Using the Metal Detector
Non-Hazardous Objects
Button Battery
Magnets
Sharp Objects
Category: Paeds
SNAP (paracetamol toxicity)
In Aug 2021 the treatment of paracetamol toxicity within the trust is due to change, for both adults and children. We will start using the SNAP N-acetyl cysteine (NAC) regime 12hrs, and 2 bags, (instead of the traditional 21hr & 3 bag regime)
Acute Flaccid Paralysis (AFP)/ Acute flaccid myelitis (AFM)
AFP/AFM is rare rare but serious neurological condition, which is associated with POLIO infection but has also been linked with other infections (and in the USA they have spikes every 2 yrs last 2020). AFP leads to weakness and paralysis affecting face and limbs but also the respiratory muscles and may lead to respiratory failure.
Paediatric Surgical Pathway
As there are now no longer a paediatric clinical team at HRI, the paediatric surgical pathway is up-dating, this is the current provisional pathway, to ensure care falls inline with GIRFT report.
Paediatric Blast Injury
Save the Children, have published a used full guide on management on blast injuries in children. Taking you through pre-hospital, ED and inpatient care.
Although blast injury is rare in the UK it’s worth a read as an adjunct to APLS/ATLS training.
- Recognising “Blast Lung” – which may be subtle initially and develop over hours (p51)
- Prophylactic antibiotics
- Compartment syndrome and fasciotomy (p105)
- Burns Fluids and escharotomies (p112)
Paediatric Ketamine Sedation
RCEM 2022 Safe sedation in the ED and RCEM Ketamine for paediatric procedural sedation guideline. Please read these documents in full or participate in RCEM learning for further information.
Underage Sexual Activity
This applies to all children/young people under 16 years old and those 16-18 years who are considered vulnerable, engaging in sexual activity. Getting this right is immensely challenging, as it is impossible to cover all variables influencing decision making within this guidance, further more you need to carefully weight the often conlicting needs of the child. (Involve seniors early if you have any doubts) Read more
0-12yrs WETFLAG
Tips:
- If particularly BIG – go up 1-2 yrs
- If particularly SMALL – go down 1-2 yr
- Prepare ET Tubes 0.5mm bigger and smaller
APLS 7e
APLS 7e Trauma
Information from APLS Aide-Memoire
Neonatal Seizures
Seizures are a common neurological emergency in the neonatal period, occurring in 1–5 per 1000 live births.1 The majority of neonatal seizures are provoked by an acute illness or brain insult with an underlying aetiology either documented or suspected, that is, these are acute provoked seizures (as opposed to epilepsy). They are also invariably focal in nature.
Clinical diagnosis of neonatal seizures is difficult. This is in part because there may be no, or very subtle, clinical features, and also because neonates frequently exhibit non-epileptic movements that can be mistaken for epileptic seizures.
Measles
Suspected/Confirmed patients should be ISOLATED & wear PPE
Treating Staff – (should not be; non-immunised, pregnant or immunocompromised)
- single-use, disposable gloves
- single-use, disposable apron (or gown if extensive splashing or spraying, or performing an aerosol generating procedure (AGP))
- FFP3 – respiratory protective equipment (RPE)
- eye/face protection (goggles or visor)
Patient
- Surgical face mask
Background
- Measles is highly infectious – (4 day prior to and after rash appears) suspected patients should be isolated within the ED
- Measles Immunisation – 1 dose 90% effective, 2 doses 95% effective
- Measles is a notifiable disease
