The Harriet Lane Handbook

Every three years, The Harriet Lane Handbook is carefully updated by residents, edited by chief residents, and reviewed by expert faculty at The Johns Hopkins Hospital. Easy to use, concise, and complete, this essential manual keeps you current with new guidelines, practice parameters, pharmacology, and more. The 23rd Edition of this portable reference continues to be the most widely used and most recognized pediatric reference worldwide—an indispensable resource for pediatric residents, students, nurses, and all healthcare professionals who treat young patients. 

Table of contents

• Instructions for online access

• Cover image

• Title page

• Table of Contents

• Pediatric Parameters and Equipment

• Copyright

• To our families

• Preface

• Part I. Pediatric Acute Care

• Part I. Pediatric Acute Care

• Chapter 1. Emergency and Critical Care Management

• I. Approach to the Unresponsive Child

• II. Management of Shock3, 5, 7, 12, 13

• III. Management of Common Emergencies

• IV. Critical Care Reference Data

• Chapter 2. Traumatic Injuries

• I. Components of the Trauma Assessment

• II. Head and Neck Trauma

• III. Concussion

• IV. Intrathoracic, Abdominal, and Pelvic Trauma16

• V. Limb and Long Bone Trauma16

• VI. Dental Trauma

• VII. Ophthalmologic Trauma16

• VIII. Animal Bites16

• IX. Burns27, 28

• X. Nonaccidental Trauma16

• Color Plates Chapter 2

• Chapter 3. Toxicology

• I. Initial Evaluation

• II. Toxidromes

• III. Ingestions and Antidotes

• IV. Acetaminophen Overdose8

• V. Lead Poisoning9

• VI. Web Resources

• Chapter 4. Procedures

• I. General Guidelines

• II. Ultrasound for Procedures2a

• III. Neurologic Procedures: Lumbar Puncture3-5

• IV. Otolaryngologic Procedures

• V. Cardiovascular procedures

• VI. Pulmonary Procedures

• VII. Gastrointestinal Procedures

• VIII. Genitourinary Procedures

• IX. Musculoskeletal Procedures

• X. Skin/Dermatologic Procedures

• XI. Online Content

• Part II. Diagnostic and Therapeutic Information

• Part II. Diagnostic and Therapeutic Information

• Chapter 5. Adolescent Medicine

• I. Theory of Adolescence/Introduction

• II. Structural Factors Impacting Adolescents and Their Health

• III. Confidentiality

• IV. Health Maintenance Elements Unique to the Adolescent Patient

• V. Sexual Health

• VI. Transitioning Adolescents into Adult Care94

• VII. Web Resources

• Chapter 6. Analgesia and Procedural Sedation

• I. Types of Pain

• II. Pain Assessment

• III. Analgesics5

• IV. Patient-Controlled Analgesia (PCA)

• V. Opioid Tapering

• VI. Procedural Sedation5, 14–17, 25–27

• VII. Web Resources

• Chapter 7. Cardiology

• I. Physical Examination

• II. Electrocardiography

• III. Congenital Heart Disease

• IV. Acquired Heart Disease

• V. Imaging

• VI. Procedures

• VII. Common Cardiac Complaints

• VIII. Exercise Recommendations for Patients with Congenital Heart Disease

• IX. Lipid Monitoring Recommendations

• X. Cardiovascular Screening

• XI. Web Resources

• Chapter 8. Dermatology

• I. Evaluation and Clinical Descriptions of Skin Findings

• II. Vascular Anomalies1

• III. Infections

• IV. Hair Loss (Fig. 8. 22, Color Plates )

• V. Acne Vulgaris

• VI. Common Neonatal Dermatologic Conditions (Fig. 8. 21; Figs. 8. 23 To 8. 30, Color Plates)

• VII. Autoimmune and Allergic Dermatologic Conditions (Figs. 8. 32 To 8. 38, Color Plates)

• VIII. Nail Disorders28

• IX. Disorders of Pigmentation29

• X. Rashes of Unknown or Inflammatory Etiology

• XI. Online Content

• Color Plates Chapter 8

• Chapter 9. Development, Behavior, and Developmental Disability

• I. Developmental Definitions1, 2

• II. Guidelines for Normal Development and Behavior

• III. Developmental Screening and Evaluation of Developmental Disorders

• IV. Specific Disorders of Development

• V. Longitudinal Care of Children with Developmental Disorders and Disabilities

• VI. Transitions from Pediatric to Adult Care for Youth with Developmental Disabilities

