Details

The Hands-on Guide to Practical Paediatrics


The Hands-on Guide to Practical Paediatrics


Hands-on Guides 1. Aufl.

von: Rebecca Hewitson, Caroline Fertleman

23,99 €

Verlag: Wiley-Blackwell
Format: PDF
Veröffentl.: 03.02.2014
ISBN/EAN: 9781118463598
Sprache: englisch
Anzahl Seiten: 288

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Beschreibungen

<p><b><b>Winner of the Paediatrics category at the BMA Book Awards 2015</b><br /><br /></b>About to start a paediatrics rotation?<br />Working with children for the first time?<br />Thinking about a career in paediatrics?<b><br /><br /></b><i>The Hands-on Guide to Practical Paediatrics</i> is the ultimate practical guide for medical students encountering paediatrics for the first time, junior doctors thinking about working with children, and new paediatric trainees. It’s full of vital information on practical procedures, prescribing for young patients, and communicating with children and young people, as well as guidance on the paediatric training programme and paediatrics as a career.<br /><br />Full of clinical tips, and covering key information on developmental stages, common paediatric emergencies and ethical dilemmas, and child protection, <i>The Hands-on Guide to Practical Paediatrics</i> is also supported by online resources including practice prescribing scenarios and video content at www.wileyhandsonguides.com/paediatrics<br /><br />Take the stress out of paediatrics with <i>The Hands-on Guide</i>!<br /><br /></p>
<p>Preface xi</p> <p>Acknowledgements xii</p> <p>About the Companion Website xiii</p> <p><b>1 Getting started 1</b></p> <p>Who’s who? 1</p> <p>Breastfeeding advisor 1</p> <p>Child protection nurse 1</p> <p>Clinical support worker 1</p> <p>Dietitian 1</p> <p>Health visitor 2</p> <p>Healthcare assistant 2</p> <p>Midwife 2</p> <p>Nursery assistant 2</p> <p>Nursery nurse 3</p> <p>Occupational therapist 3</p> <p>Orthoptist 3</p> <p>Pharmacist 3</p> <p>Pharmacy technician 3</p> <p>Physician assistant 3</p> <p>Physiotherapist 4</p> <p>Play specialist 4</p> <p>Psychologist 4</p> <p>School teacher 4</p> <p>Specialist nurse 5</p> <p>Social worker 5</p> <p>Speech and language therapist 5</p> <p>Staff nurse 5</p> <p>Ward clerk 6</p> <p>Ward sister 6</p> <p>What happens where? 6</p> <p>Playroom 6</p> <p>Teenage room 6</p> <p>Treatment room 6</p> <p>School room 7</p> <p>Parents’ room 7</p> <p>Sensory room 7</p> <p>Day care unit 7</p> <p>Milk room 7</p> <p>Postnatal ward 7</p> <p>Paediatric emergency department 7</p> <p>Be prepared 8</p> <p>Jargon buster 9</p> <p><b>2 Child development 19</b></p> <p>What can a child of this age normally do? 19</p> <p>Six weeks 20</p> <p>Six to eight months 21</p> <p>Twelve months 21</p> <p>Eighteen months 21</p> <p>Two years 22</p> <p>Three years 22</p> <p>School 22</p> <p>Developmental delay and children with disabilities 22</p> <p>Support for children with disabilities and their families 25</p> <p>Growth 26</p> <p>Obesity 28</p> <p>Immunisations 29</p> <p>The UK vaccination schedule 31</p> <p><b>3 Communication with children and their parents 37</b></p> <p>How to communicate with a baby or toddler 39</p> <p>How to communicate with an infant school child (4–6 years) 40</p> <p>How to communicate with a school-age child (7–12 years) 40</p> <p>How to communicate with a teenager 41</p> <p>How to communicate with a child using alternative communication 45</p> <p>How to communicate with anxious parents 46</p> <p>How to communicate with an expert parent or patient 47</p> <p>Breaking bad news 49</p> <p>Cultural sensitivity 54</p> <p>Illiteracy 56</p> <p>Consent 56</p> <p>Parental responsibility 57</p> <p>At what age can children consent for themselves? 57</p> <p><b>4 Child protection and safeguarding 60</b></p> <p>Different forms of abuse 60</p> <p>Physical abuse 60</p> <p>Fabricated or induced illness (FII) 62</p> <p>Emotional abuse 64</p> <p>Neglect 66</p> <p>Sexual abuse 66</p> <p>Maternal substance abuse in pregnancy 69</p> <p>Female genital mutilation 70</p> <p>Forced marriage and honour violence 70</p> <p>Which children are most vulnerable to abuse? 72</p> <p>What to do if you suspect child abuse 73</p> <p>What should I say to the parents? 75</p> <p>What to do if you suspect sexual abuse 75</p> <p>Child protection medicals 77</p> <p>Working with social care, education and the police 77</p> <p>Social care 78</p> <p>Police 78</p> <p>I’ve made a referral to social services; what happens next? 83</p> <p>What if you are worried about the immediate safety of the child? 