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BERMAN’S PEDIATRIC DECISION MAKING, FIFTH EDITION
ISBN: 978-0-323-05405-8
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Notices
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Library of Congress Cataloging-in-Publication Data
Berman’s pediatric decision making / [edited by] Lalit Bajaj . . . [et al.]. -- 5th ed.
p. ; cm.
Pediatric decision making
Rev. ed. of: Pediatric decision making / Stephen Berman. 4th ed. c2003.
Includes bibliographical references.
ISBN 978-0-323-05405-8 (pbk.)
1. Pediatrics -- Decision making. I. Bajaj, Lalit. II. Berman, Stephen. III. Berman, Stephen.
Pediatric decision making. IV. Title: Pediatric decision making.
[DNLM: 1. Pediatrics. 2. Decision Making. 3. Diagnosis. WS 200]
RJ47.B47 2011
618.92 -- dc23
2011018488
Editor: Judith Fletcher
Developmental Editor: Joanie Milnes
Editorial Assistant: Jackie Wechsler
Publishing Services Manager: Anne Altepeter
Senior Project Manager: Doug Turner
Designer: Steven Stave
Printed in the United States of America
Last digit is the print number:
9
8
7
6
5
4
3
2
1
Preface
The fifth edition of Pediatric Decision Making marks a
major editorial transition for this ground-breaking text-
book of algorithms. I turn the editorial duties over to
four outstanding clinicians for this edition, the first to be
published in the twenty-first century. I have worked
closely with these pediatricians for many years (and with
some since residency), and as their careers have matured
I have grown to greatly admire and respect their knowl-
edge, clinical skills, and teaching abilities. I am sure that
this and future editions will be creative and innovative,
providing clinicians with a valuable resource to help them
provide the very best care for children.
As a pediatrician for 39 years, I have been fortunate to
have had the opportunity to create and edit this book. I
have a career and work that I love and a wonderful sup-
portive family—my wife, Elaine, and sons, Seth and Ben.
As I reflect on why pediatrics has been so personally fulfill-
ing and meaningful, I realize the importance of having
strong personal relationships with patients and their fami-
lies. These relationships take time to mature. Caring for
children continuously over a long time, referred to as “con-
tinuity of care,” allows pediatricians to share many intense
moments of sorrow and joy with our patients and their
families.
As my clinical experience and expertise increased over
the years, my approach to patients and their families began
to change. I realized the need to balance both art and sci-
ence in caring for children. While science strives to be as
objective as possible, art remains intuitive. While science
relies on technology, art relies on communication and em-
pathy. While the art of medicine recognizes the value of
helping, the science of medicine strives to find cures. Art
touches people by sharing feelings and emotion. Art builds
an intangible bridge that connects people and makes us
aware of the shared elements of the human existence. The
art of pediatric practice helps a dying patient live every day
to the fullest, enjoying life by being with loved ones. Sci-
ence requires a thorough understanding of the scientific
method and how observations generate hypotheses that
can be tested by experiments or trials. Science is about
defining, counting, measuring, and then analyzing. Practic-
ing pediatrics is about using science and technology in
conjunction with the art of pediatric care to prevent dis-
ease, save lives, heal children, and help families cope.
In a textbook of algorithms, it is difficult to demonstrate
how to communicate with patients and families, and thus
to teach “the art of pediatrics.” Therefore, I tried to do this
with a different type of book, entitled Getting it Right for
Children: Stories of Pediatric Care and Advocacy, pub-
lished by the American Academy of Pediatrics. I learned
that successful advocacy involves storytelling that reaches
out and touches readers combined with data that provide
the evidence needed to make good policy decisions.
While I could not incorporate as much of the art of
pediatrics into Pediatric Decision Making as I would have
liked, I hope that this next generation of editors will have
more success. I am sure that they will integrate the rapid
advances in our understanding of genetics, pathophysiol-
ogy and treatment of disease, and technology into this
book in ways that will be understandable and useful to
clinicians. I thank them for accepting this role and appreci-
ate the opportunity I have to continue to work with them
and other members of our Department of Pediatrics at
The Children’s Hospital on a regular basis.
Stephen Berman, MD
v
Contributors
Mark J. Abzug, MD
Professor of Pediatrics, Infectious Diseases, University
of Colorado Denver School of Medicine; Professor of
Pediatrics, The Children’s Hospital, Aurora, Colorado
Edythe Albano, MD
Associate Professor of Pediatrics, University of Colorado,
Denver, Colorado; Clinical Director Oncology, The
Children’s Hospital, Aurora, Colorado
Nimisha Amin, MD
Pediatric Nephrologist, Private Practice, Bakersfield,
California
Mark E. Anderson, MD
Staff Physician and Team Leader, Kid’s Care Clinic at
Denver Health Medical Center; Director and PI,
Rocky Mountain Region Pediatric Environmental
Health Specialty Unit (PEHSU); Associate Professor of
Pediatrics, University of Colorado School of Medicine,
Aurora, Colorado
Marsha S. Anderson, MD
Associate Professor of Pediatrics, University of Colorado
School of Medicine, Section of Pediatric Infectious
Diseases, The Children’s Hospital, Aurora, Colorado
Susan D. Apkon, MD
Director, Rehabilitation Medicine, Seattle Children’s
Hospital; Associate Professor, Department of
Rehabilitation Medicine, University of Washington,
Seattle, Washington
Jennifer Armstrong-Wells, MD, MPH
Assistant Professor, Pediatrics, Section of Neurology,
University of Colorado, Aurora, Colorado; Assistant
Adjunct Professor, Neurology, University of California,
San Francisco, California
Daniel Arndt, MD, MA
Assistant Professor, Pediatrics, Michigan State University
School of Medicine; Director, Pediatric Epilepsy
Program, DeVos Children’s Hospital, Grand Rapids,
Michigan
Donald H. Arnold, MD, MPH
Associate Professor, Department of Pediatrics, Division
of Emergency Medicine, Center for Asthma and
Environmental Research, Vanderbilt University School
of Medicine, Nashville, Tennessee
Lalit Bajaj, MD, MPH
Associate Professor of Pediatrics, University of Colorado
School of Medicine; Research Director, Section of
Emergency Medicine, Children’s Hospital Colorado,
Aurora, Colorado
Christopher D. Baker, MD
Assistant Professor, Pediatrics, Section of Pulmonary
Medicine, University of Colorado School of Medicine,
The Children’s Hospital, Aurora, Colorado
Vivek Balasubramaniam, MD
Associate Professor of Pediatrics, University
of Colorado, Denver; The Children’s Hospital,
Aurora, Colorado
Jennifer M. Barker, MD
Assistant Professor of Pediatrics, Division of Pediatric
Endocrinology, The Children’s Hospital, Aurora,
Colorado
Barrett H. Barnes, MD
Assistant Professor of Pediatrics, Department of Pediatrics,
Section of Pediatric Gastroenterology, Hepatology,
and Nutrition, University of Virginia, UVA Children’s
Hospital, Charlottesville, Virginia
James S. Barry, MD
Assistant Professor, Department of Pediatrics, Medical
Division, University of Colorado Hospital NICU,
University of Colorado School of Medicine, Aurora,
Colorado
Stephen Berman, MD
Professor of Pediatrics, University of Colorado School
of Medicine; Chair, Children’s Hospital; Academic,
General Pediatrics; Past President, American Academy
of Pediatrics, Aurora, Colorado
Timothy J. Bernard, MD
Assistant Professor, Pediatric Neurology, University of
Colorado School of Medicine, The Children’s Hospital,
Aurora, Colorado
Robert Brayden, MD
Professor of Pediatrics, University of Colorado School of
Medicine, The Children’s Hospital, Aurora, Colorado
Alison Brent, MD
Associate Professor of Pediatrics, University of Colorado
Health and Sciences Center, Denver, Colorado
vii
viii
Steven Colson, MD
Fellow, Department of Pediatrics, Section of Pediatric
Gastroenterology, Hepatology and Nutrition, The
Children’s Hospital, University of Colorado School of
Medicine, Aurora, Colorado
Mary N. Cook, MD
Clinical Director, Department of Psychiatry and Behavioral
Sciences; Medical Director, Outpatient Services,
The Children’s Hospital; Assistant Professor, Psychiatry,
University of Colorado School of Medicine, Aurora,
Colorado
Julie-Ann Crewalk, MD
Fellow in Pediatric Infectious Diseases, Children’s
National Medical Center, Washington, DC
Donna Curtis, MD, MPH
Fellow, Pediatric Infectious Diseases, University of
Colorado School of Medicine, Aurora, Colorado
Jesse Davidson, MD
Fellow, Pediatric Cardiology and Critical Care,
The Children’s Hospital, Aurora, Colorado
Roberta L. DeBiasi, MD
Associate Professor of Pediatrics, George Washington
University School of Medicine; Faculty, Division of
Pediatric Infectious Disease, Children’s National
Medical Center, Washington, DC
Robin R. Deterding, MD
Professor of Pediatric Pulmonary Medicine and Medical
Director, Breathing Institute, The Children’s Hospital;
Director, Children’s Interstitial Lung Disease Research
Network, The Children’s Hospital, University of Colorado,
School of Medicine, Aurora, Colorado
Samuel R. Dominguez, MD, PhD
Assistant Professor, Pediatric Infectious Diseases, University
of Colorado School of Medicine, Aurora, Colorado
Ellen Roy Elias, MD
Director, Special Care Clinic; Professor, Department of
Pediatrics and Genetics, The Children’s Hospital,
Aurora, Colorado
Kathryn D. Emery, MD
Associate Professor of Pediatrics, University of Colorado
School of Medicine, Aurora, Colorado
Monica J. Federico, MD
Assistant Director of Pediatrics, The Children’s Hospital,
University of Colorado Health Sciences Center,
Denver, Colorado
Steven G. Federico, MD
Director, School-Based Health/Denver Health; Associate
Professor, General Pediatrics, University of Colorado
School of Medicine, Aurora, Colorado
Joanna M. Burch, MD
Associate Professor of Dermatology and Pediatrics,
The Children’s Hospital, Aurora, Colorado
Arelis Burgos-Zavoda, MD
Assistant Professor of Pediatrics and Dermatology,
University of Colorado Hospital; Assistant Professor
of Dermatology, The Children’s Hospital, Aurora;
Assistant Professor of Dermatology, Denver Health
Medical Center, Denver, Colorado
Jeffrey B. Campbell, MD
Associate Professor, Department of Surgery, Division of
Urology, University of Colorado School of Medicine;
Department of Pediatric Urology, The Children’s
Hospital, Aurora, Colorado
William Campbell, MD
Assistant Professor of Pediatrics, University of Colorado
School of Medicine; Physician Advisor; Early Intervention
Colorado, Denver, Colorado; Developmental-Behavioral
Pediatrician, Child Development Unit, The Children’s
Hospital, Aurora, Colorado
Kelly Casperson, MD
Urology Resident, Department of Surgery, Division of
Urology, University of Colorado School of Medicine;
Department of Pediatric Urology, The Children’s
Hospital, Aurora, Colorado
Betsey Chambers, MD
Pediatrician, Newborn Nursery, Denver Health Hospital,
Denver, Colorado
Maida Lynn Chen, MD
Assistant Professor of Pediatrics, Pulmonary and Sleep
Medicine Division, University of Washington School
of Medicine; Associate Director, Pediatric Sleep
Disorders Program, Seattle Children’s Hospital, Seattle,
Washington
Marc Chester, MD
Pediatric Pulmonologist, The Pediatric Lung Center,
Fairfax, Virginia
Antonia Chiesa, MD
Senior Instructor, Department of Pediatrics, University of
Colorado School of Medicine; Kempe Child Protection
Team, The Children’s Hospital, Aurora, Colorado
Jason Child, PharmD
University of Colorado School of Medicine, Aurora,
Colorado
Abigail Collins, MD
Instructor of Pediatrics and Neurology, Director of
Pediatric Movement Disorders, The Children’s
Hospital, Aurora, Colorado
Catherine C. Ferguson, MD
University of Colorado School of Medicine, Aurora,
Colorado
David Fox, MD
Assistant Professor, Department of General Pediatrics,
