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Summary Of Health Care Video (I'm posting it on here rather than emailing it)

Megan Puckett-Pediatric Cardiology for the Primary Care Practitioner

(The notes I took are rather messy because I was taking them as I watched the presentation, but I added them at the bottom anyways in case you need them.)

The presentation I watched on childhood heart disease was very informative. I felt as though I could recommend a child to a pediatric cardiologist myself after watching it. Dr. Joshua Donner talked about everything a person could ever want to know about heart murmurs. He chose this topic because they are extremely common in children.

                I myself had no idea that heart murmurs were as common in pediatric patients as they are. Dr. Donner said they are commonly found in as many as 80%-100% of children at some point in time. I also always thought that heart murmurs were very hazardous to a person’s health, especially that of a child; however, that is not always the case. There are two major groups of heart murmurs. These groups are known as innocent heart murmurs and non-innocent heart murmurs.  Dr. Donner touched on both types and gave examples.

                He basically summed it up as an innocent heart murmur is louder when the patient is lying down and much softer when they are standing. Innocent murmurs are also not associated with any other cardiac symptoms. They also do not cause a clicking sound. Non-innocent heart murmurs are normally recognized by the clicking sound they cause. They can also be recognized because they sound level increases when the patient is standing, rather than lying down.

                He concluded his presentation by talking about reasons children are normally referred to a pediatric cardiologist. The reasons included parental concern, family heart disease, or the recognition of uncommon cardiac disease symptoms.

                Overall, I actually enjoyed hearing him talk about the different types of murmurs. His presentation was very informative and designed very efficiently. I feel like I really took a lot from this assignment.

Notes:

Dr. Joshua Donner

Heart murmurs:

-Common to detect in baby child or teenager

-causes unnecessary tension of guardians

-Heart murmur? – sound you hear through stethoscope

-very common -80-100% of children diagnosed

-rarely anything wrong with heart

Common innocent heart murmurs:

-majority

-age 3 or 4 checkup-frequently hear murmur

-Still’s Murmur  -most common

-systolic

-louder when lying flat; quiet when sitting or standing

-loud w/ fever

-vibratory along left lower sternum border

                -loud but can’t feel with hand

                -referred to cardiologist-normally innocent

                -no cardiac symptoms

-not palpable

-no click

-diastolic component

Normal pulse

No resp. troubles

Normal ekg

No sign of valve disease or hole in heart

No meds/restriction from activity needed

Have for several years-dissappear teen years

Newborn period too

-PPS murmur

                -mainly babies

                Once left hospital; small(usually) can be in normal

                Picked up @ 2week

Left upper sternum border left/right upper chest/sides/back

Systolic;blowing quality

                Reason? Little blood flow to lounges durin development; vessels are small More flow after birth, turbulence=murmur

No other symptoms

First several months of life usually ends around 7-8

Pulmonary flow murmur

                Teen pre-sports phys.

                Left upper s.b.-systolic

                Louder when flat softer when standing

                Cannot feel

                No other abnormal cardiac findings

                Not normally ass. w/ cardiac disease

Venous hum

                Well child checkup 3-8

                Clavical-left/right uppewr chest

                Continuous murmur

                Blowing/machinery sound

                Rarely heard when flat/common when upright

                Normal ekg& echocardiogram

                Flow passing vain & chest area

Corroted bruey

                Child-fine; adult-could be peripheral vascular disease

                Can feel in neck vessels

                No other abnormal findings

               

Abnormal-pathological:

bicuspid aortic valve

                3leaflets-some only 2

2leaflet-valve not open peacefully or leak

Systolic right upper chest

Clicking sound

Diastolic murmur-leaking

Systolic murmer 2ndary to vsd

                Vsd-hole in wall separating ventricle

                Blood flow turbulent as heart squeezes

Left lower sternum border

2^nd most common

Left upper-systolic

Pulmonary valve allows blood flow turbulent

Radiates into sides & back-click

Apex of chest  during systily

Valve clicking

Mitrovalve leak

During systily-left midchest

Squatting to standing= louder rather than softer

Hypertrophic obstructive cardiomopothy-sudden death young athletes in play-don’t clear for sports

Reasons to refer patient to pediatric cardiologist:

-patient has cardiac symptoms

                Passing out

                Persi. Shortness of breath chest discomfort

                Heart races

                Freq dizzy/pale spells; baby-stop breathing

-family history for heart disease

-abnormal cardiac exam

Non innocent murmur

Large liver

Abnorm. In respiratory exam

-family concerned about heart

October 13th Assignment

A sentence that describes me:

Recap of week 9/27 - 10/1

     So, I feel the need to recap what I learned through my mentorship this past week in order to remember it all as well as to keep a record of everything.

     On Monday, the 27th, I learned how to check-in a patient. It isn't a very difficult process, it just takes some getting used to. First, you must know what the patient is there for. When you call them back, you must take and record the patients weight and temperature. If there for a scheduled physical evaluation and are over the age of three, you also take and record their blood pressure. When checking in a patient, you must be sure to get a contact number along with the name and relation of whomever brought them in. It is also mandatory to find out if the child has any known allergies. If the patient is well, you simply take them back to an open room; however, if the patient is sick, you must also learn what is ailing them before taking them back to their room.
     On Wednesday, the 29th, I learned about immunization doses. Because flu season is just beginning, I have been able to witness the giving of Flu shots on several occasions. The Flu shot dosage is a little different from normal immunizations because it is a vaccine. Children ages 3 years and younger recieve a dose of 0.25 mL, while children ages 4 and over recieve a dose of 0.5 mL. If it is the first year the patient is being given the Flu Vaccine, they must be given two doses over a time period of one month for all ages. For immunizations other than vaccines, the normal dosage is 0.5 mL for children of all ages unless otherwise prescribed.
     On Thursday, the 30th, I put into practice the knowledge I recieved in the beginning of the week by checking in a couple patients on my own. I am not able to actually fill or give shots, but I make sure to pay close attention when the nurse is doing so. Thursdays are normally slow days at the office I mentor in; nonetheless, I did learn the difference in the Flu Mist vs. the Flu vaccine. The Flu Mist is a mist that is sprayed up the nose. One dose is sprayed up each nasal cavity. The mist and vaccine are quite similar; however, the main difference is that the mist has the live virus in it whereas the vaccine contains a dead virus. Most people choose to have the vaccine because the live virus in the mist could cause a serious case of influenza to set in if the patient has any type of respiratory problems, including asthma.

     I am very fortunate to have been given the opportunity to mentor under these professionals and I cannot wait to learn more in this week of my mentorship!