Textbook of Paediatric Emergency Medicine, 3e

Description:

It is now more than ten years since the publication of the first edition of Textbook of Paediatric Emergency Medicine and interest in this specialty continues to grow at a local and international level. Paediatric emergency medicine can be a challenging and difficult area for doctors. Children cannot always communicate their problems verbally, while parents are anxious and the possibility of a missed diagnosis is ever present. Although the principles in managing paediatric patients are the same as adults there are significant differences in patterns of illness and response. In addition, the therapies available vary widely between adult and paediatric practice.

Textbook of Paediatric Emergency Medicine provides clear, concise and comprehensive coverage of all the major topics that present within paediatric emergency medicine. It offers a consensus approach to diagnosis and treatment, drawing on the latest evidence available. Short chapters with key point boxes allow for the quick and easy retrieval of information, essential when time is short.

This Third Edition captures the major changes in guidelines across the specialty in the assessment and management of paediatric patients, whilst refining established approaches to practice. The text reviews both new technologies and the better application of older techniques which have led to changes in practice. There are significant updates to the sections on resuscitation and trauma, the clinical applications of bedside ultrasound, analgesia and sedation. There is also a new focus on the teaching and research sections.

 

Table of Contents:

 

Section 1. Approach to the Paediatric Patient

1.1. Approach to the paediatric patient

Introduction

Children with fever

Evolving illness in children

The environment

Triage

Front loading care

The paediatric approach

History

Examination

Gentle, distraction, painful last

When to investigate

The parents

Management of febrile children

The role of the GP in paediatric emergency management

Reflection on the Practice of Paediatric Emergency

1.2. Common chronic paediatric conditions

Introduction

Cerebral palsy

Cystic fibrosis

The ex-premature infant

Autism spectrum disorder

Section 2. Resuscitation

2.1. Paediatric cardiopulmonary arrest

Epidemiology

Aetiology

Preventing cardiac arrest

Outcome

Differences compared to adults

Development of resuscitation guidelines

Ethics of paediatric resuscitation

2.2. Paediatric basic life support

Introduction

Paediatric versus adult basic life support

Basic life support techniques and age

Preparation and equipment

Basic life support sequence

Precautions and complications

Relief of foreign body airway obstruction

2.3. Paediatric advanced life support

Introduction

Diagnosing cardiac arrest

Epidemiology

Oxygen, ventilation and advanced airway support

Ventilation

Advanced airway support

Laryngeal mask airway

Management of the difficult airway

Monitoring

Vascular access

Fluid therapy

Management of pulseless arrhythmias

Management of pulsatile dysrhythmias

Post-resuscitation management

Cessation of cardiopulmonary resuscitation

2.4. Paediatric resuscitation in specific circumstances

Avoiding cardiac arrest during critical care management

Anaphylaxis

Asthma

Drowning

Traumatic cardiac arrest

Toxicological emergencies

Envenomation

Marine envenomation

2.5. Shock

Introduction

Diagnosis and assessment

Initial management

Further management

2.6. Sepsis recognition and initial management

Introduction

Background

Definition

Aetiology

Pathophysiology

Diagnosis

Initial emergency management

Disposition

Section 3. Neonatal Emergencies

3.1. The normal neonate

Definition and introduction

Common reasons for healthy neonates to present to the emergency department

Summary

3.2. The crying infant

Introduction

Recurrent crying

Acute crying

Disposition

3.3. Neonatal Dermatology

Skin in the Neonatal Period

Neonatal erythroderma

Red scaly rashes

Vesicles and blisters

Pustular lesions

Birthmarks

Blue/purple lesions

Vascular lesions in the neonatal period

3.4. Acute neonatal emergencies

The Neonatal Period

Neonatal resuscitation

Assessment of the neonate

The neonate with vomiting

The neonate with seizures

The neonate with breathing difficulty

The neonate with prolonged jaundice

3.5. Neonatal resuscitation

Introduction

Aetiology and pathophysiology

Preparation

Assessment at birth

Ventilation

Heart rate

Colour

Muscle tone and reflex irritability

Medications

Specific resuscitation situations

Post-resuscitation stabilisation

Prognosis

Section 4. Trauma in Children

4.1. Introduction to paediatric trauma

Prevalence

Prevention

Succinct treatment (salvage)

