How to interpret lactate - ADC Education & Practice Edition
WEBThe 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 ...
How to use lumbar puncture manometry in children
WEBMeasurement of cerebrospinal fluid pressure through lumbar puncture (LP) manometry is an essential practical skill all paediatricians should possess competency in. The ability to perform manometry is crucial in the diagnosis of idiopathic intracranial hypertension and can provide critical information on raised (or lowered) intracranial pressure in …
Paracetamol: pharmacology, prescribing and controversies
WEBParacetamol (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 is known ...
How to use clinical signs of meningitis - ADC Education & Practice …
WEBMeningitis 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.
Fifteen-minute consultation: Paediatric night sweats—when to …
WEB3-year-old Susie has been referred to the medical paediatric clinic by her general practitioner with sweating at night; her parents change Susie’s pillowcase whilst she is asleep at around 11pm as her hair looks wet with sweat. Her mother has searched ‘ sweating overnight ’ on the internet and is worried that her child has cancer. What should you do? Night sweats are a common complaint ...
How to interpret a paediatric blood culture - ADC Education
WEBBlood culture is one of the most important diagnostic tests in medicine, considering the significant morbidity and mortality associated with bloodstream infection (BSI). However, it is an often misused and misinterpreted test in everyday paediatric practice. In this article, we explore the evidence related to paediatric blood cultures, with the aim of providing clear and clinically-relevant ...
How to interpret symptoms, signs and investigations of …
WEBUnfortunately, the symptoms and signs listed above and in table 1 were not specific for dehydration; that is, the presence of one or more of the symptoms could not be used to accurately confirm dehydration as present. The most specific symptoms and signs of dehydration were reported as prolonged capillary refill time of >2 s (positive predictive value (PPV) 0.57–0.65) and decreased skin ...
NICE community-acquired pneumonia guideline review
WEBGlobally, pneumonia is responsible for significant morbidity and mortality in children. The incidence of community-acquired pneumonia (CAP) in Europe is estimated to be approximately 33 per 10 000 in those under 5 years of age and 14.5 per 10 000 in those aged 0–16 years.1 In 2019, the National Institute for Health and Care Excellence (NICE) published a guideline on prescribing antibiotics ...
Updated NICE guidance: diabetic ketoacidosis in children and …
WEBThe National Institute for Health and Care Excellence (NICE) have now published new guidance on the management of diabetic ketoacidosis (DKA) in children, with slightly different recommendations to the British Society of Paediatric Endocrinology and Diabetes (BSPED) 2020 guideline.1 It is a specific update of the fluid therapy recommendations for children and young people with DKA, within the ...
British guideline on the management of asthma: SIGN Clinical …
WEBInformation about the current guideline. This latest revision of national guidance on asthma management was produced jointly by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) in October 2014 and marks the largest revision to date including changes to the guideline structure.1 Established standards for guideline development were followed to produce ...
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