Siba Prosad Paul
Updated European guidelines for coeliac disease in children
An update for clinicians on how to diagnose and manage coeliac disease in children
Abdominal X-rays in children: indications, procedure and interpretation
Enhance your knowledge of the procedure for abdominal X-rays in children and interpretation
Neonatal abdominal X-rays: indications, procedure and interpretation
How to investigate suspected abdominal conditions in neonates
Indications for chest X-rays in children and how to obtain and interpret them
Chest X-ray (CXR) is one of the most common radiological investigations undertaken in practice with children. CXRs are requested for a number of suspected diagnoses, including pneumonia, pneumothorax and foreign body aspiration or ingestion. They may also be requested as part of a skeletal survey or to confirm the position of central and umbilical lines, as well as nasogastric tubes. Nurses play a vital role in ensuring that X-rays are performed in a safe and timely manner, and to ensure children are supported and positioned appropriately to obtain the best quality images. It is useful for nurses working with children to understand the underlying mechanism and rationale for requesting X-rays because this helps them to communicate the relevance of the procedure to other team members. This article provides an overview of the fundamental principles of obtaining a CXR and interpreting the images.
Nursing management of paediatric asthma in emergency departments
Childhood asthma is a complex disease which may be resistant to treatment and varies in its clinical presentation. The number of children admitted to emergency departments (EDs) with acute exacerbation of asthma is high and many are managed solely in the department. The correct assessment of the severity of an exacerbation can be achieved through competent history taking, examination and accurate recording of observations. Nurses working in EDs should be able to recognise the clinical signs and symptoms of acute asthma, assess severity and advise on appropriate management. Nurses should have some knowledge of first-line management and how and when to help deliver these therapies. They should also be able to guide patients in discharge and follow-up care, develop a rapport with families and educate them on topics such as trigger avoidance. The assessment and management of these patients as outlined in this article is based on the British Thoracic Society/Scottish Intercollegiate Network guidelines ( BTS/SIGN) (2016) .
Recognition and nursing management of children with non-traumatic limp
Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury. