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SPOTTING THE SICK CHILD

SPOTTING THE SICK CHILD. Dr James Thomas. Spotting the sick child introduction:. Paediatric training? Where will you pick these skills up? What learning resources do you know to help you spot the sick child?.

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SPOTTING THE SICK CHILD

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  1. SPOTTING THE SICK CHILD • Dr James Thomas

  2. Spotting the sick child introduction: • Paediatric training? • Where will you pick these skills up? • What learning resources do you know to help you spot the sick child?

  3. Curriculum statements RCGP :Care of children and young people & Care of acutely ill people • "Recognise and evaluate acutely ill patients" • "manage conditions which may present early and in an undifferentiated way, and recognise a seriously ill child and intervene urgently when necessary ."

  4. Aims of this session: • Assessment in a child friendly approach • Spotting the ill child. • Look at physiological changes in children due to acute serious illnesses and how this helps us with assessing ill children. • Look at scenarios of serious illness in childhood : • breathing difficulties,rashes and fever. • Summarise your findings • Reflect on your future learning needs.

  5. Assessment in a child friendly approach • Why is this important? • How do we achieve this child friendly environment? • What general principals do you use to examine children? • How do you make your examination child friendly?

  6. Rapid assessment toolkit for paediatrics • 3 minute paediatric toolkit • Demonstration videos

  7. Checklist • GENERAL • behaviour / colour • AIRWAY • Stridor / noisy breathing / drooling • BREATHING • Recession/accessory muscles/respiratory rate/auscultation/sats • CIRCULATION • Peripheral tempre & colour / pulse/ capillary refill/BP - video • DISABILITY • Alert / Voice only/ Pain only/ Unresponsive • ENT • Temperature

  8. Normal Values

  9. Clinical scenarios:small group work • History and examination of common causes and how you would differentiate the ill child in these cases. • Difficulty in breathing • Rashes • Fever

  10. Difficulty in breathing • Common causes • Key history points • Examination points - video • Case history 1-5 year old -video

  11. Rashes • Common causes • History ? • Examination? • Tumbler test - video • Serious causes - video

  12. Fever • History • General examination • Specific examination • Case history - video

  13. Summary • Child friendly environment and examination technique. • 3 minute toolkit • Check physiology and know age related normal values. • Use this information to allow you to be confident in your further management.

  14. Reflection • What will you do now? • Look at other resources - eGP / CKS /PALS course • AKT - look at NICE guidance • CSA - no sick child but might be a telephone consultation scenario and make sure aware of NICE guidance for fever management.

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