• VII. Social Determinants of Health and Adversity Significantly Impact Child Development, Attainment of Developmental Milestones, and/or Long-Term Health

• VII. Web Resources

• Chapter 10. Endocrinology

• I. Diabetes

• II. Thyroid Gland13-15

• III. Parathyroid Gland and Vitamin D22-24

• IV. Adrenal Gland25-29

• V. Disorders of Sodium and Water Regulation35

• VI. Growth35-37

• VII. Sexual Development39-45

• VIII. Neonatal Hypoglycemia Evaluation51, 52

• IX. Additional Normal Values

• X. Web Resources

• Chapter 11. Fluids and Electrolytes

• I. Introduction

• II. Fluid Resuscitation

• III. Fluid Removal

• IV. Electrolyte Management

• V. Algorithm for Evaluating Acid-Base Disturbances9, 20, 21

• Chapter 12. Gastroenterology

• I. Gastrointestinal Emergencies

• II. Conditions of the Gastrointestinal Tract

• III. Conditions of the Liver

• IV. Pancreatitis36-38

• V. Web Resources

• Chapter 13. Genetics: Metabolism and Conditions With Distinctive Appearance

• I. Metabolism1-8

• II. Newborn Metabolic Screening7

• III. Dysmorphology7, 11-14

• IV. Patterns of Genetic Conditions with Distinctive Appearance11, 14

• V. Etiologies of Dysmorphic Features (FIG. 13. 4)11, 14, 29

• VI. Consent and Disclosure of Genetic Testing

• VII. Web Resources

• VIII. Online Content

• Chapter 14. Hematology

• I. Anemia

• II. Erythrocytosis12, 48

• III. Neutropenia

• IV. Leukocytosis12

• V. Thrombocytopenia and Impaired Platelet Function

• VI. Thrombocytosis12

• VII. Coagulation

• VIII. Blood Component Replacement

• IX. Additional Resources

• X. Online Content

• Chapter 15. Immunology and Allergy

• I. Allergic Rhinitis1-6

• II. Food Allergy7-18

• III. Drug Allergy19-21

• IV. Immunodeficiency22-27

• V. Immunoglobulin Therapy28-34

• VI. Immunologic Reference Values

• Chapter 16. Immunoprophylaxis

• I. Common Types of Vaccines Administered to Children1

• II. Immunization Schedules

• III. Immunization Guidelines

• IV. Postexposure Prophylaxis (Table 16. 5)

• V. Special Patient Populations9

• VI. Counseling and Communication About Vaccines 22-34

• VII. Web Resources35-40

• VIII. Online Content

• Chapter 17. Microbiology and Infectious Disease

• I. Common Neonatal and Pediatric Infections: Guidelines for Diagnosis and Initial Management

