Contents Chapter Topic Page Neonatology Respiratory Cardiology

Foreword
One of the maxims of science is that what is right today is wrong tomorrow. This seems
to apply to clinical medicine more than many other areas of science. Hence one of the
concerns of preparing a manual of clinical protocols is that some parts of the publication
may well be outdated by the time the document finally sees the light of day. Nonetheless
many institutions have found having a set of clinical protocols useful especially where
the turnover of doctors is frequent. In Malaysia this was pioneered in Sarawak in the
days when one pediatrician served the whole state, in an attempt to standardize practice
in different hospitals. Pediatric service has come a long way since then. However now
more than ever before is there a need to establish practice parameters based on current
best practice and evidenced based medicine. Many young doctors are often
overwhelmed by the myriad of options available when they search the internet and it is
not always easy separating the wheat from the chaff.
At a meeting of senior pediatricians in the MOH in February 2004, it was decided that we
should all work together to produce a manual of pediatric protocols addressing clinical
problems commonly encounter in local practice. The topics to be covered were proposed
by those present and topics were allocated to various individuals to work on. We must
say that everybody involved in the task has given their best. Many a time we have gone
back to the authors of various section requesting modifications and the response has
always been positive.
After almost 11 months the final document was ready for printing. This has truly been a
team effort involving colleagues from all over the country and we are very grateful to all
the contributors who have made this manual a reality.
This manual cannot cover all the problems we meet in our wards but we sincerely hope
that we have covered the important ones. We hope, God willing, to revise this manual
every 4 years and we welcome feedback and suggestions from all who happen to use
this edition.
We would like to thank Dr. Tan Poh Tin who started the first edition of the Paediatric
Protocols for Sarawak Hospital; the third edition of which this manual was based. In
addition to our local colleagues we would like to say a special word of thanks to Prof.
Frank Shann of Melbourne for allowing us to incorporate part of his well established drug
dosage booklet into our manual.
This book is dedicated to the children of Malaysia and we pray it makes a difference to
them.
Hussain Imam Hj Muhammad Ismail
Ng Hoong Phak