Primary survey

Paediatric differences

Other issues during initial stabilisation

Secondary survey

Orthopaedic trauma

Rehabilitation

4.2. Paediatric neurotrauma

Introduction

Epidemiology

Pathophysiology

Classification

Assessment

4.3. Spinal injury

Introduction

Developmental anatomy and physiology

Initial assessment

Spinal immobilisation

Cervical spine injuries

Thoracic and lumbar spine injuries

Spinal cord injury

Spinal cord injury without radiographic abnormality

4.4. Thoracic injuries in childhood

Introduction

Initial approach in the emergency department

Chest wall injury

Pulmonary injury

Tracheobronchial injuries

Mediastinal injury

Cardiac injuries

Diaphragmatic injury

Emergency department thoracotomy

4.5. Abdominal and pelvic trauma

Introduction

History

Examination

Investigations

General management

Surgical issues

Hollow viscus injuries

Pancreatic and renal injuries

Penetrating trauma

Pelvic fractures

Disposition

4.6. Burns

Introduction

Pathophysiology

Classification

History

Examination

Investigations

Management

Management of burns

Electrical burns

Chemical burns

4.7. Children in a disaster response

Introduction

Phases of disaster response

4.8. Wound management

Introduction

Classification of wounds

Evaluation of the patient with a laceration

Treatment of wounds

Wound closure

Post-wound-closure care

Treatment of selected injuries

Section 5. Cardiovascular

5.1. Cardiovascular assessment and murmurs

Introduction

History

Physical examination

Chest X-ray

The child with an asymptomatic murmur

Pathological murmurs

Disposition

5.2. Chest pain

Introduction

Immediate approach

General approach

Summary

5.3. Syncope

Introduction

Aetiology

Typical presentations

Clinical

Investigations within the emergency department

Further investigations of syncope

Management of syncope within the emergency department

Summary

5.4. Cyanotic heart disease and tetralogy of Fallot spells

Introduction

Cyanotic congenital heart disease

Clinical features

Investigations

Management

Disposition

Tetralogy Spells

Investigations

Treatment

Disposition

5.5. Heart failure

Definition

Causes of congestive heart failure

Clinical manifestations and investigations

Management

5.6. Congenital heart disease

Introduction

Undiagnosed congenital heart disease

Complications/residua of congenital heart disease and its treatment

Congenital heart disease and intercurrent illness

5.7. Acute rheumatic fever

Introduction

Investigations

Treatment

Prevention and prophylaxis

5.8. Infective endocarditis

Introduction

Epidemiology

Pathophysiology

Microbiology

History

Examination

Modified Duke criteria

Investigations

Differential diagnosis

Treatment

Prognosis

Prevention

5.9. Kawasaki disease

Introduction

Pathophysiology

Clinical features

Incomplete Kawasaki disease

Differential diagnosis

Complications

Investigations

Treatment

Refractory Kawasaki disease

Prognosis

5.10. Cardiac arrhythmias

Introduction

Normal conduction system

The cardiac action potential

Pathogenesis of arrhythmias

General principles for arrhythmia management

Role of ‘molecular autopsy’ in sudden unexplained cardiac death in the young

Section 6. Respiratory

6.1. Stridor and noisy breathing

Introduction

Initial assessment

History

Examination

Common causes of acute stridor in children

Common causes of chronic stridor in children

6.2. Upper respiratory tract infections

Introduction

Nasopharyngitis

Stomatitis

Pharyngitis/tonsillitis

6.3. Inhaled foreign body

Introduction

Upper airway foreign bodies

Treatment

Lower airway foreign body

Prevention

6.4. Croup

Introduction

Presentation

Investigations

Differential diagnosis

Treatment and disposition

Prognosis

Prevention

6.5. Acute asthma

Introduction

Diagnosis of asthma

Risk factors for mortality

Clinical assessment

Differential diagnosis

Treatment

Discharge from hospital

Prognosis

Prevention

Future directions/research

6.6. Pertussis

Introduction

Pathophysiology

Epidemiology

History

Examination

Investigations

Differential diagnosis

Complications

Treatment

Prognosis

6.7. Community-acquired pneumonia

Introduction

Definition

Aetiology

Clinical findings

Investigations

Management

Complications

Prevention

Conclusion

6.8. Bronchiolitis

Introduction

Clinical assessment

Treatment

Prognosis

Prevention

Section 7. Gastroenterology and Hepatology

7.1. Abdominal pain

Introduction

Pathophysiology

Aetiology

Assessment

History

Examination

Investigations

Management

Disposition

Acute Appendicitis

Clinical features

Differential diagnoses

Investigations

Management

Meckel’s Diverticulum

Clinical features

Differential diagnoses

Investigations

Management

Chronic Abdominal Pain

Assessment

Diagnosis

Management

7.2. Vomiting

Non-Surgical Vomiting

Definitions

Clinical evaluation

Examination

Differential diagnoses

Investigations

Management

Conclusions

Surgical (Bilious) Vomiting

Causes

Complications

Investigations

Treatment

7.3. Gastrointestinal bleeding

Introduction

Aetiology

History

Examination

Investigations

Initial medical therapy

Surgery

Treatment

Dispositon

7.4. Gastro-oesophageal reflux

Introduction

Pathophysiology

History

Examination

Differential diagnosis

Complications

Investigations

Treatment

Follow-up

7.5. Pyloric stenosis

Introduction

Epidemiology

Clinical presentation

Examination findings

Imaging studies

Differential diagnosis

Management

Complications

7.6. Ingested foreign bodies

Introduction

History

Examination

Investigations

Treatment

Disposition

Prevention

7.7. Acute liver failure

Introduction

Aetiology

Pathophysiology

Presentation

Investigations

Management

Disposition

Prognosis

Prevention

7.8. Diarrhoea

Introduction

Definitions

Clinical evaluation

Examination

Differential diagnoses

Investigations

Management

Conclusions

7.9. Management of acute hepatitis in children presenting to the emergency department

Introduction

Aetiology

History

Examination

Investigations

Viral hepatitis

Drug- and toxin-induced liver injury

Chronic liver disease presenting as acute hepatitis

Other causes of chronic liver disease presenting in childhood

7.10. Intussusception

Introduction

Aetiology

Epidemiology

Clinical

Investigations

Management

Outcome

7.11. Herniae

Introduction

Types of herniae

Complications

Treatment

7.12. Gastroenteritis

Introduction

Aetiology

History

Examination

Differential diagnosis

Investigations

Treatment

Severely dehydrated

Other treatments

Disposition

Prognosis

7.13. Constipation

Introduction

Definitions

Pathophysiology

Management basics

Constipation in babies

Acute constipation

Chronic constipation

Investigations

Management

Medications

7.14. Inflammatory bowel disease

Introduction

New diagnoses

Known IBD patients

Common treatments and their complications

Section 8. Neurology

8.1. Cerebrospinal fluid shunt complications

Introduction

Clinical presentation

Examination

Investigations

8.2. Raised intracranial pressure

Introduction

Particular issues in children

Clinical features of raised intracranial pressure

Other examination findings in raised intracranial pressure

Investigations

Some particular causes of raised intracranial pressure

8.3. Seizures and non-epileptic events

Introduction

General comments

Classification of seizures

Febrile seizures

Presentation to Emergency Department

Presentation post a possible seizure

Presentation of a seizure

8.4. Acute weakness

Introduction

Presentation

Primary survey approach

History

Examination

Investigations

Specific conditions causing acute weakness

8.5. Acute ataxia

Introduction

Pathophysiology

Differential diagnosis

Chronic ataxia

Clinical evaluation of the patient

Examination

Investigations

Management

Disposition

8.6. Headache

Introduction

Incidence

Pathophysiology

Clinical assessment

Management

Disposition

Migraine

Pathophysiology

Clinical features

Treatment

Disposition

Conclusions

8.7. Central nervous system infections: Meningitis and encephalitis

Introduction

Meningitis

Brain abscess

Encephalitis

Conclusion

Section 9. Infectious Diseases

9.1. Infectious diseases

Fever

Empiric antibiotic therapy

Common infectious exanthems

What specimens, when should they be ordered and what tests?