83</p> <p>What is a section 17 investigation? 84</p> <p>Who is a child in need? 84</p> <p>Who is a looked-after child? 84</p> <p>What happens after it is decided that a child is in need? 84</p> <p>What is a strategy discussion? 84</p> <p>What is a section 47 enquiry? 85</p> <p>What is a child protection conference? 85</p> <p>What is a child protection plan? 85</p> <p>What is a child protection review conference? 85</p> <p>What is the child protection register? 85</p> <p>What stops us from considering the possibility of abuse? 85</p> <p><b>5 Common paediatric emergencies 88</b></p> <p>Basic Life Support 88</p> <p>Danger 88</p> <p>Response 88</p> <p>Shout for help 88</p> <p>Airway 90</p> <p>Breathing 91</p> <p>Circulation 91</p> <p>Choking child 92</p> <p>History 93</p> <p>Symptoms 93</p> <p>Signs 93</p> <p>Immediate management 93</p> <p>Advanced Life Support 95</p> <p>Airway management 97</p> <p>Breathing management 97</p> <p>Circulation management 99</p> <p>Emergency drugs 99</p> <p>ABCDE approach 101</p> <p>A – Airway 101</p> <p>B – Breathing 105</p> <p>c – Circulation 108</p> <p>d – Disability 110</p> <p>E – Exposure 112</p> <p>Reassess 113</p> <p>Take a brief history 113</p> <p>Anaphylaxis 113</p> <p>History 113</p> <p>Symptoms 114</p> <p>Signs 114</p> <p>Immediate management 114</p> <p>Further management 115</p> <p>Long-term management 115</p> <p>Acute asthma 115</p> <p>History 116</p> <p>Symptoms 116</p> <p>Signs 116</p> <p>Immediate management 116</p> <p>Further management 118</p> <p>Long-term management 118</p> <p>Drowning 119</p> <p>History 119</p> <p>Signs 119</p> <p>Immediate management 119</p> <p>Further management 120</p> <p>Sepsis 121</p> <p>History 121</p> <p>Symptoms and signs 121</p> <p>Immediate management 122</p> <p>Further management 122</p> <p>Meningococcal septicaemia 123</p> <p>History 123</p> <p>Symptoms 123</p> <p>Signs 123</p> <p>Initial management 124</p> <p>Burns and scalds 124</p> <p>History 124</p> <p>Symptoms 124</p> <p>Signs 125</p> <p>Immediate management 125</p> <p>Further management 126</p> <p>Ongoing management 126</p> <p>Seizures 128</p> <p>History 128</p> <p>Immediate management 128</p> <p>Further management 130</p> <p>Poisoning 131</p> <p>History 131</p> <p>Symptoms and signs 131</p> <p>Immediate management 131</p> <p>Further management 132</p> <p>Diabetic ketoacidosis 135</p> <p>History 135</p> <p>Symptoms 135</p> <p>Signs 135</p> <p>Immediate management 135</p> <p>Further management 136</p> <p>Trauma 138</p> <p>Catastrophic external haemorrhage 138</p> <p>Airway and cervical spine control 138</p> <p>Breathing 139</p> <p>Circulation with haemorrhage control 140</p> <p>Disability and assessment of head injury 141</p> <p>Critical care transfer services 141</p> <p>North West England 141</p> <p>North East England 142</p> <p>West Midlands 142</p> <p>East Midlands 142</p> <p>South East England and London 142</p> <p>South Central and South West England 142</p> <p>North Wales 142</p> <p>East Scotland 143</p> <p>West Scotland 143</p> <p>Northern Ireland 143</p> <p><b>6 Practical procedures 144</b></p> <p>Setting up 144</p> <p>Cannulation 145</p> <p>Taking blood (including heel prick sampling) 148</p> <p>Heel prick sampling 148</p> <p>Venepuncture in babies 151</p> <p>Capillary blood gas 152</p> <p>How to measure a spun bilirubin (SBR) 153</p> <p>How to measure packed cell volume 154</p> <p>Intraosseous access 154</p> <p>Nasogastric tube 158</p> <p>Lumbar puncture 161</p> <p>Urinary catheter insertion 166</p> <p>Suprapubic urine sample 169</p> <p>Mantoux test 171</p> <p>Injecting tuberculin 171</p> <p>‘Reading’ the Mantoux test results 173</p> <p>Peak flow 173</p> <p>Hand-held spirometry 174</p> <p>Setting up a nebuliser 175</p> <p>Inhaler technique and using a spacer 175</p> <p>Intramuscular injections (for immunisations) 176</p> <p>How to use an Epipen/Anapen 177</p> <p>Changing a nappy 177</p> <p><b>7 Prescribing in children 179</b></p> <p>General principles 179</p> <p>Getting children to actually take what you prescribe 181</p> <p>Fluids 181</p> <p>Maintenance fluids 182</p> <p>Replacement therapy 182</p> <p>Analgesia 186</p> <p>Step 1 – mild pain 187</p> <p>Step 2 – moderate pain 187</p> <p>Step 3 – severe pain 188</p> <p>Controlled drugs 188</p> <p>Blood products 188</p> <p>When to give CMV-negative products 188</p> <p>When to give