Tag Archives: pneumonia

Cough-Your Child’s Friend or Foe? (Pedcast)


I don’t know about you, but in Charlotte, the kiddies have been doing a lot of coughing this winter. Even though it has been unseasonably warm, those viruses have managed to get into the noses and lungs of babies with amazing ease, generating a lot of coughing and sleepless nights. I talk to parents every day in my office, who seem to be frantic to stop their children’s cough. Since when did cough become enemy number one for children? Yes, it’s true, a cough makes your kids uncomfortable and means that they are sick, but, in reality, his or her cough is weapon number one preventing them from contracting pneumonia.  So in today’s pedcast, I want to change your thinking about cough and have you think of this symptom as a vital protective reflex rather than a nuisance symptom keeping your child awake at night and making them miserable. Continue reading

“Point-of-care ultrasound” diagnosis of pneumonia (Article)

Pneumonia is still a fairly common type of infection in children.  In fact, it is the leading cause of death for children worldwide, killing 1.2 million children under the age of 5 years annually: that’s more the number of children succumbing to AIDS, malaria and TB combined!  Historically, doctors have relied on an ancient low-tech instrument to diagnose a lung infection, the stethoscope.  Listening to the sound of air moving through a lung is cheap and modestly accurate, but certainly not the ideal diagnostic tool to detect a serious lung infection.  X-ray has been the tool of choice, being more accurate than the lowly stethoscope. Unfortunately, while accurate, X-ray requires an X-ray technician, expensive equipment, photo processing equipment or digital scanning equipment, and an experienced physician to interpret the results. 75% of the world does not have access to these things. Clearly, sick children would benefit from a tool that is combines inexpensive, accurate, readily available, and easy to interpret in terms of results.

The researchers at NYU School of Medicine may have solved the pneumonia diagnosis problem dilemma when they discovered a tool that seems to make diagnosis of pneumonia much easier and safer. Their recent research demonstrates that ultrasound is easy to tool to use, highly sensitive (92%) and specific (97%) in diagnosing a lung infection and best of all, involves no damaging radiation like X-rays. They call this new tool “Point-of-care ultrasound” because they foresee most primary care doctors to be able to do their own testing and interpretation, even detecting pneumonias as small as one centimeter.

I don’t think you are going to see stethoscopes disappear from your doctor’s pocket anytime soon but I do expect that you will see him or her using an ultrasound probe far more often and X-ray far less often.  Ultrasound has revolutionized the practice of obstetrics in the past 25 years, and seems poised to do the same for other medical specialties.  Maybe the next time your little one has a fever and a bad cough, your child’s pediatrician will whip out their “point-of-care ultrasound”, and you will say, I read about that!

Your comments are welcome.  Feel free to share something you find interesting with friends and family: it’s easy.  Until next time.


Smo notes:


Written collaboratively by Catherine Wu and Paul Smolen MD



From the desk of Doc Smo: Hand washing (Article)

I can still hear my mother’s voice as I ran out of the bathroom:  “Have you washed your hands?!”   Hand washing after using the bathroom and before eating was imperative in my household growing up.  I noted with interest that we  celebrated the fifth annual global hand washing day on October 15th.    Epidemiologists and other health experts  note that it is particularly important for children to wash their hands, just as my mother used to insist.  Diarrheal illness and pneumonia are the two most common killers of children around the world, and these diseases often infect their victims via unwashed hands.  Experts estimate that 2.2 MILLION children under age 5 years  die annually from either diarrhea or respiratory illness.  They think that a third of  diarrhea deaths and a sixth of pneumonia deaths could be avoided by hand washing.

Proper hand washing is something every child needs to learn.  Fortunately, here in the United States our drinking water is generally  clean, so washing with it is beneficial.  Proper hand washing requires at least 20 seconds of washing with soap and clean water, followed by drying with a clean towel.  Hand sanitizers that are at least 60% alcohol are an acceptable substitute when soap and water are not available.  The following is the list of times the Center for Disease Control urges hand washing:

1.  before, during, and after preparing food;

2.  before eating food;

3.  before and after caring for someone who is sick;

4.  before and after treating a cut or wound;

5.  after using the toilet;

6.  after changing diapers or cleaning a child who has used the toilet;

7.  after blowing your nose, coughing, or sneezing;

8.  after touching an animal or animal waste;

9.  after handling pet food or pet treats; and

10. after touching garbage.

Modern medicine provides powerful medicines and treatments, but I am convinced that soap and water are almost as powerful.  Remember my DocSmo pearl “Prevention trumps treatment:”   preventing a disease is more powerful that treating a disease once it occurs.  Soap and water prevent disease.  Hey, Mom, you were right after all!  Thanks.  Your comments are welcome at www.docsmo.com.   Check out other articles and podcasts when you are there.  Until next time.