NeoTips: getting started with common neonatal procedures
Neonatal procedures can be challenging and difficult for many neonatal practitioners, clinical/trust fellows and doctors in training to undertake. In this guide, we detail the steps and tips that can be used as a guide by practitioners for the following procedures: IV cannulation, longline (PICC) insertion, umbilical arterial catheterisation and umbilical venous catheterisation, needle thoracocentesis, chest drain insertion, intubation and lumbar puncture. The guide features pictures of equipment required with a further ‘tips’ section detailing anecdotal advice on how best to aim for success in these procedures. (Sourc...
Source: Paediatrics and Child Health - May 4, 2023 Category: Pediatrics Authors: Qasim Malik, Puneet Nath, Asad Abbas Tags: Occasional review Source Type: research
Editorial Board
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - April 28, 2023 Category: Pediatrics Source Type: research
Twins: a neonatal perspective
Multiple gestational pregnancies have become more common with the development of assisted reproductive technologies and increasing maternal age. It is important to be aware of the factors that need to be considered when expecting their impending arrival to the neonatal unit. Their antenatal course has unique considerations and monochorionicity can complicate their antenatal and postnatal course so closer monitoring is required. Perinatal interventions for optimal outcomes are undertaken according to local policies, NICE and RCOG recommendations. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - April 26, 2023 Category: Pediatrics Authors: Tanoj Gopalan Kollamparambil, Neha Sharma Tags: Symposium: Neonatology Source Type: research
Social determinants of health and the neonate in the neonatal intensive care
It is increasingly recognised that social determinants of health such as socioeconomic inequalities, parental education level, addiction behaviors, mental health difficulties and breast-feeding rates all influence immediate and long-term outcomes in neonatal intensive care unit (NICU) graduates. Awareness, recognition and appropriate management of these risks may help alleviate some of these effects. This review looks at various social determinants and their effects on patients and families in the NICU. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - April 17, 2023 Category: Pediatrics Authors: Roshan Adappa, Sybil Barr Tags: Symposium: Neonatology Source Type: research
Intravenous bronchodilator choices in acute severe and life-threatening asthma
When inhaled therapy fails to reverse bronchospasm during a severe asthma attack, intramuscular epinephrine and intravenous (IV) magnesium sulphate (MgSO4), salbutamol, and aminophylline reach bronchial smooth muscle cells by the vascular route. There is no consensus on how long to wait before abandoning inhaled therapy, little agreement on which IV drug to use first, in what order, what dose to use, and IV delivery speed. IV therapy can begin with MgSO4 40 mg–75 mg−1 as a bolus rather than over 20 minutes, followed by salbutamol 15 mg.kg−1 over 10 minutes. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - April 12, 2023 Category: Pediatrics Authors: William FS. Sellers, Mike FM. James Tags: Symposium: Intensive care Source Type: research
Thyroid disorders in neonates: A practical approach to congenital hypothyroidism and thyrotoxicosis
Congenital hypothyroidism is one of the most common causes of preventable intellectual disability in the UK and worldwide. Early diagnosis is critical to allow for early intervention. At present, 1 in 2000 to 1 in 3000 babies born in the UK have congenital hypothyroidism. Of these, most will not display any clinical manifestations or symptoms in the first few weeks of life. In short, babies will develop intellectual disability if they go undiagnosed. It is therefore no surprise that the day 5 blood spot is essential for good outcomes and harm reduction. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - April 12, 2023 Category: Pediatrics Authors: Srinivas Nallagonda, Amile Inusa, Rohit Gupta, Madhavi Nallagonda Tags: Symposium: Neonatology Source Type: research
Editorial Board
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - March 30, 2023 Category: Pediatrics Source Type: research
Septic shock: early rapid recognition and ongoing management
Paediatric sepsis remains an important cause of morbidity and mortality in children. This review will summarize the main aspects of the definition, current evidence-base for interventions and suggest possible areas of improvement. Controversy remains regarding accurate definitions for paediatric sepsis, resuscitation fluid volume and type, choice of vasoactive agents for use in resuscitation and antibiotic choices. Many adjunctive therapies have been suggested with theoretical benefit, although few have proven beneficial. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - March 22, 2023 Category: Pediatrics Authors: Mariana Miranda, Simon Nadel Tags: Symposium: Intensive care Source Type: research