gamma-irradiated products 189</p> <p>Packed red cells 189</p> <p>Platelets 189</p> <p>Fresh frozen plasma (FFP) 190</p> <p>Drug level monitoring 190</p> <p><b>8 Teenagers 192</b></p> <p>Taking a history from a teenager 192</p> <p>Mental health problems 193</p> <p>Deliberate self-harm and suicide 193</p> <p>Eating disorders 196</p> <p>Substance abuse 197</p> <p>Sexual health 198</p> <p><b>9 Neonates 200</b></p> <p>Neonatal life support at birth 200</p> <p>Stimulate and airway manoeuvre 204</p> <p>Reassess 204</p> <p>Give five inflation breaths 205</p> <p>Reassess 205</p> <p>Consider oxygen saturation monitoring 205</p> <p>Further inflation breaths or regular breaths 205</p> <p>Calculating Apgar scores 206</p> <p>Newborn baby checks 207</p> <p>Newborn examination 210</p> <p>Prematurity 210</p> <p>Resuscitation at birth for premature babies 211</p> <p>Extreme prematurity and resuscitation decisions 213</p> <p>The law in the United Kingdom 214</p> <p>Best interests 214</p> <p>Parental responsibility 214</p> <p>Euthanasia is illegal 214</p> <p>Intending relief of distress is normally legal 214</p> <p>Withdrawing or withholding treatment is the same in the eyes of the law 215</p> <p>Some useful ethical frameworks and guidance 215</p> <p>Intravenous fluids in infants 215</p> <p>Neonatal nurses 216</p> <p><b>10 Looking after yourself 218</b></p> <p>Dealing with upsetting situations 218</p> <p>Short-term coping mechanisms 218</p> <p>Long-term coping mechanisms 221</p> <p>Bullying and harassment 223</p> <p>Practising paediatrics when you have your own children 224</p> <p>Emotional impact 224</p> <p>Not enough hours in the day 224</p> <p>Feeling isolated 225</p> <p>Nobody’s perfect: dealing with mistakes 226</p> <p>Avoiding making mistakes 227</p> <p>Pitfall 1: Communication 227</p> <p>Pitfall 2: Being distracted at a critical moment 229</p> <p>Pitfall 3: Failure to follow protocol 230</p> <p>Pitfall 4: Acting beyond your competence 230</p> <p>Organisation 231</p> <p>Night shifts 232</p> <p><b>11 Developing your career 234</b></p> <p>Specialist training structure for paediatrics 234</p> <p>Opportunities for research 237</p> <p>Academic training programme 237</p> <p>Out-of-programme research (OOPR) 237</p> <p>Completing research projects alongside regular training 237</p> <p>College exams 238</p> <p>Written papers 238</p> <p>Clinical exam 239</p> <p>How to boost your CV 240</p> <p>CV building for medical students 241</p> <p>CV building for Foundation trainees 243</p> <p>CV building for specialist trainees 245</p> <p>Clinical governance – more than just audit 246</p> <p>Service improvement projects 246</p> <p>Patient safety 249</p> <p>Less than full-time training 250</p> <p>Teaching and training 252</p> <p>Work-based assessments and e-portfolios 254</p> <p>Index 257</p>
<p><b>Rebecca Hewitson</b> is Paediatrics Specialist Trainee, London Deanery, The Whittington Hospital and Royal Free Hospital, London<br />  <br /> <b>Caroline Fertleman</b> is Consultant Paediatrician, The Whittington Hospital<br /> Site Sub-Dean and Honorary Senior Lecturer, University College London Medical School<br /> Training Programme Director, School of Paediatrics, London Deanery<br /> Honorary Consultant, Great Ormond Street Hospital, London</p>
<p><b>About to start a paediatrics rotation?<br /></b><b>Working with children for the first time?<br /></b><b>Thinking about a career in paediatrics?<br /><br /></b><i>The Hands-on Guide to Practical Paediatrics</i> is the ultimate practical guide for medical students encountering paediatrics for the first time, junior doctors thinking about working with children, and new paediatric trainees. It’s full of vital information on practical procedures, prescribing for young patients, and communicating with children and young people, as well as guidance on the paediatric training programme and paediatrics as a career.<br /><br />Full of clinical tips, and covering key information on developmental stages, common paediatric emergencies and ethical dilemmas, and child protection, <i>The Hands-on Guide to Practical Paediatrics</i> is also supported by online resources including practice prescribing scenarios and video content at www.wileyhandsonguides.com/paediatrics<br /><br />Take the stress out of paediatrics with <i>The Hands-on Guide</i>!<br /><br /><b>Winner of the Paediatrics category at the BMA Book Awards 2015</b></p>

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