Paracetamol: pharmacology, prescribing and controversies
Paracetamol (internationally known as acetaminophen) is the most common medicine encountered in paediatric practice. It is used widely by parents and health professionals and it has analgesic and antipyretic effects. Its short-term safety and efficacy are well established and it is readily available for purchase over the counter. Its mechanism of action is not fully understood but it …
How to use lumbar puncture manometry in children
GCS, Glasgow coma scale; ICP, intracranial pressure; LP, lumbar puncture. Use appropriate sedation or analgesia, but be aware that moderate sedation raises ICP. 4 Nitrous oxide (Entonox) increases ICP unrelated to changes in breathing. 5 If used during placement of the LP needle, stop giving nitrous oxide prior to manometry.
Harmful sexual behaviour among children and young people: NICE ...
In September 2016, the National Institute for Health and Care Excellence (NICE) published their first guideline on ‘harmful sexual behaviour among children and young people’.1 The aim of this document was to enable the safe and appropriate management of children and young people presenting with harmful sexual behaviour. This includes the identification of such children and young people ...
How to use clinical signs of meningitis - ADC Education & Practice …
Meningitis is a critical diagnosis not to miss in children presenting with fever. Since the early 20th century, classical clinical signs have been used to aid the diagnosis of meningitis. These classical signs are nuchal rigidity, Kernig’s sign and Brudzinski’s sign. Each of these relies on the principle that stretching the inflamed meningeal membranes causes clinically detectable irritation.
How to interpret lactate - ADC Education & Practice Edition
The association between hyperlactataemia and poorer outcomes in acutely unwell adults and children is well recognised. Blood lactate testing has become readily available in acute settings and is considered a first-line investigation in international guidelines for the management of sepsis. However, while healthcare professionals do appreciate the value of measuring blood lactate in acute ...
Neonatal BCG: a time for change - ADC Education & Practice Edition
The BCG vaccination programme in the UK is risk based and has usually been given to eligible babies soon after birth. On advice from the Joint Committee on Vaccination and Immunisation, NHS England and Improvement recently revised the timing of this vaccination to 28 days after birth or soon thereafter. In this article, we highlight the change in timing of vaccination, the rationale and ...
Fifteen-minute consultation: Guide to communicating with …
This article suggests communicative steps and strategies to help healthcare professionals achieve the ideals of child-centred care, which place children and young people at the centre of policy and practice. For those with 15 s, not 15 min, our suggestions can be summarised like this: help children be active agents in their own care by asking, listening well, being curious and explaining ...
Press firmly for 5 s before release and count. When fingertip pressure is applied to a patient’s distal extremity and then released, blood should refill the area within less than 2 s. Press on the sternum or digit at the level of the heart. Apply blanching pressure for 5 s. Measure the time for the blush to return.
Chloral hydrate – use as a sedative in paediatric settings
The aim of this article is to discuss chloral hydrate and its place in current therapy in various paediatric settings following the 2021 safety update from the Medicines and Healthcare products Regulatory Agency (MHRA). There are two case studies presented to apply learning relating to the place of chloral hydrate in both paediatric sedation and neurology. When the …
Fifteen-minute consultation: Rectal bleeding in children
Bleeding per rectum in children is an infrequent presentation associated with a wide range of differential diagnoses, from benign to life-threatening. Irrespective of the underlying aetiology, it is typically a worrisome symptom for caregivers. Published data are limited, particularly for the UK population, from which to provide clear evidence-based guidance for assessment and management of ...