Preface

The care of a hospitalized child has evolved dramatically since the publication of earlier editions of The Philadelphia Guide: Inpatient Pediatrics. As the first two editions were published, a common question was “What is a Hospitalist?” Hospital system pressures fueled by increasing patient complexity, changes in reimbursement models, and emphasis on value of care contributed to expansion of the hospitalist model. Hospital medicine is now the fastest growing specialty in modern history and the hospitalist model of care—a phrase coined a quarter century ago—is ensconced in virtually all hospitals. Furthermore, Pediatric Hospital Medicine is an official sub-specialty certified by the American Board of Pediatrics. Hospital Medicine has assumed even greater importance during the coronavirus disease 2019 (COVID-19) pandemic. Hospitalists have been on the frontlines caring for patients suffering from this new and mysterious disease while simultaneously redesigning systems of care. For example, they led the development of new care algorithms to manage a rare but serious COVID-19 complication termed multisystem inflammatory syndrome in children (MIS-C) and managed patient flow to accommodate the atypical seasonality of common viruses. (Who could have imagined hospital capacity issues in summer as a result of respiratory syncytial virus?) Hospitalists have also been at the forefront of public health, advocating for the wellbeing of children with efforts to resume safe schooling, increase rates of immunization against COVID-19, enforce masking policies to mitigate SARS-CoV transmission, expand mental health services, and reduce gun violence. The role of the hospitalist has fundamentally changed as these one-time generalists who became specialists have once again demonstrated their range. The question “What is a Hospitalist?” is being asked yet again but with different intent. Hospitalists provide clinical care, conduct practice-changing research, lead quality and safety efforts of hospital and its health system as well as community child advocacy efforts, improve health information systems, and so much more. They are a model speciality for innovation, collaboration, and patient-centered care.

As we prepared the third edition, Hospital Medicine remained our core focus. We believe that Inpatient Pediatrics should provide clinicians with the vital information necessary to make management decisions in the care of hospitalized children. Once again, we are fortunate that over 80 leading experts in pediatric hospital medicine and pediatric subspecialty care, many with roots at The Children’s Hospital of Philadelphia, share their collective wisdom by contributing to this book.

Designed to be an invaluable resource on the hospital wards, Inpatient Pediatrics features:

• Practical diagnostic strategies

• Extensive differential diagnosis suggestions

• Up-to-date treatment and management guidelines

• Alphabetical organization within chapters for rapid access

• Structured format with consistent headings throughout

• Bulleted format for efficient and effective presentation of relevant information

• Print and electronic versions to maximize portability and ensure access to information whenever and wherever necessary

Appendices cover normal vital signs, as well as rapid access to pediatric dosages for emergency, airway, and rapid sequence intubation medications, and cardioversion.

As many clinicians are involved in the care of children, this book is ideal for practitioners of all levels, from residents to attending physicians, physician assistants, advanced practice nurses, pediatric nurses, and health practitioners from all disciplines involved in the care of a hospitalized child.

The goal of this book is to provide a single reference with sufficient detail to guide diagnostic and therapeutic decisions for a wide range of conditions. We believe that the consistent format, detailed focus on diagnosis and management, and comprehensive coverage of topics have accomplished that goal, enabling you to give the best possible care to your patients.