Aren’t Kids Just Little Adults?

Pediatricians, myself included, cringe when well-meaning individuals ask us “aren’t kids just little adults?”. It is an easy, almost logical assumption to make, but the answer is no. Pediatricians spend three years after graduating from medical school honing their knowledge base and skill set to treat patients from infancy into young adulthood. Physicians trained to take care of adults typically have not taken care of a pediatric patient since medical school.

To illustrate the point that children should not be approached as “little adults,” consider a set of vital signs. A normal set of vital signs which include temperature, heart rate, respiratory rate, and blood pressure are, generally speaking, uniformly the same throughout adulthood. In pediatrics, heart rate and respiratory rates are different in an infant, a toddler, and a teenager. Vital signs are vital; these subtleties are memorized by pediatricians early in their training but sometimes overlooked by those not trained to care for a child.

For example, a one month old with a temperature of 100.4 undergoes what is known as a full septic work-up. The work-up includes blood and urine tests, and a lumbar puncture to evaluate the cerebrospinal fluid. In an adult, a temperature of 100.4 does not require this type of work-up.

Aside from the physiological differences between adults and children, the very practice of pediatric medicine is different from adult medicine. In adult medicine, dosing of fluids and medications has been standardized. In pediatrics, medications and IV fluids are weight-dependent. Your child’s weight determines how much acetaminophen or amoxicillin or fluids he needs. A child receiving an adult dose of a medication is likely to experience deleterious side effects.

Pediatricians are familiar with and follow practice guidelines that are established by the American Academy of Pediatrics. Practicing evidence-based medicine minimizes the risk of over-treating or under-treating children with common childhood illnesses such as ear infections and upper respiratory tract infections. Often, the most appropriate approach is “watchful waiting” with close follow up.

Heal recognizes that in medicine one size does not fit all and sends the physician that is best trained to treat each individual patient.

Dr. Marina Salama is a recent East Coast transplant to LA. She received her medical degree from The George Washington University School of Medicine and completed her residency at St. Louis University of Medicine and Mattel Children’s Hospital at UCLA. Marina lives in Santa Monica with her wonderful husband and has a passion for international medicine.

Any views or opinions expressed in this blog post are solely those of the author, an independent physician, and do not necessarily represent those of Heal. You should not assume or construe that this blog post represents the opinion of Heal. In addition, although this blog post provides information concerning potential medical issues, it should not be relied upon as medical advice. It is not a substitute for consultation with a qualified, licensed physician and does not replace a physician’s independent judgment about any given patient’s condition or appropriateness or risks of any treatment or procedure. Rather, this blog post is solely for general educational and informational purposes. Your reading of this blog post does not create any physician-patient relationship between you and the author.

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