RCPCH What0-18.nhs.uk – have released a comprehensive set of guides for children and young people. (Which our Paeds. team are now using)
- Professional Hospital Guides – HERE
- Patental Guides – HERE
Category: Paeds
Bronchiolitis
Quick Ref Guide
Actions
- Green – Send Home: Provide appropriate and clear guidance to the parent / carer and refer them to the patient advice sheet.
- Amber – Advice from Paediatrician should be sought and/or a clear management plan agreed with parents.
- Red – Move to Resus IMMEDIATE Senior/Paediatiric assessment
Ingested Magnets
Ingestion of Strong Magnets is a TIME CRITICAL EMERGENCY
(Multiple Magnets OR a single Magnet and Metallic Objects)
Strong magnets (such as Neodymium)
- Now common place around the house
- From; fridge magnets to toys and peicings
Ingested:
- Intestinal injury can occur within 8-24 hours
- However, symptoms may take weeks to develop
- Symptomatic patients are a SURGICAL emergency
Detection:
- Use X-Ray (NOT metal detectors)
- May require AP and lateral images to see how many
RCEM recommendation (best practice)
Massive Transfusion Pathway
In the case of patient with Massive Haemorrhage weather that be from Trauma, Surgical, O&G, UGIB, you can activate the MTP
Remember:
- Do the Basics – don’t forget ABCD
- Inform Transfusion and get someone to run a G&S sample down
- FFP can take up to 45min and platelets come from Leeds
- If you no longer need the MTP – inform transfusion and return products ASAP
DKA in Kids
Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes.
- Fluid – are more considered that adults due to the risk of cerebral oedema
- Insulin – WAIT – need 1hr of fluid first
- Paeds – involve them early
DKA Management Calculator (recommended by paediatrics)- HERE
Drugs & Alcohol misuse in young people
Ending up in the ED as a result of alcohol and or substance use is NOT normal behaviour
- Children who use alcohol or other substances are hugely vulnerable to sexual exploitation and other forms of abuse.
- The use of alcohol or drugs can be encouraged as part of the grooming process, or as a means of coping with a difficult situation for the young person.
- It is also likely that friends and close acquaintances of the young person are equally vulnerable.
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
Vaccination Schedules UK & International
Working out what your patient might have been vaccinated for can be tricky, and more so if they were raised outside of the UK. Luckily there are a couple of tools online you can use to make this easier.
Rape & Sexual Assault
Don’t
Preform intimate examinations on Sexual assault/Rape patients
- Unless life-threatening injuries are suspected e.g Haemorrhage.
- As our examination will inevitably destroy evidence that may aid this patient’s case
Do’s
- Consider contamination injury (HIV, HepB, HepC) – Guide
- Consider emergency contraception
- Children must have police referral for safeguarding
- Refer to The Sexual Assault Referral Centre, either via Police or Self referral
Paediatric Hypoglycaemia
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 is generally caused by disruption in one of the following:
- Carbohydrate intake
- Carbohydrate absorption
- Gluconeogenesis
- Glycogenolysis
