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[3catwoman3]

18. We learn things all the time, and in 500 years...

...we will have answers to things that are mysterious now.

Should we not employ the good tools we have now because they are not perfect tools? Does anyone really think the tools will be perfect in the future.

The HIB immunization alone has made a major impact in the safety of examining my pediatric patients. It was introduced about 10 years into my nurse practitioner career. HIB (hemophilus influenza B) can cause, among many things, a very dangerous throat infection called epiglottitis, in which the epiglottis (the "trapdoor" that closes over the airway to keep liquids and solids from going down "the wrong pipe) get infected and swollen and thereby obstruct the airway. The early symptoms of this disease are quite similar to croup, which is generally not nearly so serious.

We were taught, prior to the HIB immunization, that is we suspected epiglottitis instead of croup, we should NOT attempt to examine that child's mouth because the very act of using a tongue blade to look at the back of the throat could cause the epiglottis to go into spasm and block the airway right there in your exam room - a terrifying prospect, and always left us unable to do a proper, throrough exam. The alternative approach was a lateral neck X-ray to look for enlarged soft tissues. How many kids were exposed to unnecessary X-rays because it wasn't safe to look in their throats?

Since the advent of the HIB vaccine, I can fully examine my young patients without worrying that I am going to cause a respiratory arrest. What a relief for both the parents and for me. I cannot remember the last time I had to order a lateral neck film.