The Children’s Hospital, University of Colorado
School of Medicine, Aurora, Colorado
Julia Fuzak, MD
Clinical Instructor, Department of Pediatrics, Section
of Emergency Medicine, The Children’s Hospital,
University of Colorado School of Medicine, Aurora,
Colorado
Kelly K. Gajewski, MD
Assistant Professor of Clinical Pediatrics, Louisiana State
University Health Sciences Center, New Orleans,
Louisiana
Renata C. Gallagher, MD, PhD
Assistant Professor, Clinical Genetics and Metabolism,
Department of Pediatrics, University of Colorado
School of Medicine, Aurora, Colorado
Jason Gien, MD
Assistant Professor, University of Colorado Hospital,
University of Colorado School of Medicine, Aurora,
Colorado
Christine Gilroy, MD, MSPH
Associate Professor, Division of General Internal
Medicine, University of Colorado Health Sciences
Center, Denver, Colorado
Mary P. Glodé, MD
Professor of Pediatrics and Head, Section of Pediatric
Infectious Disease, The Children’s Hospital, University
of Colorado School of Medicine, Aurora, Colorado
Neil A. Goldenberg, MD, PhD
Associate Professor of Pediatrics and Medicine
(Hematology); Associate Center Director; Director,
Clinical Research, Mountain States Regional
Hemophilia and Thrombosis Center, University of
Colorado, Denver, Colorado; Director, Medical Affairs
and Venous Thromboembolism Trials, CPC Clinical
Research; Co-Director, Pediatric Thrombosis and Stroke
Programs, The Children’s Hospital, Aurora, Colorado
Edward Goldson, MD
Professor of Pediatrics, University of Colorado School of
Medicine, Aurora, Colorado
Carol L. Greene, MD
Professor of Pediatrics, University of Maryland School of
Medicine, Baltimore, Maryland
Joseph Grubenhoff, MD
Assistant Professor of Pediatrics, Section of Emergency
Medicine, University of Colorado School of Medicine,
Aurora, Colorado
Mindy L. Grunzke, MD
The Children’s Hospital, University of Colorado School of
Medicine, Aurora, Colorado
Sameer Gupta, MD
Assistant Professor of Pediatrics, Division of Pediatric
Critical Care, University of Minnesota Medical School,
Minneapolis, Minnesota
Greg Gutierrez, MD
Attending Physician, Denver Health Primary Care
Musculoskeletal Clinic; Attending Physician, Denver
Health Pediatric Minor Fracture Clinic; Staff, Family
Medicine Department, Denver, Colorado
Ann C. Halbower, MD
Associate Professor of Pediatrics, Pulmonary Section, The
Children’s Hospital, University of Colorado School of
Medicine, Aurora, Colorado
Sarah Halstead, MD
Clinical Instructor, Fellow, Pediatric Emergency
Medicine, The Children’s Hospital, University of
Colorado, Aurora, Colorado
Simon J. Hambidge, MD, PhD
Director of General Pediatrics, Denver Health, Denver;
Professor of Pediatrics, University of Colorado School
of Medicine, Aurora, Colorado
Megan G. Henderson, MD, FAAP
General Pediatrician, Westside Pediatric/Teen Clinic,
Denver Health; Instructor of Medicine, University of
Colorado Health Sciences, Denver, Colorado
Edward J. Hoffenberg, MD
Professor of Pediatrics; Director, Center for Pediatric
Inflammatory Bowel Diseases, The Children’s Hospital,
University of Colorado School of Medicine, Aurora,
Colorado
Christine Waasdorp Hurtado, MD
Assistant Professor, Digestive Health Institute, The
Children’s Hospital, University of Colorado School of
Medicine, Aurora, Colorado
Kyros Ipaktchi, MD
Associate Professor, University of Colorado School of
Medicine Aurora, Colorado; Attending Surgeon,
Department of Orthopaedics, Denver Health Medical
Center, Denver, Colorado
Ed Jernigan, MD
Physician, Children’s Neurology, Saint Luke’s Regional
Medical Center, Boise, Idaho
Joshua A. Kailin, MD
Pediatric Cardiology Fellow, The Children’s Hospital,
Aurora, Colorado
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