Infection control in the emergency department

Needlestick injury

Immunisation

Section 10. Metabolic Emergencies

10.1. Inborn errors of metabolism

Introduction

Physiology and pathogenesis

Clinical features

Investigation

Management

Chronic presentations

Extended newborn screening

Conclusion

10.2. Hypoglycaemia in the non-diabetic child

Introduction

The hypoglycaemia screen

Causes of hypoglycaemia

Treatment of hypoglycaemia

10.3. Diabetic emergencies in children

Diagnosis

Diabetic ketoacidosis

Hypoglycaemia

The child with an insulin pump

The child with diabetes and intercurrent illness

Diabetic child and surgery

Long-term management

10.4. Thyroid emergencies

Thyrotoxicosis

Neonatal thyrotoxicosis

Hypothyroidism

Congenital hypothyroidism

Hashimoto’s thyroiditis

10.5. Adrenal emergencies

Adrenal Crisis

Clinical presentation

Disposition

Prevention

Cushing’s Syndrome

Presenting symptoms

Diagnostic testing

Treatment

10.6. Disorders of fluids, electrolytes and acid–base

Introduction

Physiology

Clinical assessment

Investigations

Treatment

Investigation and management of fluids in different conditions

Acid–base disorders

Section 11. Haematology and oncology

11.1. The use of blood products in children

Introduction

Packed red blood cells

Platelets

Fresh frozen plasma

Cryoprecipitate

Clotting factor concentrates

Albumin

Normal human immunoglobulin

Hyperimmune immunoglobulins

Risks of blood component use

11.2. Anaemia

Introduction

Acute management

Neonatal anaemia

Anaemias of childhood

Haemolytic anaemias

11.3. Disorders of coagulation

Haemophilia

von Willebrand disease

11.4. Platelet disorders

Introduction

Immune thrombocytopaenia

Chronic immune thrombocytopaenia

11.5. Vasculitis

Introduction

Clinical presentation

Classification

Small-Vessel Vasculitis

Anti-cytoplasmic-antibody-associated vasculitis

Medium-Vessel Vasculitis

Polyarthritis nodosa

Large-Vessel Vasculitis

Secondary Vasculitis and Vasculitis Mimics

11.6. Acute leukaemia

Introduction

Classification

Clinical presentation

Differential diagnosis

Investigations

Prognosis

Complications

Management

11.7. Febrile neutropaenia

Introduction

Presentation

Investigations

Treatment

11.8. Emergencies in paediatric oncology

Emergency Complications of Paediatric Malignancy

Fever and infection

Gastrointestinal emergencies

Blood product use in oncology

Cardiothoracic emergencies

Metabolic emergencies

Genitourinary emergencies

Neurological emergencies

Brain and Spinal Cord Tumours in Children

Brain tumours

Spinal cord compression

Section 12. Dermatology

12.1. Dermatology

Introduction

Erythroderma and skin failure

Vesiculobullous rashes

Pustular rashes

Papular (raised) rashes

Red scaly (papulosquamous) rashes

Eczematous rashes

Red blanching rashes (erythematous)

Purpuric rashes

Vascular tumours – haemangiomas and haemangioma variants

Vascular malformations

Management of vascular malformations

Hyperpigmentation

Hypopigmentation

Skin texture

Mouth disorders

Anogenital rashes

Zinc and other nutritional deficiencies

Anogenital papules and lumps

Immunodeficiency states

Hair problems

Nail problems

Itch without rash

Section 13. Eyes

13.1. Ophthalmological emergencies

Introduction

History

Examination

The red eye in paediatrics

13.2. Congenital, developmental and neoplastic conditions of the eye

Deficits in visual acuity

Strabismus

Paediatric cataracts

Congenital nasolacrimal duct obstruction

Infantile glaucoma

Ocular tumours

Retinoblastoma

Rhabdomyosarcoma

Neuroblastoma

13.3. Ocular trauma

Introduction

Globe trauma

Eyelid trauma

Orbital trauma

Section 14. Ent and Dental

14.1. The ear

Otitis externa

Acute otitis media

Discharging otitis media – chronic suppurative otitis media

Otitis media with effusion

Mastoiditis

Trauma

14.2. The nose

Rhinitis and sinusitis

Epistaxis

Nasal trauma

14.3. The mouth and throat

Stomatitis

Differential diagnosis

Pharyngitis/tonsillitis

Peritonsillar abscess

Post-tonsillectomy haemorrhage

Oral/dental trauma

Oral/dental infection

Other dental issues

14.4. Retropharyngeal abscess

Introduction

History

Examination

Investigation

Treatment

14.5. Foreign bodies and caustic ingestion

Nasal foreign bodies

Aural foreign bodies

Complications

Caustic ingestion

Section 15. Obstetrics and Gynaecology

15.1. Paediatric gynaecology

Infant and prepubescent gynaecology

Adolescent gynaecology

15.2. Emergency contraception

Introduction

Clinical assessment

Available medicines

Medicine interactions

Medicine contraindications

Medicine adverse effects

Medicine outcomes

Copper intrauterine devices

Section 16. Renal

16.1. Acute kidney injury

Introduction

Pathophysiology

Clinical presentation

Treatment

Acute presentation of chronic renal failure

Acute kidney injury in the renal transplant recipient

16.2. Haematuria

Isolated microscopic haematuria

History

Examination

Investigation

Disposition

16.3. Hypertension

Introduction

History

Examination

Emergency department management

16.4. Urinary tract infection in pre-school children

Introduction

History and examination

Diagnosis

Treatment

Prognosis

Prevention

16.5. Haemolytic uraemic syndrome

Introduction

Definition of haemolytic uraemic syndrome

Classification of haemolytic uraemic syndrome

Pathophysiology of haemolytic uraemic syndrome

History

Examination

Investigations

Differential diagnosis

Treatment

Prognosis

Complications

Prevention

16.6. Idiopathic nephrotic syndrome

Introduction

Pathophysiology of proteinuria

Mechanisms of proteinuria

Definition of nephrotic syndrome

Classification of paediatric nephrotic syndrome

Idiopathic nephrotic syndrome: epidemiology

Clinical features of idiopathic nephrotic syndrome

Investigations

Differential diagnosis

Complications of idiopathic nephrotic syndrome

Treatment of initial nephrotic phase

Prognosis

16.7. Henoch–Schönlein purpura

Introduction

Epidemiology

Pathogenesis

Diagnostic criteria for Henoch–Schönlein purpura

Clinical features

Diagnosis and investigation

Differential diagnosis

Treatment

Long-term prognosis and follow-up

Section 17. Psychiatric

17.1. Paediatric psychiatric emergencies

Introduction

General approach

Common Paediatric Psychiatric Presentations

Suicidal patients

Anxiety disorders

Psychosis

Other psychiatric presentations

Acknowledgement

17.2. The treatment of the behaviourally disturbed adolescent

Introduction

The principles of psychiatric triage

The ABCC of rapid psychiatric assessment

Managing the ABCC including restraint and acute sedation

Conclusion

17.3. Autism and behavioural disturbance in the pre-adolescent child

Introduction

Underlying mechanisms in austistic spectrum of disorders/neurodevelopmental disorders

Approach to assessment

Challenges in emergency department presentations

Approach to management

Management

Ongoing management in the community

Conclusion

Section 18. Crisis Intervention

18.1. Sexual assault

Introduction

Definitions

Attitudes/myths surrounding child sexual assault

Epidemiology of child sexual assault

Child sexual assault and emergency medicine

Recognition of child sexual assault

Signs and symptoms

Genitoanal anatomy

Sexually transmitted infections

Diagnostic considerations

Role of the emergency physician

18.2. Child at risk

Introduction

Definition

The community response to the child at risk

Section 19. Administration In EMS

19.1. Managing the death of a child in the emergency department: Bereavement issues

Introduction

The resuscitation process

Talking to parents and families

Laying out of the child

Viewing the body – quiet suite

The grief response

Support of the family

Cultural implications

Legal issues

Organ and tissue donation and collection

Debriefing and support for emergency department staff

Collaboration with paediatric palliative care services

The concept of a good death

Conclusion

Section 20. Analgesia and Sedation

20.1. Analgesia

Introduction

Assessment of pain

Management

Non-pharmacological methods

Pharmacological methods

20.2. Paediatric procedural sedation within the emergency department

Introduction

Pre-procedure

Intra-procedure

Post-procedure

Non-pharmacological methods

Pharmacological methods

Section 21. Poisoning

21.1. General approach to poisoning

Introduction and epidemiology

Diagnosis

Risk assessment

Investigations

Resuscitation

Decontamination

Antidotes

Enhanced elimination

Supportive care

Consultation and disposition

21.2. Specific poisons

Common poisons

Rare and dangerous poisons

Section 22. Environmental

22.1. Envenomation

Introduction

Snakebite

Scorpion stings

Spiderbite

Tick bite paralysis

Jellyfish stings

Venomous fish stings

Venomous marine molluscs

22.2. Drowning

Introduction

Epidemiology

Aetiology

Pathophysiology

History

Examination

Investigations

Differential diagnosis

Treatment

Disposition

Prognosis

Prevention

22.3. Heat-induced illness

Introduction

Causes of heat-related illness

Investigations

Management

Prognosis and disposition

22.4. Cold injuries

Introduction

Normal physiology: a review

Hypothermia

Localised cold injuries

Frostbite

Hypothermia not due to environmental causes

22.5. Anaphylaxis

Introduction

Pathophysiology

Aetiology

Clinical features

Investigations

Treatment

Diagnosis

Prevention

Section 23. Ultrasound

23.1. Ultrasound

23.2. Diagnostic ultrasound in paediatric emergency medicine

23.3. Ultrasound guidance for procedures

Ultrasound guidance for procedures

23.4. Incorporating ultrasound into paediatric resuscitation

Section 24. Common Procedures

24.1. Estimating the weight of infants and children

Background

Age-based tools to estimate body weight

Length- and body-habitus–based tools

Tips

24.2. Basic airway management techniques

Background

Oropharyngeal and Nasopharyngeal Airways

Contraindications

Equipment

Preparation

Positioning

Procedure

Complications

Tips

Laryngeal Mask Airway

Equipment

Preparation

Positioning

Procedure

Complications

Tips

Bag-Valve-Mask and Flow-Inflating Mask Ventilation

Contraindications

Bag-Valve-Mask Equipment

Preparation

Positioning

Procedure

Complications

Tips

Flow-Inflating Bag

Equipment

Preparation

Procedure

24.3. Non-Invasive Ventilation

Non-Invasive Continuous Positive Pressure Ventilation

Contraindications

Humidified High-Flow Nasal Prong Oxygenation

Equipment

Procedure

Complications

Tips

T-Piece Ventilation Device

Equipment

Procedure

Complications

Tips

Continuous Positive Airway Pressure/Biphasic Positive Airway Pressure

Equipment

Contraindications

Relative contraindications

Procedure

Complications

Tips

24.4. Endotracheal intubation

Background

Indications

Contraindications

Equipment

Preparation

Positioning

Procedure

Complications

Tips

Confirmation of Intubation

Indications

Contraindications

Equipment

Preparation and positioning

Procedure

Complications

Tips

24.5. The surgical airway

Background

Indications

Contraindications

Needle cricothyroidotomy

Surgical cricothyroidotomy

24.6. Chest procedures

Introduction

Needle Thoracostomy

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

Tube Thoracostomy

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

Three-Sided Dressing

Indications

Contraindications

Equipment

Preparation

Procedure

Pericardiocentesis

Indications

Contraindications

Equipment

Standard preparation

Procedure

Complications

Tips

24.7. Removing and replacing a tracheostomy tube

Background

Indications for emergent replacement

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

24.8. Central and peripheral intravenous lines

Background

Indications

Contraindications

Peripheral venous catheter placement

Central venous line placement

24.9. Intraosseous infusions

Background

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

24.10. Umbilical vessel cannulation

Background

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

24.11. Defibrillation

Background

Indications for defibrillation (asynchronous)

