Essentials 1 Occasionally deliveries occur in the ED when labour cannot be delayed to enable transfer of the patient to a labour ward setting. 2 The ED should have available appropriate equipment and guidelines for the resuscitation of the newborn.…
Essentials 1 Duct-dependent congenital heart disease is the most common cause for the collapsed neonate presenting to the emergency department (ED). Left-sided obstructive heart lesions can present with shock in the first few weeks after birth, often precipitated by delayed…
Skin in the neonatal period The skin has many important functions. It provides a physical, chemical and immunological barrier and has a major role in thermoregulation, electrolyte balance, metabolism, sensation and physical appearance. Defects or changes in the skin can…
Essentials 1 Define if this presentation is part of a recurrent stereotypical pattern in an otherwise well infant or a single acute episode. 2 A careful history and examination will often lead to an appropriate diagnosis. 3 Screening tests, except…
Definition and introduction A neonate is an infant aged from birth to 28 days of life. This is a period of rapid change and vulnerability for both the infant and their parents. Neonates are at higher risk than older infants…
Essentials 1 Procedural sedation has mirrored the development of paediatric emergency medicine as a subspecialty. 2 Local (departmental, hospital, state and national) governance and educational programmes must be developed to facilitate safe sedation practice. Ask ‘Can we do this procedure?’…
Essentials 1 Acute pain is one of the most common emergency department presenting problems. 2 Pain-rating scales appropriate to the age and development of the child are useful in establishing a child’s level of pain and assessing the adequacy of…
Essentials 1 Paediatric sepsis is the final common pathway for many decompensated infections. 2 Clinical judgement is the best-performing tool for early recognition; senior clinician review should be sought if there is diagnostic uncertainty. 3 Initial resuscitation includes intravenous access,…
Essentials 1 Shock is a syndrome that arises because of acute failure of the circulation that results in inadequate tissue perfusion. It may result from hypovolaemic, distributive, cardiogenic, obstructive or dissociative causes. 2 The normotensive child may have profound compensated…
Teamwork in critical care management Paediatric resuscitation involves a series of critical decisions and procedures which should be performed rapidly and safely with the aim of stabilising and/or reversing clinical deterioration in a child. As these critical procedures (e.g. endotracheal…