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Introduction to Blood Banking and Transfusion Medicine

A safe and reliable blood supply is critical to the function of complex healthcare systems worldwide. Blood transfusion is one of the most common therapeutic medical practices. The field of transfusion medicine (blood banking and transfusion services) has expanded to therapeutic apheresis, regenerative medicine, cellular therapy, tissue banking, and coagulation. Blood Transfusion History In 1667, Jean Denis published the transfusing of lamb blood (because of its…

Primary and Acquired Immunodeficiency Disorders

A happy birth to 150 million infants born this year. May those who rule provide the simple gifts of peace: shelter,food and water, education and health. But alas, though many millions are born, most are birthed alone with no one there but Mom to hear their cries, no host of angels calls their name and no kings of Orient travel to give them precious gifts. Three…

Integration of Therapeutic and Palliative Care in Pediatric Oncology

If we listen closely, children who are dying, and their families, will tell us everything we need to know to care for them: they want to be loved, to be cared for and cared about, to know that their lives have meaning and purpose, to be remembered as the special people they are. Most of all, they want the people caring for them to appreciate and…

Cystic Fibrosis

Open full size image Vrksasana Magnificent tree reaching upward toward the sky grounding me Miraculous breath flowing throughout my body sustaining me Mind, body, spirit seeking balance and wholeness strengthening me —Robyn Petras With permission from “The Breathing Room: The Art of Living with Cystic Fibrosis” at www.thebreathingroom.org (Photo by Stephen Boyer.) Cystic fibrosis (CF) is a well-known disease to most pediatricians and pediatric palliative care…

Neurologic Diseases

None of us is as smart as all of us. —Japanese proverb It truly takes a village to meet the complex needs faced by children with neurologic conditions and their families. Front and center to this village are the parents and day-to-day care providers of such children, the ones who see the nuances of how a specific disease or condition manifests in an individual child. Medical…

Inherited Life-Threatening Illnesses

Facing the Future Every journey begins With but a small step. And every day is a chance For a new, small step In the right direction. Just follow your Heartsong. — Mattie Stepanek Many genetic conditions are inherited, while others are the result of a genetic change in the affected individual. Even in these cases, the condition can be considered inherited in the sense that it…

Prenatal and Neonatal Palliative Care

Having the baby was a surreal experience; it was entering a world of unknowns and uncertainties. Would he be born alive? Would he live for minutes, hours, days, or months? —a mother For most, pregnancy is a time filled with joyful anticipation of welcoming a new life into the family. Technological advances provide early confirmation of pregnancy, thus allowing parents to share their news with others,…

Easing Distress When Death is Near

Music, when soft voices die, Vibrates in the memory, Odours, when sweet violets sicken, Live within the sense they quicken. Rose leaves, when the rose is dead, Are heaped for the beloved's bed; And so thy thoughts, when thou art gone, Love itself shall slumber on. —Percy Bysshe Shelley What is a good death? When asked, many adults facing the end of life hope to control…

Dermatologic Conditions and Symptom Control

Beauty is not in the face; beauty is light in the heart. —Kahlil Gibran Skin disorders are often encountered in pediatric palliative care patients and can have both significant physical and emotional impact on a child's well being. The skin is the largest organ in the body and accounts for 15% of a person's body weight. Its major function is to provide protection from the external…

Hematologic Symptoms

Request You, in white who maintains the healthy attitude, Respond to my mood. Persevere the facts, Chart efficiently, But don't discard feeling from a patient's history. A sentimental phrase or a known truth solemnly spoken is not required or desired. Just feel outwardly. You see, symptoms and contraindications make dreadful memories relieved when recalled. A slow, soft eye-blink, thoughtful, unhurried pauses— lips pursed in silence— Evoked…

Gastrointestinal Symptoms

Digestion, of all the bodily functions, is the one which exercises the greatest influence on the mental state of an individual. —Jean-Anthelme Brillat-Savarin Palliative care no longer means helping children die well, it means helping children and their families to live well, and then, when the time is certain, to help them die gently. —Mattie Stepanek A 16-year-old girl with cystic fibrosis and advanced but stable…

Respiratory Symptoms

And by and by Christopher Robin came to an end of things, and he was silent, and he sat there, looking out over the world, just wishing it wouldn't stop. —A.A. Milne Of all symptoms that very ill children experience, perhaps the most dreaded and disturbing to patients, parents, and caregivers are pain and difficulty breathing. With regard to the latter, common respiratory difficulties encountered are…

Pain Assessment and Management

There is no nobler goal than achieving the relief of pain and suffering. —Ronald Melzack Pain is one of the most common symptoms experienced by children receiving palliative care and one of the most feared by children and their families. The severity of this symptom may increase with time, especially when the terminal phase is reached. Palliative therapeutics should generally be implemented once the underlying causative…

Sleep and Insomnia

Disease exists, if either sleep or watchfulness be excessive. —Hippocrates Since antiquity, sleep has been considered a time of healing, mending, and restoration. Sleeping difficulties are a significant issue for many healthy children and adolescents and are further increased in children suffering from life-threatening conditions. This can have a significant impact on both the child and his or her family. Lack of restful sleep can lead…

Delirium

When a man lacks mental balance in pneumonia he is said to be delirious. When he lacks mental balance without the pneumonia, he is pronounced insane by all smart doctors. —Martin Henry Fischer Pediatric delirium is an under-recognized and often reversible complication of critical illness that is considered a medical emergency demanding immediate management. New research on the clinical presentation of pediatric delirium and age-appropriate assessment…

Neurological Symptoms

We have scotch'd the snake, not kill'd it. She'll close and be herself, whilst our poor malice Remains in danger of her former tooth. —William Shakespeare, in Macbeth , Act II, Scene I The purpose of this chapter is to address symptoms etiologies that are an abnormality or dysfunction of the nervous system, and are not covered elsewhere in the book. Neurological symptoms present particular difficulties…