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Textbook of Paediatric Emergency Medicine
- 4th Edition - April 4, 2023
- Editors: Peter Cameron, Gary J. Browne, Biswadev Mitra, Stuart Dalziel, Simon Craig
- Language: English
- Paperback ISBN:9 7 8 - 0 - 7 0 2 0 - 8 5 3 5 - 2
- eBook ISBN:9 7 8 - 0 - 7 0 2 0 - 8 5 3 6 - 9
This leading text is essential reading for all those working in the paediatric emergency medicine setting who require concise, highly practical guidance that incorporates the la… Read more
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Request a sales quoteThis leading text is essential reading for all those working in the paediatric emergency medicine setting who require concise, highly practical guidance that incorporates the latest best practice and evidence-based guidelines.
The Textbook of Paediatric Emergency Medicine provides clear, concise and comprehensive information to support clinicians in what can be a challenging area to provide care. It not only covers diagnosis and management of all common presentations, but it also includes practical tips on communicating with both patients and their families.
As a companion book to Cameron’s Textbook of Adult Emergency Medicine, this volume is specifically tailored to the educational needs of emergency medicine trainees, but is also expected to benefit others working in the emergency setting including paramedics and emergency nurse specialists.
- Concise chapters and key point boxes allow for the quick and easy retrieval of information
- Comprehensive coverage of all major topics that present within paediatric emergency care
- Practical tips on communicating with patients and their families
- All key topics updated to include latest available evidence
- New section on COVID-19 and Infection control
- Expanded and enhanced coverage of the use of ultrasound in emergency care
- An enhanced eBook version is included with purchase. The eBook allows you to access all the text, figures and references, with the ability to search, customise your content, make notes and highlights, and have content read aloud
Emergency medicine trainee market; paediatricians in training
- Title of Book
- Instructions for online access
- Cover image
- Title page
- Table of Contents
- Copyright
- Preface
- Contributors
- Section 1. Approach to the paediatric patient
- 1.1. Approach to the paediatric patient
- Introduction
- Who sees paediatric emergencies?
- Prehospital care
- First aid response
- General Practitioner
- Emergency Department Care
- 1.2. Common chronic paediatric conditions
- Introduction
- Cerebral palsy
- Introduction
- Complications seen in the emergency department
- Respiratory complications
- Neurological complications
- Gastrointestinal complications
- Musculoskeletal complications
- Common medications used in cerebral palsy
- Baclofen
- Dantrolene sodium
- Botulinum toxin
- Spina bifida
- Introduction
- Types of spina bifida:
- Occulta
- Meningocoele
- Myelomeningocoele
- Implications for emergency department management
- Cystic fibrosis
- General
- Aetiology
- Diagnosis
- Management
- Management principles
- Respiratory
- History and examination
- Investigations
- Management
- Gastrointestinal
- Intestinal obstruction syndromes
- Endocrine
- The ex-premature infant
- Introduction
- Complications of prematurity
- Chronic neonatal lung disease
- Autism spectrum disorder
- Overview
- Characteristics of autism spectrum disorder
- Autism spectrum disorder in the emergency department
- Section 2. Resuscitation
- 2.1. Paediatric cardiopulmonary arrest
- Epidemiology
- Aetiology
- Preventing in-hospital cardiac arrest
- Outcome
- Differences compared with adults
- Development of resuscitation guidelines
- Ethical considerations in paediatric resuscitation
- Presence of family
- Termination of paediatric resuscitation
- Non-initiation of resuscitative efforts
- Nonaccidental injury
- Organ donation
- Death certificates, notification to the coroner and other legal issues
- Child death: follow-up of family
- 2.2. Paediatric basic life support
- Introduction
- Paediatric versus adult basic life support
- Aetiology of arrests
- Anatomy and physiology
- Preparation and equipment
- Basic life support sequence
- Check for danger (D)
- Assess responsiveness (R)
- Send for help (S)
- Open and maintain the airway (A)
- Breathing (B)
- Circulation (C)
- Precautions and complications with cardiopulmonary resuscitation
- Foreign body airway obstruction
- FBAO management: conscious patient with effective cough
- FBAO management: conscious patient with ineffective cough
- FBAO management: unconscious patient
- 2.3. Paediatric advanced life support
- Introduction
- Definition of advanced life support
- Diagnosing cardiac arrest
- Oxygen, ventilation and advanced airway support
- Oxygen
- Nasal prongs/nasal catheters
- High-flow nasal cannula
- Oxygen masks
- Ventilation
- Rates and ratios of external cardiac compression and ventilation in advanced life support
- Advanced airway support
- Endotracheal intubation
- Endotracheal tube size (Table 2.3.1)
- Laryngeal mask airway
- Management of the difficult airway
- Causes of a difficult airway
- Monitoring
- Vital signs
- Oximetry
- Expired CO2 detection
- Electrocardiograph
- Vascular access
- Peripheral venous cannulation
- Intraosseous access
- Central venous cannulation
- Endotracheal route
- Other techniques
- Fluid therapy
- Resuscitation drugs
- Cardiac arrest/ Arrhythmias/Dysrhythmias
- Management of pulseless arrhythmias
- Nonshockable arrhythmias
- Shockable arrhythmias
- Management of pulsatile dysrhythmias
- Bradycardias
- Tachycardias (Fig. 2.3.2)
- Ventricular tachycardia with a pulse
- Supraventricular tachycardia
- Post-resuscitation management (Box 2.3.1)
- Oxygenation and ventilation
- Haemodynamic monitoring
- Targeted temperature management
- Glucose control
- 2.4. Paediatric resuscitation in specific circumstances
- Teamwork in critical care management
- Rapid sequence induction in critical situations
- Resuscitation of children with congenital cardiac disease
- Anaphylaxis
- Asthma
- Drowning
- Traumatic cardiac arrest
- Toxicological emergencies
- Intravenous lipid emulsion
- Envenomation
- Snake envenomation (see Chapter 24.1)
- Marine envenomation: Box jellyfish
- 2.5. Shock
- Introduction
- Diagnosis and assessment
- Airway
- Breathing
- Circulation
- Heart rate
- Blood pressure
- Capillary refill
- Initial management
- Circulation
- Further management
- Hypovolaemia
- Septic shock
- Acute severe allergic reaction (anaphylaxis)
- Duct-dependent congenital heart disease
- Heart failure
- Neurogenic shock
- 2.6. Sepsis recognition and initial management
- Background
- Definition
- Aetiology
- Pathophysiology
- Diagnosis
- Initial emergency management (Fig. 2.6.1)6
- Monitoring
- General supportive measures
- Intravenous access
- Initial blood tests
- Initial treatment
- Therapeutic targets
- Disposition
- Section 3. Analgesia and sedation
- 3.1. Analgesia
- Introduction
- Assessment of pain
- Management
- Nonpharmacological methods
- Pharmacological methods
- Oral analgesic agents
- Intranasal or inhaled options
- Local anaesthetic agents
- Regional anaesthetic techniques
- Environment
- Psychological
- Cognitive–behavioural
- Physical
- Breast-feeding
- General
- Fascia iliaca compartment block (with or without ultrasound guidance)
- Femoral nerve block (with ultrasound guidance)
- 3.2. Paediatric procedural sedation within the emergency department
- Introduction
- The goal of procedural sedation
- Preprocedure
- Governance
- Patient selection and risk assessment
- Fasting
- Consent
- Equipment and personnel
- Rapport building
- Intraprocedure
- Postprocedure
- Nonpharmacological methods
- Environment
- Distraction techniques
- Physical
- Focused therapies
- Selection of agents by procedure and age
- Pharmacological methods
- Nitrous oxide
- Ketamine
- Propofol
- Ketofol
- Other agents
- Balanced sedation
- Section 4. Neonatal emergencies
- 4.1. The normal neonate
- Definition and introduction
- Immediately after birth
- The neonatal history
- The neonatal examination
- Common reasons for healthy neonates to present to the emergency department
- Feeding problems
- Crying (see Chapter 4.2, The crying infant)
- Vomiting and spilling
- Preventative advice
- Conclusion
- 4.2. The crying infant
- Introduction
- Recurrent crying
- Colic
- Management
- Gastrooesophageal reflux
- General advice
- Acute crying
- Assessment
- Examination
- Investigations
- Disposition
- 4.3. Neonatal dermatology
- Skin in the neonatal period
- Neonatal erythroderma (Fig. 4.3.1)
- Potential causes of erythroderma
- Investigations in erythroderma
- Management of the erythrodermic neonate
- Red scaly rashes
- Infantile seborrheic dermatitis/eczema
- Psoriasis
- Ichthyosis
- Neonatal lupus erythematosus (Fig. 4.3.2)
- Zinc deficiency/acrodermatitis enteropathica
- Langerhans cell histiocytosis (see Chapter 15.1, Dermatology)
- Tinea corporis
- Congenital syphilis
- Vesicles and blisters
- Herpes simplex
- Varicella
- Staphylococcus aureus
- Miliaria
- Epidermolysis bullosa
- Management in the emergency department
- Autoimmune blistering disease
- Pustular lesions
- Infection
- Neutropenia
- Erythema toxicum neonatorum (toxic erythema of the newborn)
- Transient neonatal pustular dermatosis
- Acropustulosis of infancy