Managing expectations in the child of short stature with no underlying cause
Idiopathic short stature is a common reason for referral to the general paediatric or endocrine clinic. It can negatively impact the quality of life for the child and young person, extending into adulthood for some. However, these children are healthy individuals and treatment is not usually indicated. Whilst those with constitutional delay in growth and puberty can be given hormonal supplementation to induce puberty, there is no treatment available in the UK for the remaining children and young people as growth hormone is not approved for idiopathic short stature. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - March 21, 2023 Category: Pediatrics Authors: Lucy Abernethy, Tracy Tinklin Tags: Personal practice Source Type: research
The A-B-C of high-flow nasal oxygen therapy use in a sick child
Heated humidified high flow nasal cannula therapy (HFNC) is a relatively new method of oxygen delivery that came into vogue only a decade ago. The additional physiological benefits it provides make HFNC more than just a fancy oxygen delivery device. Theoretically, Continuous Positive Airway Pressure (CPAP) continues to be the gold standard therapy for moderate to severe respiratory disease. Practically, there are limitations to its use especially in older children outside of an intensive care setting. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - March 17, 2023 Category: Pediatrics Authors: Toranj H. Wadia, Ramnarayan Padmanabhan Tags: Symposium: Intensive care Source Type: research
Editorial Board
(Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - March 1, 2023 Category: Pediatrics Source Type: research
The infant with rectal bleeding
This article discusses common and rarer but not to be missed causes of rectal bleeding in infants and their immediate management. The aim is to provide a guide for the general paediatrician. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - February 24, 2023 Category: Pediatrics Authors: Sarah Reynolds, Sriharsha Yatham, Namita Anand, Baneera Shresthra Tags: Personal practice Source Type: research
Long-term management of children with tracheo-oesophageal fistula
Tracheoesophageal fistula with or without oesophageal atresia (TOF/OA) is a common congenital anomaly of the aero-digestive system. Timely diagnosis of the primary structural defect and later identification of complications are key to ensuring good outcomes. This short article outlines the epidemiology and natural history of TOF and offers practical advice to healthcare professionals to assist them in diagnosis, initial and longer-term management. The structural and functional features of TOF/OA are discussed alongside the associated conditions (including tracheomalacia and gastro-oesophageal reflux) and attendant clinical...
Source: Paediatrics and Child Health - February 23, 2023 Category: Pediatrics Authors: Caroline Poulter, Matthew Hurley Tags: Symposium: respiratory medicine Source Type: research
Paediatric blood sampling: how to improve your chances of getting it right
Medicine is often described as ‘more of an art than science’. Part of the art of providing healthcare for children requires us to take blood samples. Taking blood from children aged 1 day to 18 years provides challenges that are unique and distinct to those involved in taking blood from adults. Fortunately, there are techniq ues, skills and equipment that help reduce pain and distress, for children, families and those taking the blood. This short article discusses the methods, approaches and techniques used for successful blood taking in children. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - February 23, 2023 Category: Pediatrics Authors: Laura Riddick Tags: Personal practice Source Type: research
Investigation and management of stridor in neonates
Stridor is an uncommon yet potentially serious symptom in neonates. It is indicative of airway obstruction. This short article describes how to approach a baby with stridor. Assessment and investigation should proceed in a structured manner. Important clues about the likely cause can be determined using a combination of a careful history and clinical examination. The character and nature of any stridor, combined with information about the onset of symptoms are particularly important. These may help to determine the best initial investigations, including direct visualization of the airway and management. (Source: Paediatrics and Child Health)
Source: Paediatrics and Child Health - February 22, 2023 Category: Pediatrics Authors: Karthika Shanthakunalan, Giri Wijayasingam, Purushothaman Sudarshan, Andrew Prayle, Mat Daniel Tags: Symposium: Respiratory medicine Source Type: research
