Dermnet NZ - a dermatology resource
Rashes are really common in the Paediatric ED and the diagnosis is usually made by pattern recognition:
PTSD and Anxiety Responses
In complex PTSD (Post Traumatic Stress Disorder), anxiety is a predominant theme
Anaphylaxis action plans
At times it can be challenging to deliver good discharge advice and ensure parental understanding. In the kid who presents with anaphylaxis it is vital that we get it right.
DFTB podcast - 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). These children may present to ED at the first appearance of the rash, with an acute flare or with a superimposed infection.
Identifying hypertension in children
We know how to spot hypotension in children but what about hypertension?
Ready, set, go – red-light, green-light.
Perhaps you have heard of the red-light; green-light analogy when it comes to things that occupy your time. I remember the first time I came across this concept. Again, I credit the psychologist, Meryem Brown, for enlightening me. Let me explain, as I found this concept really helpful in managing my stress and energy levels.
How long does a child with a streptococcal throat infection or impetigo need to be excluded from school/day care?
This great poster from Queensland Health contains the exclusion criteria for the most common infections we see in children.
Reducing procedural pain in infants
This video from the 'Be Sweet to Babies' research team at CHEO in Ottawa, Canada, demonstrates 3 techniques that have been shown to be effective in reducing procedural pain in infants.
As there is a greater focus on physician wellness, our colleges are beginning to recognise the impact of burnout in physicians on the patient. Check ACEM's call to action here.
A missing piece of apple
A 4year old boy presents after choking on a piece of apple. His mum reports that he was eating a slice of apple when he started to cough and struggle to catch his breath. She reports that there was a significant improvement within a minute but that he continues to cough and wheeze since the event. She denies apnoea, colour change or loss of consciousness.
Do yourself a favour and head over to DFTB to read a fantastic update on DKA. Check it out here.
The PREDICT position paper on the use of high flow in infants with bronchiolitis
Over the past 5 years, the use of high flow in infants with bronchiolitis has significantly increased, particularly outside of an ICU setting.
Top 5 papers in Paediatric Surgery
DFTB has published another great resource - Craig McBride discusses the top 5 papers in Paediatric surgery. Check it out here.
After listening to a colleague describe his experience of being a medical parent, I have been reflecting on how we prepare our patients and their parents for investigations and treatments.
He introduced me to some fantastic resources which I hope to share over the coming weeks
Hair tourniquet is a relatively rare phenomenon which seems to affect the toes of infants in the majority of cases. It can however be found in older populations and can be found on fingers and genitalia.
The crying infant
It’s 2am, the evening team are long gone and the department is just starting to look under control. A new patient appears, Sam is 6weeks old and presents with his exhausted parents, their chief complaint is that he ‘just won’t stop crying’.
Please see the attached QCH guideline for constipation – the main thing I have noticed working in paeds ED is that often children don’t receive high enough doses of laxatives, and they aren’t continued for long enough.
ConSEPT and EcLiPSE
Been doing some preparation for the next PEMS course - came across this fantastic summary of the ConSEPT and EcLiPSE trials and the implication for change in practice on DFTB - well worth checking out this excellent resource - well done to our DFTB's colleagues!! Check it out here
Have you come across the work of Emergency Physician colleague, Dr Shahina Braganza?
This website is a repository of normal paediatric bone X-rays from birth to 15years. It is a great resource for when you are looking at a hand X-ray of an infant thinking 'Is this normal? Where are all the bones?!' Check it out here
Time to take off the mask?
With the current state of Australia burning, I have been reflecting on the impact this will have on the mental health of our friends, colleagues and fellow countrymen and women. There are moments when watching the media coverage alone is overwhelming from my safe, non-threatened living room; how unimaginable it must be for those experiencing the fires firsthand, with loss of lives, livelihood, homes and precious life memories.
Have you come across Precious Wings? This is a wonderful organisation that supports families who have experienced the death of a child. This video about their work is worth watching. *trigger warning if you have lost a child*
Merry Christmas everyone, and a great big thank you to everyone working over the festive period (I'm sure that's probably most of you!).
A little pre-Christmas pearl, a link to a paper demonstrating how dedicated paediatric EDs help improve patient waiting times and disposition.
Don't forget the lego
It’s almost Christmas and I cannot think of a better time to share one of my favourite studies.
From the team at Don’t Forget The Bubbles - Don’t Forget the Lego. Check it out here
Reading a young person's ECG
Useful link that helps with interpretation of teenage/young person's ECG. Check it out here
Dr Danielle Scarfe