Adverse childhood experiences
Attached is a great article on understanding and treating adverse childhood experiences by the Trauma Nurse Manager at Queensland Children's Hospital. Thanks Tona Gillen for sharing this with our community!
My personal wellness plan
One of our community is part of the founding group of WRAPEM - this is a great wellness resource so be sure to check it out!
Tickets are now on sale for the Don’t Forget the Bubbles 2020 conference!
24-26th August (precourse workshops 23rd), Brisbane, an amazing 3 day program, packed with 78 speakers
Count us in! Who is gonna join us?
Check out the program and get your tickets via the link below
The mindful art of taking the weather with you…
Living with a sometimes angsty 17-year-old daughter provides me with an endless supply of life lessons. The lesson I have been learning lately is about emotional contagion.
Remembering the inner child
Eric Berne (circa 1950s) is one of the psychologists attributed with coining the terms the “inner” adult, parent and child with regards to states of mind or personality – it’s part of the psychological theory referred to as transactional analysis. I am sure I came across this when I did PY101 at University all those years ago but it was a fact that remained dormant in the archives of my mind (a dusty and cob-webbed place) until I found myself “burned out” and attending a psychologist (about 23 years ago when I worked as a Speech pathologist, and was parenting a young child and managing complex relationships with my in-laws).
Neonatal respiratory distress
Great reminder about neonatal respiratory distress on DFTB. Check it out here!
Mastering the art of distraction
There are a lot of tricks that need to be learnt when caring for the sick or injured child. Children are often fearful and distressed for a number of reasons when they are in hospital. It could be that they are experiencing pain, or that they are fearful of strange people that are lifting up their top to assess their work of breathing, or we provoke pain by pricking their finger. Whatever the reason it is our job as a health care professional to help ease their pain and anxiety.
Clinical reasoning in neonatology
Neonates are the masters of the nonspecific presentation- a high index of suspicion is required to identify the unwell neonate!
One of the keys to early recognition of a sick neonate is taking a history of ADL's:
If you don't know what normal feeding/eating/sleeping/crying is for a neonate, then how will you know what is abnormal?
A 14yr old girl presents via ambulance with severe left iliac fossa pain. She reports that it started that earlier that afternoon, as a mild discomfort in her left iliac fossa that radiated into her left flank. This was associated with nausea and loss of appetite. She decided to go to bed early but was woken a short time later by a sudden increase in her pain associated with vomiting.
Debriefing in the ED
Debriefing is a powerful tool that can be used after simulation training or real life critical events in the ED. It is designed to allow for discussion of processes, encouragement of reflection and implementation of a shared mental model of care. It is also something that we don't always do very well, and we might not know where to start with regards to implementation.
The preschool child presenting with wheeze is unlikely to have pneumonia
Wheeze is one of the most common presenting complaints in preschool aged children. These children are often febrile and have increased work of breathing at presentation, so there can be an urge to order a chest x-ray to exclude a bacterial pneumonia.
I have a superwoman complex – I think I can do it all. I think that my family will cease to function if I don’t do it all. I think that no one else can do the things I do. I say yes to any request because I can do it all. Only ever accepting perfection, and striving always to be better, smarter, perfect! In fact, for a while, I CAN do it all, I can BE it all. Superwoman is my friend – well it seems that way. Superwoman’s ways can be subtle. She seems to be helpful and has good motivations. But soon, she takes over my life. She has moved in lock, stock and barrel – taken over my home and my life, and instead of my short-term guest who helps me out on occasion, she refuses to leave. I revert to survival mode – I lose my boundaries and I become driven to perform – to perform in all areas of my life – to be the SUPER mum, the SUPER wife, the SUPER daughter, the SUPER doctor.
Metabolic and endocrine
When faced with a sick child, don't overlook "outside the box" diagnoses- think about surgars and salts - could this be an endocrine or metabolic presentation?
A simple point of care electrolytes will help point you in the right direction (i.e. If BGL is low or high or low Na etc).
When is it asthma, not reactive airways disease?
This pretty much takes away all the confusion with a couple of very simple to follow pathways.
BP in children
Found an old but good article on the importance of taking B.P's in children.
Queensland paediatric resuscitation tools
Thanks Christa Evans and Fiona Thomson for sharing this.
Lots of resources and a digital resus calculator courtesy of the CREDD team led by Dr Christa Bell. Every ED in Qld is getting these books and for those of you working in QH there is a desktop icon that takes you there. Open access anywhere else.
A febrile child
A 2year old boy presents with a history of being unwell for the last 72hours. His parents report that over the past few days he has just not been himself. Today he has developed fevers, had a number of vomits and has cried for most of the day. He has had minimal oral intake.
Dr Danielle Scarfe