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 …
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 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.
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 ...
How to test for clinical signs of meningitis. Neck stiffness: Passively flex the patient’s neck. This test is positive if there is palpable resistance. Kernig’s sign: Position the patients supine with their hips flexed to 90°. This test is positive if there is pain on passive extension of the knee.
Antihistamine use in children - ADC Education & Practice Edition
The use of second-generation H (1)-antihistamines, such as cetirizine, loratadine and fexofenadine should be first-line therapy for the management of urticaria secondary to food allergic reactions, allergic rhinitis or chronic spontaneous urticaria (CSU) in children. Cetirizine has at least as quick an onset of action as chlorphenamine, and is ...
Fifteen-minute consultation on the infant with a large head
An infant with a large head (2.5 SDs above normal for weight and gender or above 99.6th centile for age) is a common clinical presentation. Usually, it is due to benign isolated macrocephaly or familial macrocephaly (FM) where some close family members are similarly affected1; neither condition requires any further intervention. However, there are a …
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 ...
How to use: the direct antiglobulin test in newborns
The direct antiglobulin test (DAT) detects the presence of immunoglobulin, complement or both bound to the red blood cell membrane. The test, historically called the ‘Coombs test’, was first described in 1945 by Cambridge immunologist Robin Coombs. Suspected haemolytic disease of the newborn, due to either Rhesus disease or ABO incompatibility, is one of most common reasons for requesting ...