Paediatric Hypoglycaemia (BM <2.6) is a relatively common presentation in the Emergency Department. However, if we don’t do the BM it’s easy to miss.
Hypoglycaemia in paediatric diabetic patients is managed separately – see here
Hypoglycaemia in neonates (<72 hours of life) also has specific management – see here (Flowcharts A + B)
Hypoglycaemia is generally caused by disruption in one of the following:
Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes.
DKA Management Flow Chart – HERE
Diabetic children sometimes attend ED with hyperglycaemia, but not in DKA (what should we do?)
Paeds have produced some advice to follow:
As part of a short series on very basic principles of wound closure we are going to discuss the use of adhesive strips. This practical advice is intended offer some guidance in the use of adhesive strips, assumes the full assessment of the wound has already occurred and the wound is suitable for this method of closure.
Read moreOr Boxer’s Knuckle. This is a rupture of the sagittal band of the MCPJ joint, most commonly of the middle finger.
Used for a several types of knee injury, the knee splint provides support and comfort to the knee joint, whilst allowing for the patient to weight bear as appropriate.
The below indicative video demonstrates application of a leading brand.
The process is very similar with other manufacturers, but the specific manufacturer’s instruction should be adhered to for the splint applied.
Splints should be applied next to the skin, and certainly not over baggy clothing, as this may lead to movement of the splint, not providing the correct support.
Single and Double layer wool and crepe bandaging
Most commonly in the ED setting used to gently restrict movement of a joint, either due to injury of the sturcutres of the joint, or in order prevent stressing of wound closure.
The below shows a double wool and crepe bandage to the knee, which is also known as a Robert Jones bandage, the technique can be applied to other limbs, and for a single layer simply stop after the first layer of bandage is applied.
Robert Jones bandages are useful in the absence of appropriately sized knee splints, or if the patient is unable to tolerate a splint.
Note that although the text of the video states to finish mid-calf the bandage material should be extended past the calf to the top of the ankle as is the practice shown.
Used to immoblise a thumb due to fracture or ligamental injuries.
Read moreVideo tutorials for the procedure for the application of some basic slings.
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