- Eosinophilic pustular folliculitis (scalp)
- Milia and sebaceous gland hyperplasia
- Birthmarks
- Congenital melanocytic naevi
- Small (<0.5 cm) and medium (0.5–7 cm) congenital melanocytic naevi
- Large (7–15 cm) and giant (>15 cm) congenital melanocytic naevi
- Epidermal naevi
- Inflammatory verrucous epidermal naevus
- Sebaceous naevus
- Incontinentia pigmenti
- Pigmentary mosaicism
- Café au lait macules
- Cutis aplasia
- Blue/purple lesions
- Blueberry muffin syndrome (Fig. 4.3.5)
- Vascular lesions in the neonatal period
- Cutis marmorata
- Harlequin colour change
- Salmon patch (naevus simplex, stork mark, angel’s kiss)
- Vascular anomalies
- 4.4. Acute neonatal emergencies
- The neonatal period
- Neonatal resuscitation (see Chapter 4.5, Neonatal resuscitation)
- Assessment of the neonate
- The collapsed neonate
- Sepsis
- Antibiotics
- Viruses
- Cardiac emergencies
- Congenital heart disease
- Arrhythmia (see Chapter 5.10, Cardiac arrhythmias)
- Endocrine disorders
- The neonate with vomiting
- Intestinal obstruction
- Small bowel atresia
- Malrotation and midgut volvulus
- Meconium ileus
- Hirschsprung disease
- Hypertrophic pyloric stenosis
- The neonate with seizures
- The neonate with breathing difficulty
- Lung parenchymal pathology
- Airway obstruction
- Laryngomalacia
- Nonpulmonary disease
- The neonate with jaundice
- 4.5. Neonatal resuscitation
- Introduction
- Epidemiology
- Aetiology and pathophysiology
- Preparation
- Assessment at birth
- Breathing
- Positive pressure ventilation
- Heart rate
- Compression technique
- Colour
- Muscle tone and reflex irritability
- Medications
- Vascular access
- Adrenaline
- Naloxone
- Glucose
- Volume expansion
- Bicarbonate
- Specific resuscitation situations
- Premature neonate
- Meconium aspiration
- Congenital heart disease
- Postresuscitation stabilisation
- Controversies
- Respiratory function monitoring during resuscitation
- Next steps to improve outcome when resources are limited
- Ethics of resuscitation
- Prognosis
- Section 5. Cardiology
- 5.1. Cardiovascular assessment and murmurs
- Introduction
- History
- Physical examination
- Chest X-ray
- Electrocardiography
- Atrial enlargement
- Ventricular enlargement
- The child with an asymptomatic murmur
- Pathological murmurs
- Disposition
- 5.2. Chest pain
- Introduction
- Immediate approach
- General approach
- History
- Cardiac causes
- Noncardiac causes
- Anxiety
- Physical examination
- Investigations
- Chest pain following COVID-19 mRNA vaccine
- Conclusion
- 5.3. Syncope
- Introduction
- Aetiology
- Typical presentations
- Vasovagal syncope
- Breath-holding spells and reflex anoxic seizures
- Cardiac syncope
- Hypovolaemic states
- Seizures
- Hyperventilation and conversion syncope
- Clinical
- History
- Examination
- Investigations within the emergency department
- Further investigations of syncope
- Management of syncope within the emergency department
- Conclusion
- 5.4. Cyanotic heart disease and tetralogy of Fallot spells
- Introduction
- Cyanotic congenital heart disease
- Differential diagnosis
- Increased capillary oxygen extraction (peripheral cyanosis)
- Clinical features2–6
- Investigations
- Management2–6
- Disposition
- Tetralogy spells
- Introduction3–6,9–12
- Investigations3–6
- Laboratory
- Electrocardiograph
- Chest x-ray
- Echocardiography
- Treatment3–6,9–12
- Disposition
- 5.5. Heart failure
- Definition
- Causes of congestive heart failure
- Clinical manifestations and investigations
- Presentation1–3
- General features1–3
- Staging5–10
- Assessment
- Investigations1–3
- Routine
- Specialised
- Referral
- Management1–3,11–15
- Acute management
- Diuretics
- Angiotensin-converting enzyme inhibitors
- β-blockers
- Digoxin
- Levosimendan
- 5.6. Congenital heart disease
- Introduction
- Incidence
- Pathophysiology
- Undiagnosed congenital heart disease
- Findings that may indicate congenital heart disease
- Diagnostic approach
- Common presentations and initial management
- Neonate/infant
- Older child
- Complications/residua of congenital heart disease and its treatment
- Early
- Late
- Congenital heart disease and intercurrent illness
- Dehydration, including gastroenteritis
- Respiratory disease
- 5.7. Acute rheumatic fever
- Introduction
- Epidemiology
- Pathophysiology
- Diagnosis of acute rheumatic fever
- Clinical manifestations (history and examination)
- Investigations
- Laboratory evidence of group A β-haemolytic streptococcal infection
- Acute phase reactants
- Electrocardiogram
- Echocardiogram
- Differential diagnosis
- Treatment
- Acute management
- Symptomatic treatment of arthritis
- Treatment of carditis and control of heart failure
- Management of chorea
- Prevention and prophylaxis
- Prognosis
- 5.8. Infective endocarditis
- Introduction
- Epidemiology
- Pathophysiology
- Microbiology
- History and presenting clinical features
- Examination
- Modified duke criteria8
- Major criteria
- Positive blood cultures for infective endocarditis
- Evidence of endocardial involvement
- Minor criteria
- Investigations
- Laboratory
- Imaging
- Differential diagnosis
- Treatment
- Medical
- Surgical
- Prognosis
- Prevention
- 5.9. Kawasaki disease
- Introduction
- Pathophysiology
- Clinical features
- Cardinal diagnostic features of Kawasaki disease
- Other features of Kawasaki disease
- Incomplete Kawasaki disease
- Differential diagnosis
- Complications
- Investigations
- Treatment
- Refractory Kawasaki disease
- Prognosis
- 5.10. Cardiac arrhythmias
- Introduction
- Normal conduction system
- The cardiac action potential
- Vaughan Williams antiarrhythmia drug classification
- Pathogenesis of arrhythmias
- Bradyarrhythmias
- Tachyarrhythmias
- Reentry
- Enhanced automaticity
- After depolarisations
- General principles for arrhythmia management
- Bradyarrhythmias
- Sinus bradycardia
- Sinus node dysfunction
- Management
- Conduction disturbances: atrioventricular block
- Clinical features
- Management
- Bundle branch block
- Tachyarrhythmias
- Wide complex tachyarrhythmia
- Narrow complex tachyarrhythmia
- Wolff-Parkinson-White syndrome
- Atrial flutter
- Atrial fibrillation
- Ventricular fibrillation
- 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
- Larynx
- Subglottis
- Trachea
- 6.2. Upper respiratory tract infections
- Introduction
- Nasopharyngitis
- Introduction
- History
- Examination
- Investigations
- Treatment
- Stomatitis
- Introduction
- History
- Examination
- Investigation
- Treatment
- Pharyngitis/tonsillitis
- Introduction
- History
- Examination
- Investigations
- Treatment
- 6.3. Inhaled foreign body
- Introduction
- Upper airway foreign bodies
- History
- Examination
- Investigations
- Treatment
- Total obstruction
- Partial obstruction
- Lower airway foreign body
- History
- Examination
- Investigations
- Treatment
- Prevention
- 6.4. Croup
- Introduction
- Presentation
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment and disposition
- Mild or moderate croup
- Severe croup
- Prognosis
- Prevention
- 6.5. Acute asthma
- Introduction
- Diagnosis of asthma
- Infrequent intermittent asthma
- Frequent intermittent asthma
- Persistent asthma
- Risk factors for mortality
- Clinical assessment
- Examination
- Investigations
- Differential diagnosis
- Treatment: mild/moderate
- Treatment: severe
- Treatment: life threatening
- Discharge from hospital
- Discharge pack
- Prognosis
- Prevention
- Future directions/research
- 6.6. Pertussis
- Introduction
- Pathophysiology
- Epidemiology
- History
- Stage 1: Catarrhal (1–2 weeks)
- Stage 2: Paroxysmal (2–6 weeks, can be longer)
- Stage 3: Convalescent (1–2 weeks)
- Examination
- Investigations
- Differential diagnosis
- Complications
- Treatment
- Chemoprophylaxis of contacts
- Prevention
- Current immunisation schedule
- Prognosis
- 6.7. Community-acquired pneumonia
- Introduction
- Definition
- Aetiology
- Clinical findings
- Investigations
- Management
- Complications
- Prevention
- Conclusion
- 6.8. Bronchiolitis
- Introduction
- Epidemiology
- Pathophysiology
- Clinical assessment
- History
- Examination
- Assessment
- Differential diagnosis
- Investigations
- Treatment
- Drug therapy
- Prognosis
- Prevention
- Section 7. Gastroenterology and hepatology
- 7.1. Abdominal pain
- Introduction
- Pathophysiology
- Assessment
- History
- Neonates and infants
- Preschool
- School age
- Adolescents
- Examination
- Investigations
- Pathology
- Imaging
- Management
- Disposition
- Acute Appendicitis
- Introduction
- Clinical features
- Differential diagnoses
- Investigations
- Ultrasound
- Computed tomography scan
- Magnetic resonance imaging
- Active observation
- Management
- Meckel diverticulum
- Introduction
- Clinical features
- Differential diagnoses
- Investigations
- Management
- Chronic Abdominal Pain
- Introduction
- Assessment
- Diagnosis
- Management
- 7.2. Vomiting
- Introduction
- Definitions
- Clinical evaluation
- History
- Presenting complaint and past history
- ABC: fluids in and out
- Examination
- General observation
- Hydration status
- Cardiovascular and respiratory status
- Abdominal examination
- Neurological examination
- Differential diagnoses
- Surgical causes of bilious vomiting
- Intestinal atresia
- Anorectal anomalies
- Meconium ileus
- Hirschsprung disease
- Malrotation with volvulus
- Irreducible inguinal hernia (see also Chapter 7.11)
- Intussusception (see also Chapter 7.10)