• II. Microbiology

• III. Antibiotic Therapy And Stewardship

• B. Antibiotic Stewardship

• C. Resistance in Common Organisms

• IV. Exposures to Bloodborne Pathogens and Prophylaxis

• Chapter 18. Neonatology

• I. Newborn Resuscitation

• II. Routine Newborn Care of a Term Infant

• III. Newborn Assessment

• IV. Fluids, Electrolytes, and Nutrition

• V. Cyanosis in the Newborn

• VI. Respiratory Diseases

• VII. Apnea and Bradycardia

• VIII. Cardiac Diseases

• IX. Hematologic Diseases

• X. Gastrointestinal Diseases

• XI. Neurologic Diseases

• XII. Urologic Disorders

• XIII. Retinopathy of Prematurity29

• XIV. Commonly Used Medications in the Neonatal Intensive Care Unit

• XV. Web Resources

• XVI. Prenatal Assessment of Fetal Health

• Chapter 19. Nephrology

• I. Urinalysis1: See Table 19. 1

• II. Kidney Function Tests

• III. Blood Pressure (BP) and Chronic Hypertension6-11

• IV. Urinary Tract Infections12-17

• V. Proteinuria19-21

• VI. Hematuria19, 24

• VII. Acute Kidney Injury25, 26

• VIII. Chronic Kidney Disease32, 33

• IX. Dialysis34-36

• X. Tubular Disorders

• XI. Nephrolithiasis38-44

• XII. Web Resources

• Chapter 20. Neurology

• I. Neurologic Examination

• II. Neurologic Emergencies

• III. Chronic Or Gradually Progressive Conditions

• IV. Web Resources

• Chapter 21. Nutrition and Growth

• I. Assessment of Growth

• II. Management of Overweight and Obese Children

• III. Malnutrition in Infants and Children

• IV. Re-Feeding Syndrome

• V. Nutritional Needs of Healthy Children

• VI. Breastfeeding and the Use of Human Milk

• VII. Enteral Nutrition

• VIII. Parenteral Nutrition

• IX. Web Resources

• Chapter 22. Oncology

• I. Nonspecific Symptoms in the Primary Care Setting (TABLE 22. 1)1, 2

• II. Pediatric Hematologic Malignancies (TABLE 22. 2)3-4

• III. Pediatric Solid Tumor Malignancies (TABLE 22. 3)3-4

• IV. Pediatric Central Nervous System (CNS) Tumors3-4, 7-10 (TABLE 22. 4)

• V. Oncologic Emergencies4, 11-18, 19

• VI. Commonly Used Chemotherapeutic Drugs, Associated Acute and Long-Term Toxicities (TABLE 22. 5)

• VII. Common Chemotherapy Complications and Supportive Care3, 13

• VIII. Antimicrobial Prophylaxis in Oncology Patients20-22 (TABLE 22. 7)

• IX. Hematopoietic Stem Cell Transplantation (HSCT) (Also Called Bone Marrow or Stem Cell Transplantation)3, 4, 23

• X. Complications of HSCT3, 4, 23-26

• XI. Cancer Survivorship5, 27-29

• XII. Fertility Preservation30

• XIII. Web Resources

• XVI. Online Content

• Chapter 23. Palliative Care

• I. Introduction to Hospice and Palliative Medicine

• II. Communication and Decision-Making

• III. Care of the Dying Child

• IV. Web Resources

• Chapter 24. Psychiatry

• I. Overview

• II. Postpartum Depression

• III. Common Psychiatric Conditions of Children and Adolescents

• IV. Psychiatric Emergencies

• V. Web Resources

• Chapter 25. Pulmonology and Sleep Medicine

• I. Evaluation of Pulmonary Gas Exchange

• II. Pulmonary Function Tests (PFT)

• III. Asthma12-13, 19

• IV. Bronchiolitis20-27

• V. Bronchopulmonary Dysplasia (BPD)28-33

• VI. Cystic Fibrosis (CF)34-46

• VII. Obstructive Sleep Apnea Syndrome (OSAS)47-53

• VIII. Infant and Child Sleep53-54

• IX. Brief Resolved Unexplained Event (BRUE)58-59

• X. Web Resources

• XI. Online Content

• Chapter 26. Radiology

• I. General Pediatric Principles

• II. Choosing the Right Study

• III. Head

• IV. Neck and Airway

• V. Chest

• VI. Heart

• VII. Abdomen

• VIII. Genitourinary Tract

• IX. Musculoskeletal

• X. Confirming Tube Placement and Line Insertion

• XI. Web Resources

• Chapter 27. Rheumatology

• I. Brief Overview of Clinical Characteristics of Rheumatologic Diseases

• II. Interpretation of Lab Studies Used In The Diagnosis and Monitoring of Rheumatologic Disorders1

• III. Medications: Mechanisms of Action, Toxicities, and Recommended Surveillance2 (SEE TABLE 27. 4)

• Part III. Reference

• PART III. REFERENCE

• Chapter 28. Blood Chemistry and Body Fluids

• I. Reference Values

• II. Evaluation of Body Fluids

• III. Conversion Formulas

• Chapter 29. Biostatistics and Evidence-Based Medicine

• I. Biostatistics and Evidence-Based Medicine (EBM)1-3

• II. Biostatistics and Epidemiology

• III. Web Resources

• Part IV. Formulary

• PART IV. FORMULARY

• Chapter 30. Drug Dosages

• I. Note to Reader

• II. Sample Entry

• III. Explanation of Breastfeeding Categories

• IV. Explanation of Pregnancy Categories

• V. Nomogram and Equation for Body Surface Area

• VI. Drug Index

• Chapter 31. Drugs in Kidney Failure

• I. Dose Adjustment Methods

• II. Antimicrobials Requiring Adjustment in Kidney Failure

• III. Non-Antimicrobials Requiring Adjustment in Kidney Failure

• Index

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