First minutes matter: trauma training
In a cardiac arrest, seizure or choking episode, every second counts. It is therefore important that we educate our community and equip them with the skills to manage time-critical medical events while waiting for help to arrive.
Birdie’s Tree: Growing together through natural disasters
We live in uncertain times, with COVID-19 and natural disasters dominating the news cycle for the past 18months. These events can be distressing for young children and it can be difficult for parents to know how best to navigate their child through these experiences.
Impact of oral corticosteroids on respiratory outcomes in acute preschool wheeze: a randomised clinical trial
Pre-school wheeze is really common, with evidence suggesting that 50% of children will have at least one episode of acute wheeze by the age of 6years.
Over the last 10-15years, there have been a number of studies looking at the use of steroid therapy in this group.
At this time, whilst we recognise that there are a group of children that will benefit from steroid therapy, the evidence remains unclear as to which children presenting to the ED should be prescribed them.
Tillaux and triplane fractures
Matthew, a 15year old boy presents with a painful, swollen ankle after a skateboarding accident. He has seen his GP who has arranged an X-ray in the community and the report states that he has a Tillaux fracture. You have never come across this type of fracture before and have no idea what this means!
Zero point survey
Paediatric resuscitations can cause significant anxiety for health care professionals and this can impact team organisation and performance.
When preparing for a paediatric resuscitation you may prepare drugs and equipment, but do you take the time to prepare yourself, your team or your environment?
Cast related harm
You have just seen Amelia, a 3year old girl who has represented after being seen in the department 3days ago when she was diagnosed with a toddler’s fracture. She was placed in a below knee backslab and discharged with fracture clinic follow up.
Her parents report that over the last 48hours she has started to complain of pain to her heel on that side and is becoming increasingly distressed by this.
Ultrasound guided venous access videos
Securing venous access in paediatric patients can be technically challenging.
There is increasing evidence of the benefits of using ultrasound guidance when attempting venous access in all paediatric patients, not just those with difficult access.
Decision aid: antibiotics for acute otitis media
Acute otitis media (AOM) is really common, with evidence suggesting 90% of children will have at least one episode by the age of 6years.
We know that AOM can be caused by viral pathogens, bacteria or a combination of both.
The wheezy pre-schooler presenting to ED is very common, with evidence suggesting that 50% of children will have at least one episode of acute wheeze by the age of 6years.
Painful procedures in the ED
Painful procedures in the emergency department are often a source of anxiety for children, parents and even emergency medicine practitioners.
A colleague recently highlighted some good resources for a clinical issue they had when they saw a young child who was unwell with vomiting and thought to have ingested a plant in their garden.
When a family in crisis presents to the ED, it can be difficult to know where to direct them for help. Enter Ask Izzy.
Constipation is really common, with approximately 10% of kids seeking medical attention at some stage.
Education and behaviour modification are essential aspects of management but unfortunately are often overlooked.
Honey in button battery ingestion
A button battery impacted in the oesophagus can cause significant tissue injury in as little as two hours and thus requires urgent removal in theatre (ideally within 2hours of ingestion).
Whilst waiting to transfer the patient to theatre, honey is increasingly being used to reduce the risk of caustic injury in children >12months.
Abdominal pain in testicular torsion
You have just seen Leo, a 13year old boy who presents with an acute onset of RIF pain. You think that he has appendicitis and present the case to your consultant who asks “did you examine his scrotum?” You wonder, does every teenage boy presenting with abdominal pain really need a scrotal exam?
Rashes that affect the palms and soles
Whilst many rashes involve the dorsum of the hands and feet, very few involve the palms and soles.
Here are 6 conditions to think about in the patient presenting with a rash involving the palm and/or sole.
Rashes are really common in the Paediatric ED and the diagnosis is usually made through pattern recognition.
Unfortunately, the majority of educational resources in Paediatrics are filled with pictures of children with light skin tones. This means that children with darker skin tones may be misdiagnosed or experience a delayed diagnosis. Skin Deep is attempting to correct this.
Decision aid: antibiotics for sore throat
It is estimated that Group A Strep is responsible for 15-30% of cases of acute tonsillitis.
Over the past few years we have seen a practice shift, moving away from prescribing antibiotics for all children presenting with acute tonsillitis, instead targeting therapy at those in high risk groups.
Fractures of the bones of the hand account for 10% of all fractures. In children, the majority of these are phalangeal fractures.
It is important to recognise that even minor, minimally displaced phalangeal or metacarpal fractures can cause significant functional impairment if they lead to overlap of the fingers when attempting to grip. This is otherwise known as a rotational deformity.
Fingertip units for topical steroids in eczema
Eczema in kids is really common, particularly in infants under the age of 2 where the prevalence can be as high as 20% (ASCIA 2019). Topical steroids are commonly prescribed for acute flares, but just how much should we be advising parents to apply?
Congenital heart disease in PEM
The sick child with known congenital heart disease makes even the most experienced emergency clinician nervous.
DFTB - COVID-19 and children: what do you need to know?
As our understanding of the COVID-19 pandemic continues to evolve, it is becoming evident that the disease process in children is very different to that seen in adults.
This post from DFTB beautifully summarises the information available regarding COVID-19 infection in children and provides links to important resources and papers.
Magnet ingestions have a high risk of requiring surgical intervention.
DFTB Podcast - Antibiotic myth busting
A must listen to podcast by the one and only DFTB team. Dr Ian Lewins speaking to Dr Alasdair Munro Clinical Research Fellow in Paediatric Infectious Diseases about antibiotics and some commonly held myths.
Dr Danielle Scarfe