MyCpdZw - Protocols Details

FEBRILE CHILDREN

The mainstay of diagnosis is physical examination by a physician who is experienced in the care of children and adolescents.

Diagnosis

Can be difficult! Be cautious!

Approx 10% have bacterial disease.

UTI accounts for a greater percentage

All need thorough clinical assessment.

Exclude underlying metabolic, cardiac & endocrine problems.

Bacterial sepsis more likely is: WCC > 15,000, Left shift, T>38.5

Management

1. Management of all children under 1 year should be discussed with medical officer prior

to discharge/admission,

2. All toxic children need full “septic work-up” (FBC, U&E’s, Blood cultures, urinalysis and

Urine MSC, CXR, LP as indicated),

3. Children <1 month of age should generally all receive a “septic work-up” & be admitted,

4. Children 1-3 months should receive a “sepsis work-up”, Consider discharge after

consultation with medical officer if child is clinically well, and the tests are normal

5. Children 3/12-3 years should be treated as clinically indicated if well.

6. Children 3/12-3 years who are unwell & have no clear focus for fever should have “septic

work-up” & be admitted for appropriate treatment,

7. Generally, any child who remains unwell or has difficult social circumstances should be

admitted,

8. Any child who is discharged should be reviewed within 1-2 days by their LMO or more

promptly if they deteriorate or do not improve,

9. Manage fever initially with paracetamol 15 mg/kg PO or 30 mg/kg PR as a single dose.

Recent Protocols

COVID 19

COVID 19 is a disease caused by the most recently discovered coronavirus which is a large family of corona viruses causing illnesses. In humans it causes Respiratory infections for example Severe Acute Respiratory Disease (SARs) PRESENTATION Fever 77-98% Cough 46-82% Myalgia/Fatigue 11-52% Shortness of breath 3-31% Incubation period 14 days, most people develop symptoms between 5-6ays from exposure Stage1 (Early infection). Stage 2. Stage 3(Hyperinflation phase) Viral response---------------------------Pulmonary Phase----------------------Host Response *Anyone presenting with flu like symptoms should be assumed to be a COVID 19 case until proven otherwise*

WARFARIN OVERDOSE/ TOXICITY

Overdose of the oral anticoagulant warfarin (Coumadin), or drug interactions with warfarin, can lead to toxicity. Similarly, toxicity can result from exposure to superwarfarins, which are long-acting anticoagulants used in rodenticides. ... Warfarin is the most common oral anticoagulant in current use

SUICIDAL IDEATION

Suicidal ideation, also known as suicidal thoughts, is thinking about or having an unusual preoccupation with suicide.

SPINAL CORD INJURY

Emergency signs and symptoms of a spinal cord injury after an accident may include: Extreme back pain or pressure in your neck, head or back. Weakness, incoordination or paralysis in any part of your body. Numbness, tingling or loss of sensation in your hands, fingers, feet or toes. Loss of bladder or bowel control.