Category Archives: Paediatrics

Indications for urgent referral of childhood eczema

Same day: Eczema herpeticum (widespread HHV infection of eczema). Will need same-day dermatology opinion and, if it affects periorbital skin, same-day ophthalmology opinion as well. Give systemic aciclovir in the meantime (not sure of practicalities of this). Within two weeks: … Continue reading

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Child safeguarding

(Notes on reading Bluestream Academy module on safeguarding) Local Children’s Safeguarding Board (LCSB): key system for organisations to come together to liaise on ways of safeguarding children/promoting their health. Established by the Children’s Act 2004, which gives each locality the … Continue reading

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Signs of Kawasaki’s disease

Kawasaki’s disease is an arteritis (primarily affecting the coronary arteries). Signs: high fever for 5 or more days and: Polymorphous erythematous rash (can be urticarial, scarlatiniform or morbilliform and can contain small aseptic pustules) Cervical lymphadenopathy Bilateral conjunctival injection Changes … Continue reading

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Indications for referring children with eczema

Immediately Eczema herpeticum where child is systemically unwell   Within two weeks Severe eczema not responding to optimal therapy within a week Bacterially infected eczema not responding to treatment   (Quick Quiz BMJ module)

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Risk factors for sepsis in newborns

As signs of sepsis in newborns are subtle and non-specific, it’s important to be aware of situations in which a baby is at higher risk of problems. Maternal pyrexia Maternal colonisation with potentially harmful organisms such as GBS (in either … Continue reading

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Noisy breathing in newborns

Periodic increases/decreases in breathing sounds are normal in babies. Wheeze: Can be infection (mild or serious) or heart failure. Check for signs of heart problems; murmur, absent femorals, etc. Check sats. Normal sats and normal feeding are reassuring. If any … Continue reading

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Breastfeeding problems

A couple of pointers from the BMJ learning module on problems in newborns: Mastitis is not always infectious in nature. Infectious mastitis is likely to be associated with systemic flu-like symptoms (not necessarily a temperature). In the absence of such … Continue reading

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