- Inflammatory
- Meckel diverticulum
- Adhesions
- Investigations
- Bedside tests
- Formal investigations
- Investigations specific to bilious vomiting
- Management
- Fluids
- Antiemetic medication
- Antibiotics
- Analgesia
- Consultation
- Surgical-specific management
- Transfer
- Complications
- Bilious vomiting
- Conclusion
- Differential diagnostic possibilities
- General approach
- Surgical review
- 7.3. Gastrointestinal bleeding
- Introduction
- Definitions
- Aetiology
- History
- Examination
- Investigations
- Laboratory testing
- Stool testing
- Imaging
- Endoscopy
- Capsule endoscopy
- Primary medical management
- Fluid resuscitation and blood transfusion
- Nasogastric aspiration and lavage
- Treatment of acute UGIB
- Pharmacological treatment (Table 7.3.4)
- Variceal bleeding
- Disposition
- 7.4. Gastrooesophageal reflux
- Introduction
- Pathophysiology
- History
- Examination
- Differential diagnosis
- Complications
- Failure to thrive
- Respiratory
- Oesophagitis
- Investigations
- Treatment
- Simple measures
- Pharmacological
- Surgical
- 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
- Coins
- Button (disc) batteries
- Magnets
- Other metallic foreign bodies
- Nonmetallic foreign bodies
- Disposition
- Prevention
- 7.7. Acute liver failure
- Introduction
- Definitions
- Pathophysiology
- Hepatic encephalopathy
- Aetiology
- Infectious hepatitis
- Immune dysregulation
- Autoimmune hepatitis (AIH)
- Gestational alloimmune liver disease
- Hemophagocytic lymphohistiocytosis
- Inherited metabolic disease
- Drug- and toxin-induced liver injury
- Paracetamol
- Anticonvulsants
- Aspirin and Reye syndrome
- Mushrooms
- Structural anomalies
- Idiopathic PALF (iPALF)
- Presentation
- History
- Examination
- Investigations
- Management
- Prognosis
- 7.8. Diarrhoea
- Introduction
- Clinical evaluation
- History
- Presenting complaint and past history
- ABC – fluids in and out
- Examination
- General observation and examination
- Cardiovascular and respiratory status
- Abdominal examination
- Neurological examination
- Differential diagnoses
- Investigations
- Common investigations:
- Urine:
- Stool:
- Blood:
- Less common investigations
- Blood:
- Imaging:
- Management
- Fluids
- Dietary modification
- Antibiotics and Probiotics
- Consultation
- Conclusion
- Differential diagnostic possibilities
- General approach
- 7.9. Acute hepatitis
- Introduction
- Aetiology
- History
- Examination
- Investigations
- Viral hepatitis
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis E
- Viral hepatitis due to other viruses
- Drug- and toxin-induced liver injury
- Chronic liver disease presenting as acute hepatitis
- Autoimmune hepatitis
- Wilson disease
- Other causes of chronic liver disease presenting in childhood
- 7.10. Intussusception
- Introduction
- Aetiology
- Epidemiology
- Clinical
- Investigations
- Abdominal X-ray
- Ultrasound
- Management
- Outcome
- 7.11. Herniae
- Introduction
- Types of herniae
- Inguinal
- Femoral
- Umbilical and paraumbilical herniae
- Epigastric herniae
- Complications
- Treatment
- 7.12. Gastroenteritis
- Introduction
- Aetiology
- History
- Examination
- Assessment of dehydration
- Laboratory investigations in the assessment of dehydration
- Differential diagnosis
- Investigations
- Treatment
- Mildly dehydrated
- Appropriate oral fluids
- Method of giving oral fluids
- Indications for re-presentation
- Refeeding
- Moderately dehydrated
- Intravenous rehydration
- Rapid intravenous rehydration
- Severely dehydrated
- Other treatments
- Disposition
- Prognosis
- 7.13. Constipation
- Introduction
- Definitions
- What is normal?
- Neonates
- Infants
- Toddlers
- Types of constipation
- Assessment
- History
- Functional constipation
- Common withholding postures
- Examination
- Investigations
- Management
- Discharge recommendations
- Basics
- Medications
- Behaviour modification
- Dietary changes
- Rectal medication for disimpaction
- Inpatient disimpaction
- 7.14. Inflammatory bowel disease
- Introduction
- New diagnoses
- Presentation
- Examination
- Investigations in the emergency department
- Differential diagnosis
- Diagnosis/management
- Known inflammatory bowel disease patients
- Crohn disease
- Perianal disease
- Ulcerative colitis
- Toxic megacolon
- Common treatments and their complications
- Section 8. Neurology
- 8.1. Cerebrospinal fluid shunt complications
- Introduction
- Cerebral spinal fluid shunts
- Complication rate
- Clinical presentation
- Causes of shunt complications
- Shunt occlusion/obstruction/blockage
- Infection
- Early postoperative complications
- Migration and penetration of shunts
- Disconnection
- Fracture
- Investigation
- Palpation
- Pump bulb test
- Computed tomography
- Lumbar puncture
- ‘Shunt series’ radiographs
- Ultrasound
- Magnetic resonance imaging
- Management
- 8.2. Raised intracranial pressure
- Introduction
- Basic science
- Normal physiology
- Pathophysiology
- Clinical features
- Important points to consider
- Symptomatology based on age
- A Central herniation syndrome
- B Lateral mass herniation syndrome
- C Cerebellar tonsillar herniation syndrome
- Some specific signs
- Herniation syndromes
- Causes
- Idiopathic intracranial hypertension
- Increased cerebrospinal fluid (hydrocephalus)
- Space-occupying lesion
- Decreased or fixed intracranial volume
- Investigation
- Imaging
- Manometry
- Management of ICP
- 8.3. Seizures and nonepileptic events
- Introduction
- General comments
- Classification of seizures
- Febrile seizures
- Presentation to emergency department
- Presentation following a possible seizure
- History
- Examination
- Differential diagnosis and specific seizure syndromes
- Infancy
- Seizure types
- Familial (and nonfamilial) infantile epilepsy
- West syndrome (infantile spasms)
- Dravet syndrome
- Nonepileptic events of infancy
- Childhood
- Seizure types
- Nonepileptic events
- Adolescence
- Seizure types
- Nonepileptic events
- Hypnogogic jerks
- Rage attacks
- Presentation of a seizure
- Convulsive status epilepticus
- Drug therapy
- First line
- Second line
- Third line
- Investigations
- Blood tests
- Neuroimaging
- EEG
- ECG
- Disposition
- 8.4. Acute weakness
- Introduction
- Presentation
- Trauma masquerading as weakness
- Primary survey approach
- General inspection
- ABC
- DEFG
- History
- Examination
- Investigations
- Laboratory
- Imaging
- Specific conditions causing acute weakness
- Conditions of the central nervous system
- Stroke
- Brain tumours
- Seizures and todd paralysis
- Hemiplegic migraine
- Spinal cord lesions
- Transverse myelitis
- Spinal cord trauma
- Spinal cord space-occupying lesions
- Tumours
- Arteriovenous malformations
- Epidural abscess
- Tethered cord/diastematomyelia
- Lower motor neuron lesions
- Poliomyelitis and other enteroviral infections
- Guillain-Barré syndrome
- Bell palsy
- Toxic neuropathies
- Anticholinesterases
- Lead and other heavy metals
- Chemotherapeutic agents
- Hereditary neuropathy
- Conditions of the Neuromuscular Junction
- Botulism
- Myasthenia gravis
- Tick paralysis
- Neurotoxic envenomations
- Muscular disorders
- Infectious myositis
- Juvenile dermatomyositis
- Metabolic/endocrine myopathies
- Somatisation disorders/conversion disorder
- 8.5. Acute ataxia
- Introduction
- Pathophysiology
- Cerebellum
- Cerebral hemispheres and vermis
- Cerebellar peduncles and connections
- Differential diagnosis
- Acute cerebellar ataxia
- Acute cerebellitis
- Poisoning
- Anticonvulsants
- Benzodiazepines
- Alcohols
- Essential oils
- Cough suppressants
- Substances of abuse
- Tumours
- Trauma
- Infections
- Vascular conditions
- Other neurological conditions
- Metabolic disorders
- Chronic ataxia
- Hereditary ataxias/spinocerebellar degenerative
- Congenital malformations
- Clinical evaluation of the patient
- History
- Examination
- Investigations
- Management
- Prognosis
- Disposition
- 8.6. Headache
- Introduction
- Incidence
- Pathophysiology
- Clinical assessment
- History
- Site
- Nature
- Onset of the headache
- Progression
- Pyrexia
- Behavioural change and avoidance behaviour
- Sleep disturbance
- Postural symptoms
- Neurological deficit
- Family history (especially of migraine)
- Analgesic use
- Examination
- Investigation
- Blood tests
- Imaging
- Lumbar puncture
- Other investigations
- Management
- Disposition
- Migraine
- Essentials
- Pathophysiology
- Clinical features
- Investigation
- Treatment
- Disposition
- Conclusion
- 8.7. Central nervous system infections: meningitis and encephalitis
- Introduction
- Meningitis
- Classification
- Aetiology
- Bacteria
- Viruses
- Fungi
- Clinical findings
- Investigations
- Examination of the cerebrospinal fluid
- Other investigations
- Management
- Antibiotics
- Steroids
- Fluids
- Prevention
- Chemoprophylaxis
- Complications
- Age <2 months
- Age ≥2 months
- Viral meningitis
- Brain abscess
- Encephalitis
- Aetiology
- Aciclovir
- Clinical findings
- Investigations
- Management
- Complications
- Conclusion
- Section 9. Infectious diseases
- 9.1. Infectious diseases
- Fever
- Defining and measuring temperature
- Fever: to treat or not to treat?
- Practical approach to the febrile child
- Fever with localising signs
- Fever without focus
- Pyrexia of unknown origin
- Empiric antibiotic therapy
- Antimicrobial resistance
- Common infectious exanthems
- What specimens, when should they be ordered and what tests?
- Collection of microbiological specimens
- Blood cultures
- Cerebrospinal fluid
- Urine
- Stool specimens
- Throat swab
- Nasopharyngeal aspirate
- Nasal swab
- Infection control in the emergency department
- Needlestick injury
- The child presenting with a (community) needlestick injury
- Hospital staff exposure to blood-borne viruses
- Immunisation
- Immunisation of staff
- Opportunistic immunisation
- 9.2. SARS-CoV-2
- Introduction
- Incubation and transmission
- Epidemiology
- History and examination
- Investigations
- Diagnosis
- Differential diagnosis
- Complications
- Treatment
- Prognosis
- Prophylaxis: management of contacts
- Current immunisation strategies
- Section 10. Endocrinology and metabolic
- 10.1. Inborn errors of metabolism
- Introduction
- Physiology and pathogenesis
- Clinical features
- Investigation
- Management
- Correction of altered homeostasis
- Reduction of toxic compound production
- Removal/enhancement of excretion of toxic compounds
- Chronic presentations
- Extended newborn screening
- Conclusion
- 10.2. Hypoglycaemia in the nondiabetic child
- Introduction
- The hypoglycaemia screen
- Causes of hypoglycaemia
- Endocrine causes
- Metabolic causes
- Pharmacological and toxic causes
- Treatment of hypoglycaemia
- 10.3. Diabetic emergencies in children
- Introduction
- The child with suspected diabetes
- The child with diabetic ketoacidosis
- Initial management
- Bedside:
- Laboratory:
- Rehydration
- Reverse ketosis, correct acidosis and hyperglycaemia
- Monitor and treat complications
- Potassium
- Cerebral oedema
- Hypoglycaemia
- Hyperchloraemic metabolic acidosis
- Sepsis
- Abdominal pain
- Persisting acidosis
- Identify and treat any precipitating event
- The child with hypoglycaemia
- The child with an insulin pump
- The child with diabetes and intercurrent illness
- The child with diabetes and surgery
- 10.4. Thyroid emergencies
- Thyrotoxicosis
- Symptoms
- Signs
- Neonatal thyrotoxicosis
- Hypothyroidism
- Congenital hypothyroidism
- Hashimoto thyroiditis
- 10.5. Adrenal emergencies
- Adrenal crisis
- Introduction
- Clinical presentation
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Fluid management
- Replacement of corticosteroid
- Hypoglycaemia
- Hyperkalaemia
- Disposition
- Prevention
- Cushing syndrome
- Introduction
- Presenting symptoms
- Diagnostic testing
- Treatment
- 10.6. Disorders of fluids, electrolytes and acid–base
- Introduction
- Physiology
- Clinical assessment of hydration
- Haemorrhagic shock
- Fluid deficit
- Oedema
- Investigations
- Treatment
- Replacement of circulating volume
- How much fluid?
- How to administer fluid in shock
- Investigation and management of fluids in different conditions
- Dehydration
- Sepsis and meningococcal disease
- Haemorrhagic shock
- Head injury
- Burns
- Diabetic ketoacidosis
- Gastrointestinal loss
- Renal loss
- Insensible loss
- Hypernatraemia and hypernatraemic dehydration
- Diabetes insipidus
- Hyponatraemia and hyponatraemic dehydration
- Syndrome of inappropriate antidiuretic hormone secretion
- Potassium disorders
- Hyperkalaemia
- Hypokalaemia
- Maintenance fluids
- Acid–base disorders
- Metabolic acidosis
- Metabolic alkalosis
- Pyloric stenosis
- Section 11. Haematology and oncology
- 11.1. The use of blood products in children
- Introduction
- Use of blood products in resuscitation1–4
- Packed red blood cells1
- Indications
- Recommended initial dose of packed red blood cell transfusion
- Adverse reactions
- Platelets
- Indications
- General
- Immune thrombocytopenia
- Chemotherapy-induced thrombocytopenia7
- Administration
- Adverse reactions and other problems
- Fresh frozen plasma
- Administration
- Cryoprecipitate
- Clotting factor concentrates
- Albumin
- Indications
- Administration
- Adverse effects and risks
- Normal human immunoglobulin
- Hyperimmune immunoglobulins
- Risks of blood component use2
- Infections8
- Transfusion-related acute lung injury
- Transfusion-mediated immunomodulation
- Transfusion-associated graft-versus-host disease
- Other transfusion-related adverse reactions
- 11.2. Anaemia
- Introduction
- Production defect
- Increased RBC turnover
- Acute management
- Neonatal anaemia
- Physiological
- Immune related
- Neonatal infection
- Haemoglobinopathies and enzymopathies
- Blood loss
- Anaemias of childhood
- Iron deficiency
- Stages
- Causes
- Adverse effects
- Diagnosis
- Treatment
- Haemolytic anaemias
- Acquired haemolytic anaemias
- Autoimmune haemolytic anaemia
- Nonimmune haemolytic anaemia
- Erythrocyte fragmentation syndromes
- Thrombotic thrombocytopenic purpura
- Hereditary haemolytic anaemia
- Glucose-6-phosphatase dehydrogenase deficiency
- Hereditary spherocytosis
- Haemoglobinopathies
- Thalassaemias
- Heterozygous β-thalassaemia
- Homozygous β-thalassaemia
- α-Thalassaemia
- Sickle cell disease
- Sickle cell trait
- 11.3. Disorders of coagulation
- Vitamin K deficiency bleeding
- Introduction
- Clinical presentation
- Investigations
- Treatment
- Haemophilia
- Introduction
- Clinical presentation
- Investigations
- Treatment
- von Willebrand disease
- Introduction
- Clinical presentation
- Investigations
- Treatment
- 11.4. Platelet disorders
- Introduction
- Immune thrombocytopaenia
- Introduction
- Clinical presentation
- Diagnosis
- Management
- Current treatments
- Medical emergencies
- Chronic immune thrombocytopaenia
- 11.5. Vasculitis
- Introduction
- Clinical presentation
- Small-vessel vasculitis
- IgA vasculitis (formerly Henoch-Schönlein purpura)
- Anticytoplasmic-antibody-associated vasculitis
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss)
- Medium-Vessel Vasculitis
- Kawasaki disease
- Polyarthritis nodosa
- Clinical presentation
- Investigation and treatment
- Large-vessel vasculitis
- Takayasu disease
- Clinical presentation
- Secondary vasculitis and vasculitis mimics
- 11.6. Acute leukaemia
- Introduction
- Classification
- Clinical presentation
- Differential diagnosis
- Investigations
- Prognosis
- Complications
- Hyperleukocytosis
- Tumour lysis syndrome
- Superior vena cava and superior mediastinal syndrome
- Spinal cord compression
- Management
- 11.7. Febrile neutropaenia
- Introduction
- Presentation
- Investigations
- Treatment
- Low-risk children
- 11.8. Emergencies in paediatric oncology
- Introduction
- Fever and infection
- Initial assessment
- Gastrointestinal emergencies
- Gastrointestinal bleeding
- Gastrointestinal obstruction
- Pancreatitis
- Perforation
- Infection and inflammation
- Neutropaenic enterocolitis (typhlitis)
- Perirectal abscess
- Gastrointestinal complications of stem cell transplantation
- Sinusoidal obstruction syndrome
- Blood product use in oncology
- Irradiation of blood products
- Platelet transfusion
- Blood transfusion
- Cardiothoracic emergencies
- Superior vena cava syndrome and superior mediastinal syndrome
- Pneumonia
- Pleural and pericardial effusions
- Metabolic emergencies
- Tumour lysis syndrome
- Hyperleucocytosis
- Sodium abnormalities
- Hypercalcaemia
- Genitourinary emergencies
- Urinary tract obstruction
- Other renal complications
- Neurological emergencies
- Seizures
- Acute alterations in consciousness
- Brain and spinal cord tumours in children
- Brain tumours
- Supratentorial brain tumours
- Spinal cord compression
- Conclusion
- Section 12. Renal
- 12.1. Acute kidney injury
- Introduction
- Pathophysiology
- Clinical presentation
- Treatment
- Acute presentation of chronic renal failure
- Acute kidney injury in the renal transplant recipient
- 12.2. Haematuria
- Introduction
- Isolated microscopic haematuria
- History
- Examination
- Investigations
- Disposition
- 12.3. Hypertension
- Introduction
- History
- Examination
- Emergency department management
- Severe hypertension
- 12.4. Urinary tract infection in preschool children
- Introduction
- History and examination
- Diagnosis
- Treatment
- Age <3 months
- Age 3 months to 3 years old
- Age >3 years old
- Antibiotic choice6,7
- Parenteral treatment (IV/IM)
- Oral treatment
- Management after discharge from emergency department or observation wards
- Prognosis
- Prevention
- 12.5. Haemolytic uraemic syndrome
- Introduction
- Incidence
- Pathophysiology
- Pneumococcal-associated haemolytic uraemic syndrome
- Complement-mediated haemolytic uraemic syndrome
- History
- Examination
- Investigation
- Coagulation tests (prothrombin time, partial thromboplastin time) are normal
- Differential diagnosis
- Management
- Complications
- Prevention
- 12.6. Idiopathic nephrotic syndrome
- Introduction
- Pathophysiology of proteinuria
- Nephron and glomerular filtration barrier
- Renal handling of albumin
- Mechanisms of proteinuria
- Definition of nephrotic syndrome
- Classification of paediatric nephrotic syndrome
- Epidemiology
- Response to corticosteroids
- Minimal change disease
- Terminology of minimal change disease
- Pathogenesis of minimal change disease
- Primary (idiopathic) focal segmental glomerulosclerosis
- Terminology of focal segmental glomerulosclerosis
- Pathogenesis of primary focal segmental glomerulosclerosis
- Clinical features of idiopathic nephrotic syndrome
- Oedema
- Other features
- Investigations
- Urine analysis
- Blood tests
- Imaging
- Differential diagnosis
- Complications of idiopathic nephrotic syndrome
- Hypovolaemia
- Infection
- Thrombosis
- Management of initial nephrotic phase
- Immunisation
- Corticosteroid medication
- Management of proteinuria
- Prophylactic antibiotics
- Patient with frequent relapses of nephrotic syndrome or persistent nephrotic syndrome
- Prognosis
- 12.7. Immunoglobulin A vasculitis
- A note on nomenclature
- Introduction
- Epidemiology
- Pathogenesis
- Signs and symptoms
- Investigations
- Differential diagnosis
- Acute haemorrhagic oedema of infancy
- Treatment
- Prevention
- Preventing persistent kidney disease in patients with newly diagnosed IgA nephritis
- Follow-up
- Prognosis
- Section 13. Trauma in children
- 13.1. Introduction to paediatric trauma
- Prevalence
- Prevention
- Systematic paediatric trauma care
- Primary survey
- Catastrophic external haemorrhage control
- A Airway and cervical spine control
- B Breathing and oxygen delivery
- C Circulation and haemorrhage control
- D Disability
- E Exposure and environment
- Radiology during the primary survey
- Early analgesia
- Ongoing monitoring
- Psychological support of child and family members
- Secondary survey
- Tertiary survey
- Definitive care, disposition
- Rehabilitation
- 13.2. Paediatric Neurotrauma
- Introduction
- Epidemiology
- Pathophysiology
- Classification
- History
- Examination
- Glasgow Coma Scale
- Investigations
- Laboratory
- Radiological
- Skull X-rays
- Computed tomography scan
- Magnetic resonance imaging
- Management
- Mild traumatic brain injury
- Moderate and severe traumatic brain injury
- Airway control, oxygenation and ventilation
- Circulation
- Hypertonic saline
- Mannitol
- Positioning
- Intracranial pressure monitoring
- Antibiotics
- Steroids
- Thermoregulation: prophylactic hypothermia and prevention of hyperthermia
- Decompressive craniectomy
- Biomarkers
- Disposition
- 13.3. Spinal injury
- Introduction
- Developmental anatomy and physiology
- Initial assessment
- Spinal immobilisation
- Cervical spine injuries
- Mechanisms of injury
- Flexion
- Extension
- Rotation
- Vertical compression
- Clinical assessment
- Radiographic images
- Flexion and extension
- Computerised tomography
- Magnetic resonance imaging
- Radiographic evaluation
- Cervical spine clearance guidelines
- Atlantoaxial rotatory subluxation
- Thoracic and lumbar spine injuries
- Mechanism of injury
- Clinical assessment
- Radiographic evaluation
- Management
- Spinal cord injury
- Spinal cord injury syndromes
- Clinical assessment
- Radiographic evaluation
- Treatment
- Spinal cord injury without radiographic abnormality
- 13.4. Thoracic injuries in childhood
- Introduction
- Initial approach in the emergency department
- Chest wall injury
- Rib fractures
- Pulmonary injury
- Contusion
- Pneumothorax
- Tension pneumothorax
- Pulmonary lacerations
- Haemothorax1,14,16
- Tracheobronchial injuries
- Mediastinal injury
- Aortic transection
- Cardiac injuries
- Commotio cordis
- Penetrating cardiac trauma
- Diaphragmatic injury
- Oesophageal injury
- Emergency department thoracotomy
- 13.5. Abdominal trauma
- Important characteristics of paediatric patients with abdominal trauma
- Anatomy
- Physiology
- Lethal trauma triad and thermoregulation
- Physiological reserve
- Weight-based dosing of medications and blood products
- Mechanism of injury
- Handlebar injuries
- Seatbelt injuries
- Assessment and management
- History
- Physical exam
- Vital signs
- Inspection
- Palpation
- Percussion and auscultation
- Investigations
- Laboratory testing
- Focused assessment with sonography for trauma
- Computed tomography
- Initial management
- Take-home message
- 13.6. Burns
- Introduction
- Pathophysiology
- Classification
- Superficial
- Partial thickness
- Superficial partial thickness
- Deep partial thickness
- Full thickness
- History
- Examination
- Primary survey
- Evaluation of burn area
- Investigations
- Management
- Prehospital
- Emergency department
- Fluid resuscitation
- Management of burns
- Major burns
- Minor burns
- Superficial burns
- Small superficial burns
- Superficial facial burns
- Partial-thickness/small full-thickness burns
- Tetanus prone burns
- Electrical burns
- Introduction
- Clinical effects
- Skin
- Cardiac
- Muscular
- Neurological
- Renal
- Other
- Management
- Specific issues
- Burns
- Fluids
- Myoglobinuria
- Compartment injury
- Disposition
- Admission
- Discharge
- Chemical burns
- Treatment
- 13.7. Children in a disaster response
- Introduction
- Mass-casualty events
- Types of disasters
- Natural
- Human-generated
- Gradual onset/hybrid
- What disasters affect children?
- What are children’s vulnerabilities in disasters that affect disaster planning?
- Disaster planning and response
- Response
- Care for the carers
- Training and testing disaster plans
- Conclusion
- 13.8. Wound Management
- Introduction
- Anatomy of the skin
- Pathophysiology of wound healing
- Wound infection
- Classification of wounds
- Evaluation of the patient with a laceration
- History
- Examination
- Investigation
- Treatment of wounds
- Wound anaesthesia
- Wound preparation and cleansing
- Antibiotic prophylaxis
- Wound closure
- Sutures
- Needles
- Suturing techniques
- Staples
- Tissue adhesives
- Skin tapes
- Post-wound-closure care
- Dressing and suture removal
- Immobilisation and drains
- Treatment of selected injuries
- Abrasions
- Eyelid lacerations
- Lip lacerations
- Tongue lacerations
- Fingertip amputation
- Nailbed lacerations
- Subungual haematoma
- Puncture wounds to the foot
- Bites
- Animal bites
- Human bites
- Section 14. Orthopaedics and rheumatology
- 14.1. Orthopaedics and rheumatology
- Introduction
- The child with acute musculoskeletal pain or dysfunction
- General approach
- Assessment
- History
- Body proportions
- Physiology of developing bone
- Joints and ligaments
- Exposure to mechanisms
- Immunology
- Psychology
- Healing
- Examination
- Investigations
- Pathology
- Radiology
- Plain radiographs
- Ultrasound
- Bone scintigraphy
- Magnetic resonance imaging
- Generalised or multifocal bone/joint pain
- Introduction
- History
- Examination
- Investigations
- Specific conditions
- Infection
- Postinfectious (immune-mediated)
- Inflammatory/vasculitic
- Neoplastic
- Haematological
- Neoplastic presentations
- Bone tumours
- Other important subacute paediatric musculoskeletal presentations
- Traction apophysitis
- Torticollis
- Vertebrospinal inflammation
- Conclusion
- 14.2. The child with a limp
- Introduction
- History
- Trauma
- Infection (point focus)
- Postinfective
- Inflammatory
- Primary bone disorders
- Neoplastic
- Haematological
- Physical
- Psychological and idiopathic pain syndromes
- Abdominal
- Spine
- Examination
- Investigation
- Clinical decision-making in a child with a limp
- Relative immune deficit
- Injury mechanism
- Joint disease
- Specific conditions
- Transient synovitis
- History
- Clinical examination
- Differential diagnosis
- Management
- Prognosis
- Septic arthritis and osteomyelitis
- Introduction
- Presentation
- Microbiology
- Management
- Prognosis
- Prevention
- Most common (80% of most isolates)
- Other organisms
- Perthes disease
- Pathophysiology
- Emergency department presentations
- Slipped upper femoral epiphysis
- Epidemiology and pathophysiology
- Clinical presentation
- Differential diagnosis
- Treatment
- Complications
- 14.3. Fractures and dislocations
- Fracture patterns in childhood
- Initial assessment and management
- Upper limb and shoulder girdle injuries
- Clavicular fractures
- Fractures
- Presentation features
- Assessment
- Refer
- Shoulder dislocation
- Proximal humerus
- Midshaft humeral fractures
- Injuries to the elbow region
- Supracondylar fracture
- Management of supracondylar fractures
- Intercondylar (T-condylar) fracture
- Lateral condyle
- Medial epicondylar avulsion
- Pulled elbow (radial head subluxation)
- Reduction of radial head subluxation
- Elbow dislocation
- Proximal radial and ulnar fractures
- Olecranon fractures
- Radial neck fractures
- Monteggia fracture-dislocation
- Midshaft radial and ulnar fractures
- Distal radial and ulnar fractures
