Burns this month – with much discussion amongst the editorial group prior to publication. There are lots of different children’s burns protocols it transpires. RCEM’s is not aligned with the London and South East Burns Network’s. The message is “use your own burns referral unit’s guideline”. The other important message about burns is watch out for NAI but, even if the burn is accidental, refer all children to their health visitor as HVs in the UK are responsible for talking to families about safety in the home.
Also, complications of Kawasaki Disease, ADHD and the updated MAP guideline (managing cows milk allergy in primary care) which emphasises that 98% of crying babies do not have CMPA. Do leave comments below.
A bit of a viral soup this month with articles on ‘flu vaccines, how long should children have off school when unwell, NAFLD, and dermatomyositis. Do leave comments below.
Bloody diarrhoea this month. Inflammatory bowel disease patients are getting younger. Also croup and acanthosis nigricans, 2 things that probably don’t go together very often. Do leave comments below.
I’m uploading this month’s newsletter while teaching in Vietnam at the invitation of a very impressive charity, https://www.newbornsvietnam.org/. I’m glad of the extra 6 hours of September – thanks to the time difference – to publish this on time!
Palivizumab this month; are all your eligible patients having it? A glance at the updated BTS/SIGN guideline on asthma, a very rare case of a cardiac cause of chest pain, how to estimate a child’s weight in an emergency and a bit on haemolysis secondary to G6PD deficiency. Do leave comments below…
Possible causes of macrocephaly this month. Also the start of a new series on causes of coca-cola coloured urine and updates on safeguarding CPD requirements and the terminology of children “in care”. Do leave comments below:
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:
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…
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: