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General issues of
pediatric service and
child care
Pediatrics studies the patterns of child development, the causes and mechanisms
of diseases, methods of their recognition, treatment and prevention.
The origins of many adult diseases are in childhood. Therefore, what will be the
childhood and the conditions for the growth and upbringing of the child, such
will be the health status of an adult.
The word "pediatrics" comes from two Greek words:paid– child andiatria-
healing.
The path to the development and establishment of pediatrics as an independent
discipline was complex and lengthy. The first work in history, “On the
Nature of the Child,” was written by the founder of medicine, Hippocrates,
in the 4th century BC. In the future, they will write about children, their
care and upbringing.Celsus,Soran, Galen (I, II centuries). For a long time, a
child was considered as a smaller copy of an adult; there were no sound
rules for caring for children. Treatment of children was carried out
according to the same principles as adults. Child care was mainly carried
out by women, who passed on their experience from generation to
generation. The morbidity and mortality rates of children, especially at an
early age, have been very high for many centuries.
For now…

Thanks to scientific research and development in the field of

pediatrics and their implementation in medical practice, the
quality of care for children is improving every year. For example,
thanks to the development neonatology сurrently, it is possible to
care for very premature and low birth weight babies. Thanks to
research in the field of genetics, it has become possible to
diagnose many congenital and genetic diseases in the early stages
of a child’s development and, if possible, treat them.
Thanks to the development of chemistry and pharmacology, many drugs have
appeared for the effective treatment of serious illnesses in children.
Thanks to scientific advances in the field of microbiology, virology, and
pharmacology, doctors have the opportunity to prevent and reduce the
incidence of children with the most common and sometimes very severe
infections through vaccination (vaccinations).
 Periods of childhood and their characteristics
A child constantly grows and develops and at each age stage of his life appears in
special morphological, physiological and psychological qualities, therefore
there is a certain need to distinguish a number of periods, or stages, of
development.
Significant anatomical and physiological characteristics of each period are of
great importance for the scientifically based development of medical, social
and other measures to protect the health and development of the child.
Therefore, periods of childhood are important both for medical practice and
for recommending adequate lifestyle, nutrition, education, disease
prevention and much more.
1. The neonatal period, which is divided into
earlyneonataland lateneonatalperiods.

Earlyneonatalperiod is the period from the moment of ligation of the umbilical

cord until the end of 7 days of life (168 hours). This period is the most
important for the child’s adaptation toextrauterineexistence.
The most significant physiological changes during this period are the beginning
of pulmonary respiration and the functioning of the pulmonary circulation
with the closure of intrauterine hemodynamic pathways (ductus arteriosus
and foramen ovale), as well as changes in energy metabolism and
thermoregulation. From this moment it beginsenteralchild nutrition. During
the newborn period, all body functions are in a state of unstable equilibrium,
adaptation mechanisms are easily disrupted, which significantly affects the
general condition of the newborn and even his survival.
Lateneonatalthe period covers 21 days (from the 8th to the 28th day of the
child’s life). The most important characteristics of this stage are the intensive
development of analyzers (primarily visual), the beginning of the
development of coordination of movements, the formation of conditioned
reflexes, the emergence of emotional, visual and tactile contacts with the
mother. Around three weeks of age, many children begin to respond to
communication with a smile and facial expressions of joy. This first
emotional joyful contact is considered by many to be the beginning of the
child’s mental life.
 2. Infancy. It lasts from the 29th day of
life to a year.
During this period, the main stages of adaptation toextrauterinelife is already
completed, the mechanism of breastfeeding is sufficiently formed, very
intensive physical, neuropsychic, motor and intellectual development of the
child is taking place.
 3.Pre-schoolperiod – from one year to
3 years.
It is characterized by a slight decrease in the rate of physical development of
children and a greater degree of maturity of the basic physiological systems.
Muscle mass increases rapidly, the eruption of baby teeth ends, motor capabilities
rapidly expand, all analyzers intensively develop, speech improves, and
individual character traits and behavior are clearly defined.
4. Preschool period – from 3 to 7
years.
During this period, the structure of various internal organs is
differentiated, intelligence intensively develops, memory
improves, coordinated movements improve, individual interests
and hobbies are formed, the length of the limbs increases, baby
teeth gradually fall out, and permanent teeth begin to grow.
5. Junior school age – from 7 to 11
years.
At this age, children replace their baby teeth with permanent teeth,
improve their memory, increase their intelligence, develop
independence and strong-willed qualities, and expand their range
of interests.
6. Senior school age – from 12 to
17–18 years.
This is the most difficult period of psychological development, the
formation of will, consciousness, citizenship, and morality. This
period is characterized by a sharp change in the function of the
endocrine glands. This is the period of sexual development and
the pubertal growth spurt.
Main directions of preventive work in
pediatrics.