- Distal radial epiphyseal fractures
- Carpal injuries: the scaphoid
- Metacarpal fractures
- Phalangeal fractures
- Thumb fractures
- Fingertip injuries
- Lower limb and pelvis injuries
- Pelvic fractures
- Hip dislocation
- Femoral fractures
- Injuries about the knee
- Distal femoral physeal separation
- Tibial spine injury
- Avulsion of tibial tubercle
- Patellar dislocation
- Patellar fractures
- Lower leg fractures
- Ankle fractures
- Tillaux fracture
- Triplane fracture
- Inversion injuries
- Conclusions
- Future directions
- 14.4. Risk management in acute paediatric orthopaedics
- Introduction
- Nonidentification or delayed identification of paediatric fractures
- Low-risk fractures
- Adverse events in acute paediatric orthopaedics
- Section 15. Dermatology
- 15.1. Dermatology
- Introduction
- Erythroderma and skin failure
- Vesiculobullous eruptions
- Infections
- Inflammatory
- Immune mediated
- Photosensitive dermatoses
- Drug induced
- Pustular eruptions
- Infectious
- Inflammatory
- Drug induced
- Papular eruptions (widespread)
- Infectious
- Inflammatory
- Infectious
- Tumours
- Inflammatory
- Red scaly (papulosquamous) eruptions
- Inflammatory
- Infectious
- Red blanching (erythematous) eruptions
- Infectious
- Inflammatory
- Vascular
- Drug
- Petechiae and purpura
- Infectious
- Inflammatory
- Haematological
- Trauma
- Tumours
- Malformations
- Hyperpigmentation (widespread)
- Hyperpigmentation (localised)
- Hypopigmentation
- Anogenital rashes
- Inflammatory
- Infectious
- Hair and scalp
- Itchy
- Hair loss
- Nails
- Painful
- Discoloration
- Management
- Vesiculobullous rashes
- Varicella (chickenpox)
- Management
- Zoster
- Management
- Hand, foot and mouth disease
- Herpes simplex infection
- Management
- Eczema herpeticum
- Management
- Impetigo (School sores)
- Management
- Staphylococcal scalded skin syndrome
- Management
- Erythema multiforme
- Management
- Reactive infectious mucocutaneous eruption
- Stevens-Johnson syndrome/toxic epidermal necrolysis
- Management
- Dermatitis herpetiformis
- Management
- Other immune-mediated blistering disorders
- Isolated blisters
- Chronic erosions or ulcers
- Management
- Prevention
- Sunburn and photosensitivity
- Primary photosensitivity disorders
- Polymorphous light eruption
- Juvenile spring eruption
- Hydroa vacciniforme
- Solar urticaria
- Porphyrias and other inherited disorders with photosensitivity
- Erythropoietic protoporphyria
- Congenital erythropoietic porphyria
- Familial porphyria cutanea tarda
- Photosensitivity and bullous reactions to drugs
- Management
- Photosensitivity reactions to plants
- Management
- Plant contact dermatitis
- Id reactions
- Pustular rashes
- Acne
- Management
- Acne and depression
- Acne fulminans
- Management
- Acne with Gram-negative folliculitis
- Early onset acne
- Atypical acneiform rashes
- Folliculitis
- Acute generalised exanthematous pustulosis
- Pustular psoriasis
- Papular (raised) rashes
- Scabies
- Management
- Papular acrodermatitis of childhood
- Management
- Papular urticaria
- Management
- Molluscum
- Management
- Adnexal tumours: pilomatricoma
- Keratosis pilaris
- Management
- Granuloma annulare
- Langerhans cell histiocytosis
- Management
- Juvenile xanthogranulomas
- Xanthomas
- Angiofibromas in tuberosclerosis
- Red scaly (papulosquamous) rashes
- Psoriasis
- Management
- Tinea corporis
- Management
- Pityriasis rosea
- Management
- Secondary syphilis
- Seborrhoeic dermatitis
- Management
- Lichen striatus
- Eczematous rashes
- Atopic eczema: general issues
- Atopic eczema: general management principles:
- Atopic eczema: dietary principles
- Atopic eczema: use of topical corticosteroid preparations
- Systemic effects of topical steroid use
- Local effects of topical steroid use
- Atopic eczema: acute flare
- Atopic eczema: admission to hospital
- Atopic eczema: generalised infantile
- Atopic eczema: facial
- Atopic eczema: perioral eczema versus juvenile rosacea
- Perioral eczema
- Juvenile rosacea
- Atopic eczema: periorbital
- Atopic eczema: molluscum
- Atopic eczema: discoid
- Atopic eczema: juvenile plantar dermatosis
- Atopic eczema with systemic associations
- Irritant contact dermatitis
- Allergic contact dermatitis
- Generalised dry skin: ichthyosis
- Generalised dry skin: ectodermal dysplasias
- Red blanching rashes (erythematous)
- Fever and exanthem
- Scarlet fever
- Toxic shock syndrome
- Kawasaki disease
- Erythema infectiosum
- Roseola infantum
- Enteroviruses
- Infectious mononucleosis
- Measles
- Rubella
- Unilateral laterothoracic exanthem
- Management
- Urticaria
- Serum sickness
- Management (see urticaria)
- Lupus erythematosus
- Neonatal lupus erythematosus (see Chapter 4.3, Neonatal dermaology) Juvenile dermatomyositis
- Juvenile idiopathic arthritis
- Erythema nodosum
- Management
- Necrobiosis lipoidica
- Palmoplantar hidradenitis
- Pernio (chilblains)
- Spider naevi
- Other erythematous rashes
- Purpuric rashes
- Fever and petechiae
- Fever and petechiae in an unwell child (including meningococcal sepsis)
- Fever and petechiae in a well child
- Meningococcal sepsis and other septicaemia
- Vasculitis and IgA vasculitis (Henoch-Schönlein purpura)
- Thrombocytopenic purpura
- Leukaemia
- Coagulation disorders
- Child abuse
- Artefactual purpura
- Papular-purpuric gloves-and-socks syndrome
- Dusky purple nodules on hands and feet
- Chronic pigmented purpura
- Other causes of childhood purpura
- Vascular tumours: haemangiomas and haemangioma variants
- Haemangiomas of infancy
- Association with stridor
- Eye involvement
- Involvement of facial structures
- Ulceration
- Macular facial lesions
- Sudden onset of swelling and bruising in a large vascular lesion
- Multiple haemangiomas (diffuse neonatal haemangiomatosis)
- Cardiac failure with a hepatic mass
- Management
- Congenital haemangioma
- Kaposiform haemangioendothelioma/tufted angioma
- Pyogenic granuloma
- Management
- Vascular malformations
- Neonatal vascular malformations
- Facial nevus simplex (small pink/red stains on the eyelids/central forehead)
- Facial capillary malformations (port-wine stain)
- High-flow lesions
- Symptoms of vascular malformations
- Pain, swelling
- Bleeding, coagulopathy
- Chest pain or shortness of breath
- Intestinal bleeding, anaemia
- Bladder or bowel dysfunction in older children
- Leg length discrepancy
- Multiple telangiectatic vessels
- Fabry disease
- Management of vascular malformations
- Hyperpigmentation
- Diffuse hyperpigmentation
- Localised macular hyperpigmentation: including café au lait macules
- Neurofibromatosis
- McCune-Albright syndrome
- Incontinentia pigmenti
- Peutz-Jeghers syndrome
- Segmental pigmentary disorder (including linear and whorled hyperpigmentation and hypopigmentation of Ito)
- Mastocytosis
- Presentations with dermal (blue/grey) pigmentation
- Postinflammatory hyperpigmentation
- Dermal melanocytosis (Mongolian spot)
- Naevus of Ota
- Localised raised hyperpigmentation
- Congenital pigmented naevi
- Management
- Acquired pigmented naevi
- Dysplastic naevi
- Halo naevi
- Spitz naevi
- Hypopigmentation
- Pityriasis versicolor
- Pityriasis alba
- Vitiligo
- Postinflammatory hypopigmentation
- Linear and whorled hypopigmentation (‘hypomelanosis of Ito’)
- Tuberous sclerosis
- Generalised hypopigmentation
- Skin texture
- Lax skin
- Firm or thickened skin
- Mouth disorders
- Primary herpetic gingivostomatitis
- Herpangina
- Transient lingual papillitis
- Angular cheilitis
- Geographic tongue
- Recurrent mouth ulcers
- Anogenital rashes
- Irritant napkin dermatitis
- Management
- Candida napkin dermatitis
- Anogenital psoriasis
- Perianal streptococcal dermatitis
- Management
- Staphylococcal-mediated anogenital rashes
- Herpes simplex virus
- Varicella
- Threadworms
- Lichen sclerosus
- Vulval itch/vulvitis in prepubertal girls
- Zinc and other nutritional deficiencies
- Malabsorption
- Langerhans cell histiocytosis
- Constipation
- Anogenital papules and lumps
- Anogenital warts
- Molluscum
- Congenital syphilis
- Immunodeficiency states
- Hair problems
- Head lice
- Tinea capitis
- Kerion (inflammatory ringworm)
- Alopecia areata
- Management
- Traumatic alopecia
- Management
- Diffuse hair loss
- Hypertrichosis
- Hirsutism
- Nail problems
- Paronychia
- Acute paronychia (inflammation of the nail fold)
- Chronic paronychia
- Management
- Nail psoriasis
- Ingrown toenail
- Tinea unguium (onychomycosis)
- Itch without rash
- Collection of specimens
- Bacterial swabs (Gram stain and culture)
- Swabs for herpes simplex virus or varicella-zoster virus
- Swabs for polymerase chain reaction (for pertussis, varicella-zoster virus, herpes simplex virus, Mycobacterium ulcerans, etc.)
- Swabs for Chlamydia trachomatis
- Skin scrapings for fungal/dermatophyte culture
- Section 16. Ophthalmology
- 16.1. Ophthalmological emergencies
- Introduction
- History
- Examination
- Reduced pupil light response
- The red eye in paediatrics
- The red eyelid
- Preseptal versus orbital cellulitis
- Blepharitis
- Hordeolum (stye)
- Chalazion (meibomian cyst)
- Dacryocystitis
- Dacryoadenitis
- The red eye
- Conjunctivitis
- Neonatal conjunctivitis
- Conjunctivitis in older children
- Allergic conjunctivitis
- Keratitis
- Recurrent corneal erosion
- Uveitis
- Episcleritis and scleritis
- 16.2. 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
- 16.3. Ocular trauma
- Introduction
- Time-critical ocular trauma
- Retrobulbar haemorrhage
- Chemical eye injury
- Open globe injury
- Globe trauma
- Subconjunctival haemorrhage
- Conjunctival lacerations
- Corneal abrasion
- Corneal foreign bodies
- Corneal lacerations
- Hyphaema
- Eyelid trauma
- Ecchymosis
- Orbital trauma
- Thermal burns
- Traumatic iritis
- Nonaccidental injury
- Section 17. ENT and dental
- 17.1. The ear
- Otitis externa
- Introduction
- History
- Examination
- Investigations
- Treatment
- Prevention
- Complications
- Acute otitis media
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Prevention
- Discharging otitis media: chronic suppurative otitis media
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Otitis media with effusion
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Mastoiditis
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Trauma
- Introduction
- History and examination
- Investigation
- Treatment
- Complications
- 17.2. The nose
- Rhinitis and sinusitis
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Prevention
- Epistaxis
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Nasal trauma
- Introduction
- History and examination
- Investigations
- Treatment
- Complications
- Epistaxis
- Nasal trauma
- 17.3. The mouth and throat
- Stomatitis
- Introduction
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Complications
- Pharyngitis/tonsillitis
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Peritonsillar abscess
- Introduction
- History and examination
- Investigations
- Treatment
- Complications
- Posttonsillectomy haemorrhage
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Oral/dental trauma
- Introduction
- History
- Examination
- Investigations
- Treatment
- Luxation
- Avulsion
- Intrusion
- Root fractures
- Hard tissue injuries
- Soft tissue injuries
- Prevention
- Oral/dental infection
- Introduction
- History
- Examination
- Investigations
- Treatment
- Prevention
- Other dental issues
- Spontaneous oral haemorrhage
- Pharyngitis/tonsillitis
- Tonsillectomy
- Oral/dental trauma
- Oral/dental infection
- 17.4. Retropharyngeal abscess
- Introduction
- History
- Examination
- Investigation
- Treatment
- 17.5. Foreign bodies of the nose and throat plus caustic ingestions
- Nasal foreign bodies
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Aural foreign bodies
- Introduction
- History
- Examination
- Investigation
- Treatment
- Complications
- Caustic ingestion
- Introduction
- History
- Examination
- Investigations
- Treatment
- Complications
- Prevention
- Section 18. Obstetrics and gynaecology
- 18.1. Paediatric gynaecology
- Infant and prepubescent gynaecology
- Vaginal discharge
- Introduction
- History
- Examination
- Investigations
- Management
- Vaginal bleeding
- Introduction
- Hormonal causes
- Nonhormonal causes
- Nonvaginal causes of bleeding
- History
- Examination
- Investigations
- Management
- Adolescent gynaecology
- Vaginal discharge and sexually transmitted infections
- Introduction
- History
- Examination
- Investigations
- Management
- Disposition
- Abnormal vaginal bleeding
- Introduction
- Examination
- Investigations
- Management
- Disposition
- Pelvic pain
- Introduction
- History
- Examination
- Investigations
- Management
- Disposition
- 18.2. Emergency contraception
- Introduction
- Clinical assessment
- Available medicines
- Medication interactions
- Medicine contraindications
- Medicine adverse effects
- Medicine outcomes
- Copper intrauterine devices
- Section 19. Male genitalia
- 19.1. Male genitalia
- The acute scrotum
- Introduction
- Torsion of a testicular or epididymal appendage
- Torsion of the testis
- Epididymo-orchitis
- Idiopathic scrotal oedema
- Henoch-Schönlein purpura
- Testicular tumours
- Irreducible inguinal hernia
- Rupture of the testis
- Acute hydrocele
- Acute problems of the penis and foreskin
- Introduction
- Adhesions
- Smegma
- Phimosis of the foreskin
- Balanitis
- Paraphimosis
- Meatal stenosis
- Priapism
- Section 20. Adolescent medicine in the emergency department
- 20.1. Adolescent medicine in the emergency department
- Introduction
- Adolescent health problems in the emergency department
- Support in times of crisis
- Kids Helpline (www.kidshelp.com.au)
- Lifeline (www.lifeline.org.au)
- Beyond Blue (www.beyondblue.org.au)
- Resources focusing on young people’s health and well-being
- Headspace (www.headspace.org.au)
- Reach Out (www.au.reachout.com)
- Alcohol and substance use
- Australian Alcohol and Drug Foundation (www.adf.org.au)
- Family Drug Support Australia (www.fds.org.au)
- Legal Information
- Youth Law Australia (www.yla.org.au)
- The approach to the adolescent in the emergency department
- Establishing rapport
- Seeing adolescents alone
- Psychosocial screening
- Using the HEEADSSS framework
- H Home
- E Education (or employment)
- E Eating and exercise
- A Activities
- D Drugs
- S Sexuality and Gender
- S Suicide
- S Safety
- Confidentiality
- The mature minor principle
- Physical examination
- Linking adolescents with community follow-up
- Conclusion
- Facilities for managing aggressive, intoxicated or distressed adolescents
- Opportunistic health screening
- 20.2. Eating disorders and anorexia
- Introduction
- Anorexia nervosa
- History
- Examination
- Investigations
- Weight profile
- Restriction and diet history
- Associated behaviours with eating
- Exercise
- Body dysmorphic concerns
- Complications
- Differential diagnosis
- Management
- Goals of management in the emergency department
- Consider medical admission for patients with4,5,8,9:
- Feeding
- Refeeding syndrome
- Prognosis
- Bulimia nervosa
- Section 21. Psychlatric
- 21.1. Paediatric psychiatric emergencies
- Introduction
- General approach
- Assessment
- History
- Collateral history
- Examination
- Investigations
- Synthesis of assessment
- Common paediatric psychiatric presentations
- The acutely disturbed child
- Suicidal attempts and intentional self-harm
- Introduction
- Assessment
- Engagement
- Medical evaluation
- Preliminary suicide evaluation including psychosocial history
- Mental health assessment
- Hazards during assessment
- Management
- Maintaining safety in the emergency department
- Medical care
- Safety planning
- Arranging follow-up after the attempt
- Suicidal patients: important considerations
- Anxiety disorders
- Psychosis
- Psychosis and other psychiatric disorders
- Nonpsychotic hallucinations
- Psychosis and hallucinations induced by an underlying medical condition
- Treatment
- Other psychiatric presentations
- Acute dystonic reactions
- Night terrors
- History
- Management
- Excessive use of electronic screens
- 21.2. Acute behavioural disturbance in children and young people
- Introduction
- Arousal
- Behaviour
- Containment
- Cognitive processes
- The principles of psychiatric triage
- Purpose of triage
- Pre triage
- The hierarchy of needs
- Management
- Behaviours that usually calm the patient and deescalate aggression
- Practice
- Avoid
- The four main themes
- Safety plan and risk management
- Time is risk
- Managing the ABCC including restraint and acute sedation
- Sedating the young brain
- Tracking the seven stages of sedation
- Five tips on sedating young people
- Treating comorbid medical disorder
- Mental state signs of organic dysfunction
- Treating comorbid psychiatric disorder
- Differential diagnosis: psychiatric
- Identify patient’s threat to themself
- Managing a threat to themself
- Identify medical risks
- Manage specific medical risks
- Three tips for monitoring young people
- Transfer is a potential escalation of risk
- The special problem of the autistic spectrum disorders
- Conclusion
- Controversies in the immediate term
- Controversies in the medium term
- Controversies in the long-term
- Section 22. Crisis intervention
- 22.1. 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
- Nonspecific
- Specific
- Genitoanal injury
- Sexually transmitted infections
- Diagnostic considerations
- Role of the emergency physician
- Documentation
- Mandatory reporting legislation
- Long-term effects
- 22.2. Child at risk
- Introduction
- Definition
- Physical abuse
- Presentation
- History
- Physical examination
- Bruising of the skin
- Laceration and abrasion of the skin
- Burns or scalds
- Fractures
- Eye injuries
- Ear injuries
- Head injuries
- Intraabdominal injury
- Sentinel injuries
- Investigations
- Emotional abuse
- History and examination
- Neglect
- History and examination
- Treatment
- Medical child abuse
- The community response to the child at risk
- Responsibilities to report
- What to do as the medical practitioner, in suspected cases
- Legal responsibilities
- Role of child protection agency
- Section 23. Poisoning
- 23.1. General approach to poisoning
- Introduction and epidemiology
- Diagnosis
- Risk assessment
- Investigations
- Resuscitation
- Decontamination
- Antidotes
- Enhanced elimination
- Supportive care
- Consultation and disposition
- 23.2. Specific poisons
- Common poisons
- Paracetamol
- Nonsteroidal antiinflammatory drugs
- Benzodiazepines
- Opioids
- Anticholinergics and antihistamines
- Corrosive ingestions
- Rare and dangerous poisons
- Salicylates
- β-Blockers
- Calcium-channel blockers
- Digoxin
- Clonidine
- Iron
- Warfarin and rodenticides
- Oral hypoglycaemics
- Tricyclic antidepressants
- Toxic alcohols
- Psychostimulants
- Essential oils
- Organophosphates and carbamates
- House fires
- Section 24. Envenomation
- 24.1. Envenomation
- Introduction
- Snakebite
- Introduction
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- Future directions
- Scorpion stings
- Introduction
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- Spiderbite
- Introduction
- History
- Australian funnel web spiders
- Widow spiders including Australian redback spiders
- Banana spiders
- Recluse or fiddleback spiders
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- Tick bite paralysis
- Introduction
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- Jellyfish stings
- Introduction
- Box jellyfish
- Irukandji syndrome
- Portuguese man-of-war
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- Venomous fish stings
- Introduction
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- Venomous marine molluscs
- Introduction
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Prognosis
- Prevention
- 24.2. Drowning
- Introduction
- Definition
- Epidemiology
- Aetiology
- Pathophysiology
- History
- Examination
- Investigations
- Differential diagnosis
- Treatment
- Disposition
- Prognosis
- Prevention
- 24.3. Heat-induced illness
- Introduction
- Causes of heat-related illness
- Clinical syndromes
- The neonate/infant
- Heat syncope
- Heat cramps
- Heat exhaustion
- Heat stroke
- Other heat-related syndromes
- Investigations
- Management
- Heat syncope and heat cramps
- Heat exhaustion
- Heat stroke
- Malignant hyperthermia
- Serotonin syndrome, neuroleptic malignant syndrome and anticholinergic syndrome
- Prognosis and disposition
- 24.4. Cold injuries
- Introduction
- Normal thermal physiology: A review
- Hypothermia
- Perfusing rhythm present
- Perfusing rhythm not present
- History
- Examination
- Diagnosis
- Treatment
- Prehospital treatment
- Treatment in the emergency department
- Neonatal resuscitation
- Complications
- Disposition
- Localised cold injuries
- Frostbite
- Clinical features and diagnosis
- Treatment
- Disposition
- Hypothermia not due to environmental causes
- 24.5. Anaphylaxis and food reactions
- Introduction
- Pathophysiology
- Aetiology
- Clinical features
- Investigations
- Treatment
- Adrenaline
- Airway and breathing
- Circulation
- Supplemental treatment
- Duration of treatment
- Admission/observation
- Diagnosis
- Types of anaphylaxis
- Common
- Less common
- Uncommon
- Recurrent anaphylaxis
- Differential diagnosis
- Prevention
- Future directions and research
- Section 25. Administration in EMS
- 25.1. Managing the death of a child in the emergency department: Bereavement issues
- Introduction
- Clinical
- Operational
- Legal and forensic
- Ethical
- Spiritual and emotional
- Follow-up care for family
- Follow-up care for team
- 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 26. Transport and retrieval
- 26.1. Paediatric emergency retrieval
- Paediatric retrieval
- What is different about children?