Indications for synchronous cardioversion

Contraindications

Equipment

Standard preparation

Standard procedure

Automated external defibrillators procedure

Complications

Tips

24.12. Transurethral catheterisation and suprapubic bladder aspiration

Background

Indications

Contraindications

Transurethral catheterisation

Suprapubic aspiration

24.13. Lumbar puncture

Background

Indications

Contraindications

Equipment

Preparation and positioning

Procedure

Complications

Tips

24.14. Reduction of paediatric inguinal hernias

Introduction

Preparation

Procedure

Inguinal hernias in girls

Complications

24.15. Paraphimosis

Introduction

Indications

Contraindications

Procedures

Complications

Tips

24.16. Gastrostomies and other enteral feeding devices – trouble shooting in the emergency department

Background

Anatomy of a percutaneous endoscopic gastrostomy tube

Percutaneous endoscopic gastrostomy insertion method

Complications

Percutaneous endoscopic gastrostomy displacement

Buried bumper

Gastrocolocutaneous fistula

Peristomal leak

Peristomal infection

Mechanical problems – blockage

Jejunal feeding devices

Granulation tissue

Section 25. Orthopaedics and Rheumatology

25.1. Orthopaedics and rheumatology

Introduction

The child with acute musculoskeletal pain or dysfunction

Generalised or multifocal bone/joint pain

Other important subacute paediatric musculoskeletal presentations

Conclusion

Acknowledgement

25.2. Child with a limp

Introduction

History

Examination

Investigation

Clinical decision making in a child with a limp

Specific conditions

25.3. Fractures and dislocations

Fracture patterns in childhood

Initial assessment and management

Upper limb and shoulder girdle injuries

Lower limb and pelvis injuries

Conclusions

25.4. Risk management in acute paediatric orthopaedics

Introduction

Non-identification or delayed identification of paediatric fractures

Adverse events in acute paediatric orthopaedics

Section 26. Male Genitalia

26.1. Male genitalia

The acute scrotum

Epididymo-orchitis

Idiopathic scrotal oedema

Testicular tumours

Irreducible inguinal hernia

Rupture of the testis

Acute hydrocele

Acute problems of the penis and foreskin

Introduction

Phimosis of the foreskin

Balanitis

Priapism

Section 27. Transport and Retrieval

27.1. Paediatric emergency retrieval

Paediatric retrieval

What’s different about children?

Paediatric emergency referrals

Paediatric referral and retrieval – roles and expectations

Paediatric retrieval staff

Paediatric retrieval equipment

Criteria for transport

Degrees of urgency

Transport platforms

While waiting

Stabilisation

Communication and retrieval leadership

Framework for communications during paediatric retrieval

Interface with adult retrieval

Parents

Paediatric retrieval and end-of-life situations

Quality

Summary

27.2. Sick child in a rural hospital

Introduction

Challenges in the rural setting

Caring for the critically ill child

What can be done to assist care in remote environments?

Relations between rural and urban hospitals

Acknowledgement

Section 28. Teaching Paediatric Emergency Medicine

28.1. Availing web-based resources

Accessing web-based resources

Needs of paediatric emergency medicine staff

Educational tools available online

Social media

Pitfalls of online content

28.2. Teaching paediatric emergency medicine

Introduction

Desirable attitudes in paediatric emergency medicine

Skill set for paedicatric emergency

Putting knowledge into perspective

Helping others acquire knowledge, skills and attitudes: modes of learning

Learning resources

Conclusions

Section 29. Paediatric Research in the Emergency Department

29.1. Research in children in the emergency department

Introduction

Research science

The ethics of medical research

The practice and governance of research

Implementation research: an emerging research field

Multicentre research

Funding research

Section 30. Adolescent Medicine in the Emergency Department

30.1. Adolescent medicine in the emergency department

Introduction

Adolescent health problems in the emergency department

The approach to the adolescent in the emergency department

Summary

30.2. Eating disorders and anorexia

Introduction

History

Examination

Investigations

Complications

Differential diagnosis

Management

Prognosis

Index

 

An aparitie	2018
Autor	Peter Cameron, Gary J. Browne, Biswadev Mitra,Stuart Dalziel ,Simon Craig
Dimensiuni	21.6 x 2.5 x 27.9 cm
Editura	Elsevier
Format	Hardback
ISBN	9780702073052
Limba	Engleza
Nr pag	688