By Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker
The recent variation of this best-selling name from the preferred a hundred situations sequence explores universal paediatric eventualities that might be encountered via the clinical pupil and junior health care professional in the course of useful education at the ward, within the emergency division, in outpatient clinics and in the neighborhood, and that are prone to function in qualifying examinations. The booklet covers a entire diversity of displays from cough to constipation, geared up by means of sub-specialty quarter for ease of reference. accomplished solutions spotlight key take domestic issues from each one case and supply useful suggestion on how you can take care of the demanding situations that happen while working towards paediatric drugs in any respect degrees.
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Extra resources for 100 Cases in Paediatrics
He is crying normally and has no signs of increased respiratory effort. Heart rate is 160 beats/min, femoral pulses are palpable, heart sounds are normal and no murmur is audible. Oxygen saturation is 70 per cent in air and does not rise with facial oxygen, which has been administered by the midwife. There is no hepatosplenomegaly. 0 kPa Questions • What is the likely diagnosis and differential diagnosis? • How do you interpret the blood gas results? • What is the emergency management? 29 100 Cases in Paediatrics ANSWER 9 This baby is most likely to have transposition of the great arteries.
G. bubble blowing. Encourage mobility Monitor for development of a pleural effusion. If the chest X-ray is suspicious, an ultrasound will be diagnostic. If present, a longer course of antibiotics is recommended to prevent empyema (a purulent pleural effusion). A chest drain may be necessary if there is worsening respiratory distress, mediastinal shift on the chest X-ray, a large effusion or failure to respond to adequate antibiotics Ensure adequate nutrition – children have often been anorectic for several days.
In a third of cases there is associated congenital heart disease so an echocardiogram should be performed. Supraventricular tachycardia needs to be differentiated from sinus tachycardia. In the latter, the heart rate is usually Ͻ220 beats/min, there is greater variability in the heart rate and there is often a history consistent with shock. Features of heart failure • • • • • • • • • • 34 Tachycardia Tachypnoea Hepatomegaly Poor feeding Sweating Excessive weight gain (acutely) Poor weight gain (chronically) Gallop rhythm Cyanosis Heart murmur Cardiology Initial treatment in this emergency follows the standard resuscitation guidelines and the baby should be administered oxygen.
100 Cases in Paediatrics by Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker