Category Archives: For General Practitioners

April and May became combined this year…

April came and went a bit too fast for my Paediatric Pearls head.  So I’ve produced a joint April/May newsletter for 2019.  There’s a bit of safeguarding again this month with a link to a paper on what young people in care think of the language we use, a guide to enteral rehydration of children with D&V, acrodermatitis enteropathica and a reminder of what is normal on a paediatric ECG.  Do leave comments below:

It is safer to rehydrate children with D&V enterally than intravenously

I got a few blank faces on a ward round recently when I was working out volumes of diarolyte for rehydrating a child with D&V.  We tend to use “5mls every 5 minutes” in our Emergency Departments whatever the size of the child and however dehydrated they are and then, when they fall asleep and we want to move them out of our department for fear of 4-hour breaches, we put an iv line in, take bloods which we then have to act on and start iv fluids which we should then monitor more often than most of us do.  Where is the half way point?

Have a look at http://www.paediatricpearls.co.uk/wp-content/uploads/Fluid-management-in-childhood-gastroenteritis.pdf for some help with enteral rehydration (which is safer and more efficient overall than intravenous fluids).  Please let me know if you disagree with my calculations and work them all out for yourself from scratch if you happen to be dealing with a 16kg child like in the worked example…

March 2019 PDF published

Part 2 of Medically Unexplained Symptoms this month.  Also antibiotics in cystitis, too many investigations in community acquired pneumonia, carotenaemia and heart murmurs in unwell children.  Do leave comments below:

February 2019 newsletter

NICE on honey this month.  And antibiotics in URTIs.  Also blueberry muffin syndrome courtesy of our dermatology contributor, medically unexplained symptoms from a great on line resource from MindEd (https://www.minded.org.uk/Component/Details/525083) and information for practitioners and young people and families after a first afebrile seizure.  Please do leave comments below:

January 2019 newsletter

Genetics this month and an explanation of the microarray test.  Managing measles contacts in the “lessons from the front line” section, use of a smartphone app for recording palpitations and the start of a new dermatology series – skin manifestations of systemic disease.  Do leave comments below.

December 2018 PDF

Christmas disease this month, acute psychosis in children, an Emoji guide to the workings of the facial nerve, sleep hygiene and the start of a 2 part series on measles.  Happy New Year and do leave comments below!

October 2018 newsletter

This month brings a handout entitled “Towards a healthy lifestyle…” which is a collaboration between dietitians, physiotherapists, psychiatrists and paediatricians at Homerton Hospital.  We have found many families are keen to do something about their child’s weight but don’t know where to start.  Hopefully this friendly article aiming for families to be “healthy enough” is a good place to start.

Also a bit on faltering growth, on-line safety, BRUE and the investigations that do not need to be done.  Tachycardia is (of course) mentioned again.  Do leave comments below.

September 2018 PDF content

September’s newsletter reminds us of the CPD requirements for child safeguarding for all of us, warns us of the dangers of missing Kawasaki Disease, talks about PHE’s #askaboutasthma campaign and describes the differences between fever and sepsis.  Do leave comments below:

August 2018 uploaded

August brings more returning travellers, this time with dengue fever.  Also adolescent sleep problems, adverse childhood experiences (ACEs), an update on rhinitis and the neurological effects of rotavirus.  Do leave comments below.

July 2018 newsletter published

July 2018 brings HEADSSS as a communication tool in adolescent medicine this month, vaccine hesitancy, chikungunya, empyemas, a good headache course coming to London and appropriate use of the EEG.  Please do leave comments below.