these infections that lead to death in 1900, are very rare in today’s children. Just forty years ago, at the onset of my pediatric career, pediatricians regularly saved children by treating them for meningitis, sepsis, pneumonia, and dehydration secondary to acute gastroenteritis; but not today. Those days of infectious disease deaths, relative to the past, are mostly gone. But pediatricians still regularly saves by using tools other than traditional medical therapies.  What are those tools you ask? Well stay tuned to find out and explore this interesting topic further in this edition of Portable Practical Pediatrics.

Musical intro

Accidents are the leading cause of death in children today

You are probably asking yourself, if deaths from infections are becoming rare in America, what are children suffering from today?  Take a look at the 2015 statistics of the leading ten causes of death in children by age from the CDC, and you will quickly see the answer to that question. CDC statistics child deaths 2015

 

 

Today, death from unintentional accidents is by far, the leading cause of death in children. Unintentional accidental death from motor vehicle accidents, drowning, fires, burns, choking/ suffocations, and pedestrian accidents lead the list of tragedies.  Causes of childhood deaths 2015. Note, that deaths from pneumonia, the grim reaper of 1900 barely made the list in today’s list child deaths. You can see that while it is great news that children are not dying of pneumonia, parents, pediatricians, and society at large, still have a long way to go if we are to eliminate the tragedy of child deaths from injuries. Injury prevention is the next great frontier in pediatrics.

How do Pediatricians Save Lives Today?

But how are pediatricians saving lives today?  When I started practicing pediatrics, a week didn’t go by when I didn’t save a life of a child by treating them for meningitis or pneumonia. That fact was one of the main reasons that I decided to spend my life treating sick children. It is incredibly thrilling and rewarding to take a child with a life threatening infection and bring them back to health with the tools pediatricians have today. Fortunately, another incredibly powerful tool at a pediatrician’s disposal has almost ended the era infectious disease deaths in children–vaccines. So how are pediatricians saving lives today?  Rather than by using antibiotics,  my life saving is done in a more subtle fashion, using the tools of persuasion, education, reminders, nagging, storytelling, praising, and what I like to call authoritative convincing. By using these tools , I know I am saving lives even though I am not there to see it happen.  I save lives by preventing tragedies from ever happening, by using words and thoughts to convince parents and children to hedge against taking risks. Yes, I save children today by convincing parents that their children need to be properly restrained while riding in a car, by convincing parents that every child needs enough swim lessons to be safe around water, by convincing parents not to let their children play unsupervised on a trampoline, by reminding families how dangerous head first diving into water is, by educating parents how effective helmets are at reducing brain injuries, by making sure that guns locked and are out of reach of children, by reminding parents to have functional smoke  and carbon monoxide alarms, and encouraging parents to feed their young children in high chairs and avoid feeding their children foods that pose a high risk choking; all simple straight forward advice but life saving.

 

How Do I Know My Tools are Working?

You may be wondering if I am just full of myself, deluding myself into believing that I am actually saving children’s lives with some words at checkups and during visits for injuries. It is true, I have not been collecting statistics or data to prove that my life saving tools of persuasion, education, reminders, nagging, storytelling, and authoritative convincing  are effective… but I know they are. I know because families tell me they are. I can’t tell you how many times I have heard children and parents tell me that they got rid of the trampoline because I convinced them it was too dangerous, let the dirt bike “break” making it no longer available for Johnny to use, or put their child back into a booster when they realized that an adult seatbelt was not safe for their school aged children. I’ve even had children tell me that they heard my voice in their heads, warning them not to dive,  just before they were about to go head first into the lake on a hot day.  I know from 35 years of experiences like these that my words have changed behavior and avoided countless tragedies. I also know because I sense the gratitude that parents of my patients express to me when I help them set limits for their children; in front of their children. No longer is it just mom and dad saying no, it’s someone with some street credibility and real world experience who is saying the exact same thing.

Summary

Fortunately, today’s pediatricians are using far less antibiotics, IV fluids, and clever pharmacology than they did a generation ago, mainly due to the incredible effectiveness of vaccines. Today’s pediatricians are improving the health of children by using their influence to convince parents and children to properly buckle up in the care, to put on their helmet whenever they are playing on rolling toys, to forego the toys with powerful motors, to not play with guns fire or explosives, and to ensure that all children have strong swimming skills. After a health visit where I am directing the conversation, my goal is to put my voice in each child’s head that will quietly whisper to them, “Would Doc Smo and my parents want me doing this?”  By using some very simple but powerful tools: persuasion, education, reminders, nagging, storytelling, praising, and authoritative convincing, I hope that my voice will keep them all safe.

Outro

Thank you for joining me today and making Portable Practical Pediatrics one of the 10 best pediatric blogs in the world as judged by Feedpost.com! Top 100 Best Pediatric Blogs

My audience continues to grow thanks in large part to you. If you enjoy learning about pediatrics and child health with pedcasts, consider taking a moment to like and share an episode on my blog www.docsmo.com, the DocSmo.com Facebook page, or on iTunes. This is Doc Smo, broadcasting from studio 1E, that’s my first child’s bedroom on the east side of my house, hoping you children can always skirt, situations where they can get hurt. Until next time.

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