100 Cases in Paediatrics by Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph

By Ronny Cheung, Aubrey Cunnington, Simon Drysdale, Joseph Raine, Joanna Walker

The recent version of this best-selling name from the preferred a hundred situations sequence explores universal paediatric eventualities that may be encountered through the clinical scholar and junior health care professional in the course of functional education at the ward, within the emergency division, in outpatient clinics and locally, and that are prone to function in qualifying examinations. The ebook covers a accomplished variety of displays from cough to constipation, geared up by way of sub-specialty zone for ease of reference. complete solutions spotlight key take domestic issues from every one case and supply sensible suggestion on how you can take care of the demanding situations that ensue while practicing paediatric medication in any respect degrees.

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Capillary refill time is 5 s, heart rate is 180/min, blood pressure is unrecordable, and the femoral pulses cannot be felt. The heart sounds are unremarkable. 0ЊC. 3. 5 mmol/L Questions • What is the interpretation of the blood gas result? • What is the most likely diagnosis and what is the differential? • What is the initial management of a collapsed neonate? 01, which is a severe acidosis. The PaCO2 is normal, so the acidosis is not respiratory in origin. The low bicarbonate and large negative base excess indicate that this is a metabolic acidosis.

Congenital cardiac lesions presenting with neonatal collapse • • • • ! g. g. g. g. g. g. g. panhypopituitarism In any collapsed neonate, it is essential to adopt a standard approach to resuscitation. The airway should be maintained, high-flow oxygen administered, intravenous access obtained and fluid resuscitation should be given for the shock. Blood glucose measurement must be checked early and corrected if low. A blood gas sample should be analysed. Intravenous antibiotics should be given promptly as sepsis is a possible treatable cause.

Frequent clinical review is paramount. Blood gases (capillary or venous) and a chest X-ray may be required. If there is no improvement or the child deteriorates, additional treatment is needed. These include IV salbutamol, IV magnesium sulphate (a smooth muscle relaxant) and IV aminophylline, although the effectiveness of the latter two is still controversial. His precipitating ‘cold’ is almost certainly viral and antibiotics are unlikely to be beneficial. Before discharge a thorough review of his asthma is needed: • How often does he miss his regular drugs?

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