There are primary, secondary and tertiary disease prevention.

Primary preventionconsists of preventing diseases by eliminating or
neutralizing causative and predisposing factors. It includes a set
of social, economic, hygienic, medical and educational measures
that must be carried out not only by healthcare institutions, but
also by government and public organizations. Primary prevention
of diseases is not only a medical, but also a social problem.
Main directions of primary
prevention:
1. Clinical observation of children of all age groups.
2. Carrying out nonspecific and specific immunoprophylaxis.
3. Improving the quality of life, creating a healthy lifestyle.
4. Preparing children for entry into preschool and school.
5. Psychological assistance to children at risk.
6. Family planning.
7. Systematic observation of a woman inprenatalpregnancy and postnatal period.
8. Organization of rational nutrition.
9. Hygienic control over food quality.
10. Increasing the level of sanitary educational work.
11. Prevention of childhood injuries.
12. Prevention of alcoholism and drug addiction among children and
adolescents.
13. Epidemiological control.
Secondary preventionprovides for active early detection of diseases and functional
disorders, prevention of their progression and possible complications.
Secondary prevention is ensured by the optimal organization of medical and
recreational work, dispensary observation andanti-relapsetreatment of
diseases.
Main directions of secondary
prevention:
1. Identification of predisposition or early signs of the disease.
2. Formation of risk groups.
3. Dynamic monitoring of risk groups.
4. Monitoring of physical and mental development, sensory system,
etc.
The main goal of primary and secondary prevention-This is the
formation in the family of medical and hygienic skills of a
healthy lifestyle.
 Tertiary preventionprovides for dynamic monitoring of patients with chronic
diseases.
Main directions of tertiary
prevention:
1. Rehabilitation of patients with chronic diseases and disabled
children.
2. Psychological support for a sick child and his family.
3. Medical and social adaptation of patients with chronic diseases and
disabled children to work.
4. Orthopedic correction.
5. Organization of public organizations to support patients with
chronic diseases, etc.
Professional ethics in the activities of a
doctor.

The philosophy of medicine is based on universal principles of ethics

and morality.
By definition M.Fowler: “Ethics is the area of ​philosophy that
determines what is right and what is wrong in professional
conduct, where is good and where is evil.”
 Ethics (ethos -custom, custom)is a philosophical doctrine of morality. Ethics
determines the norms of people's behavior and their moral relations.
 Medical ethics- these are the norms and rules governing the behavior of a
nurse and relationships with others, which must be observed by her in
everyday activities.
Deontology (deoptos- due, proper, 1ogos -teaching) -it is a branch of ethics that
deals with issues of duty and moral requirements.
Medical deontology- a set of ethical standards when medical workers perform
their professional duties, professional techniques of psychological
communication, principles of behavior with patients, their relatives and
friends.
Duty of a medical worker:
·moral -this is the provision of medical care regardless of social status, religion,
etc.;
·professional -under no circumstances commit actions harmful to the patient’s
physical or mental health.
The main ethical principle is to do no harm!
 Basic principles of the relationship between doctors and a sick child and his
parents:
 1. Act professionally, within the limits of your competence.
 2. Maintain a friendly attitude with children and their loved ones.
 3. Be able to listen to the child and his parents, understand their experiences.
 4. Support the child and his parents in difficult situations, remove them in a
timely mannerpsycho-emotionalvoltage.
 5. Treats all children equally.
 6. Maintain restraint, calm and tact when performing your professional duties.
Thank you for your attention!