- Paediatric emergency referrals
- Paediatric referral and retrieval: roles and expectations
- The referrer
- The coordinator/administrator
- The paediatric retrieval specialist
- The paediatric emergency transport team
- Paediatric retrieval staff
- Paediatric retrieval equipment
- Airway
- Difficult airway
- Breathing
- Circulation
- Monitoring
- Ultrasound
- Anaesthetic agents
- Muscle relaxants
- Cardiovascular medications
- Sedation and antidote
- Antibiotics
- Antiepileptics
- Asthma treatment
- Other
- Criteria for transport
- Degrees of urgency
- Time-critical retrieval
- General conditions requiring urgent referral
- Definitions
- Transport platforms
- Road ambulance
- Rotary wing aircraft
- Fixed-wing aircraft
- Weather
- 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
- Conclusion
- 26.2. Sick child in a rural hospital
- Introduction
- Challenges in the rural setting
- Income
- Housing
- Education
- Culture
- The illnesses
- Birth history
- Trauma
- Infection and diet
- The health services
- Caring for the critically ill child
- Decisions to consider when child presents with an emergency
- Coordination of a resuscitation team prior to the child’s arrival
- Potential problems in the stabilisation of the child
- What can be done to assist care in remote environments?
- Personnel
- Education
- Content of training
- Consultation support
- Transport
- Management protocols
- Hospital facilities
- Relations between rural and urban hospitals
- Section 27. Teaching paediatric emergency medicine
- 27.1. Web-based resources
- Accessing web-based resources
- Needs of paediatric emergency medicine staff
- Educational tools available online
- Social media
- Pitfalls of online content
- Links
- Conflict of interest
- 27.2. Teaching paediatric emergency medicine
- Introduction
- Desirable attitudes in paediatric emergency medicine
- Humility
- Caring
- Empathy and compassion
- Nonjudgemental approach
- Honesty and integrity
- Advocacy and healthy paternalism
- Self-monitoring and awareness of cognitive errors
- Skill set for paediatric emergency medicine
- Effective communication
- Skillful clinical examination
- Mastering procedural skills
- Learning to teach
- Self-preservation
- Putting knowledge into perspective
- Helping others acquire knowledge, skills and attitudes
- Engagement
- Feedback
- Learning resources
- People
- Books
- Other media
- Distance learning and virtual environments
- Simulation
- Pandemic challenges
- Conclusion
- Section 28. Paediatric research in the emergency department
- 28.1. Research in children in the emergency department
- Introduction
- Research science
- Research question
- Literature review
- Types of studies
- The ethics of medical research
- Key principles
- Ethics of research involving children
- Ethics review process
- The practice and governance of research
- Research documents
- Research protocol
- Case report forms
- Patient information statement and consent form
- Study document file
- The research team
- Databases and analysis
- Reporting guidelines
- Key regulatory documents
- International Conference on Harmonisation of Good Clinical Practice guidelines (ICH-GCP)12
- National- and state-based regulations
- Project registration
- Privacy and confidentiality
- Implementation research
- Multicentre research
- Funding research
- Section 29. Common procedures
- 29.1. Estimating the weight of infants and children
- Background
- Age-based tools to estimate body weight
- Best guess formula
- Length- and body-habitus–based tools
- Tips
- 29.2. Basic airway management techniques
- Background
- Oropharyngeal and nasopharyngeal airways
- Indications
- Contraindications
- Nasopharyngeal airway
- Oropharyngeal airway
- Equipment
- Preparation
- Nasopharyngeal airway
- Oropharyngeal airway
- Positioning
- Procedure
- Nasopharyngeal airway
- Oropharyngeal airway
- Complications
- Tips
- Laryngeal mask airway
- Indications for laryngeal mask airway
- Equipment
- Preparation
- Positioning
- Procedure
- Complications
- Tips
- Bag–valve-mask and flow-inflating mask ventilation
- Indications
- Contraindications
- Relative contraindication
- Bag–valve-mask equipment
- Preparation
- Positioning
- Procedure
- Complications
- Tips
- Flow-inflating bag
- Equipment
- Preparation
- Procedure
- 29.3. Noninvasive ventilation
- Noninvasive continuous positive pressure ventilation
- Indications
- Contraindications
- Relative 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
- 29.4. Endotracheal intubation
- Background
- Indications
- Contraindications
- Equipment
- Preparation
- Laryngoscope
- Endotracheal tube
- Positioning
- Procedure
- Complications
- Tips
- Confirmation of intubation
- Background
- Indications
- Contraindications
- Equipment
- Preparation and positioning
- Procedure
- Digital capnography
- End-tidal colorimetric capnometer
- Complications
- Tips
- 29.5. The surgical airway
- Background
- Indications
- Contraindications
- Needle cricothyroidotomy
- Equipment
- Preparation
- Procedure
- Complications
- Tips
- Surgical cricothyroidotomy
- Equipment
- Optional
- Preparation
- Procedure
- Guidewire or Seldinger technique
- Preparation and procedure
- Complications
- Tips
- 29.6. Chest procedures
- Introduction
- Needle thoracostomy
- Background
- Indications
- Contraindications
- Equipment
- Preparation
- Procedure
- Complications
- Tips
- Tube thoracostomy
- Background
- Indications
- Contraindications
- Equipment
- Preparation
- Procedure
- Inserting the tube
- Securing the tube
- Complications
- Tips
- Three-sided dressing
- Background
- Indications
- Contraindications
- Equipment
- Preparation
- Procedure
- Pericardiocentesis
- Background
- Indications
- Contraindications
- Equipment
- Emergent procedure
- Nonemergent procedure
- Indwelling catheter
- Standard preparation
- Nonemergent procedure
- Procedure
- Nonemergent procedure
- Complications
- Tips
- 29.7. Removing and replacing a tracheostomy tube
- Background
- Indications for emergent replacement
- Contraindications
- Equipment
- Preparation
- Procedure
- Removing an old tracheostomy tube
- Replacing the tracheostomy tube
- Option 1. Using a new tracheostomy tube
- Option 2. Using an endotracheal tube
- Option 3. Using a suction catheter as a guide
- Option 4. Endotracheal intubation and other rescue measures
- Securing the tracheostomy tube
- Complications
- Tips
- 29.8. Central and peripheral intravenous lines
- Background
- Indications
- Contraindications
- Peripheral venous catheter placement
- Equipment
- Preparation
- Procedure
- Complications
- Local complications
- Systemic complications
- Tips
- Central venous line placement
- Equipment
- Preparation
- Procedure
- Complications
- Tips
- 29.9. Intraosseous access
- Background
- Indications
- Cardiopulmonary arrest
- Contraindications
- Relative contraindications
- Equipment
- Preparation
- Identification of the entry site
- Positioning the child
- Selecting the correct side
- Procedure
- Complications
- The EZ-IO intraosseous vascular access system
- Tips
- 29.10. Umbilical vessel cannulation
- Background
- Indications
- Contraindications
- Equipment
- Preparation
- Procedure
- Umbilical vein catheterisation
- Umbilical artery catheterisation
- Complications
- Tips
- 29.11. Defibrillation
- Background
- Current technology for defibrillators
- Pads versus paddles
- Asynchronous versus synchronous
- Indications for defibrillation (asynchronous)
- Indications for synchronous cardioversion
- Contraindications
- Equipment
- Standard preparation
- Standard procedure
- COACHED
- Automated external defibrillators procedure
- Complications
- Tips
- 29.12. Transurethral catheterisation and suprapubic bladder aspiration
- Background
- Indications
- Indications for transurethral catheterisation
- Indications for suprapubic bladder aspiration
- Contraindications
- Urethral catheterisation
- Suprapubic aspiration
- Transurethral catheterisation
- Equipment
- Preparation
- Procedure
- Complications
- Tips
- Suprapubic aspiration
- Equipment
- Preparation
- Procedure
- Complications
- Tips
- 29.13. Lumbar puncture
- Background
- Indications
- Contraindications
- Equipment
- Preparation and positioning
- Lateral decubitus position
- Sitting position
- Procedure
- Complications
- Local
- Central nervous system/systemic
- Tips
- 29.14. Reduction of paediatric inguinal hernias
- Introduction
- Preparation
- Procedure
- Inguinal hernias in girls
- Complications
- 29.15. Paraphimosis reduction
- Introduction
- Indications
- Contraindications
- Procedures
- Noninvasive methods
- Invasive methods
- The Dundee technique
- Postreduction management
- Contraindications to attempted reduction
- Complications
- Tips
- 29.16. 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 30. Ultrasound
- 30.1. Ultrasound
- 30.2. Diagnostic ultrasound in paediatric emergency medicine
- Introduction
- Haemodynamic assessment with ultrasound
- Lung ultrasound
- Musculoskeletal
- Abdominal ultrasound
- Neurological
- 30.3. Ultrasound guidance for procedures
- Ultrasound guidance for procedures
- Vascular access
- Peripheral venous access
- Central venous access
- Suprapubic aspiration
- Nerve blocks
- Foreign body identification and removal
- Joint aspiration
- Neonatal lumbar puncture
- Confirmation of nasogastric tube position
- Fracture reduction
- 30.4. Incorporating ultrasound into paediatric resuscitation
- Introduction
- Undifferentiated severe respiratory distress
- Intubation
- Cardiac arrest
- Shock
- Assessment of fluid status and the response to fluid therapy
- Serial evaluations at the bedside
- Conclusion
- Index
- No. of pages: 688
- Language: English
- Edition: 4
- Published: April 4, 2023
- Imprint: Elsevier
- Paperback ISBN: 9780702085352
- eBook ISBN: 9780702085369
PC
Peter Cameron
Affiliations and expertise
Emergency Physician, Alfred Health Emergency ServiceGB
Gary J. Browne
Affiliations and expertise
Professor of Emergency Medicine, The Children’s Hospital at Westmead; Chair of Discipline of Emergency Medicine, The University of Sydney; Head of Academic Emergency Medicine, The Children’s Hospital at Westmead, Sydney, AustraliaBM
Biswadev Mitra
Affiliations and expertise
Emergency Physician, Alfred Health Emergency ServiceSD
Stuart Dalziel
Affiliations and expertise
Director of Emergency Medicine Research, The University of Auckland and Starship Children’s Hospital, Auckland, New ZealandSC
Simon Craig
Affiliations and expertise
Adjunct Clinical Associate Professor, Monash University; Emergency Physician, Monash Medical Centre, Monash Health, Melbourne, Australia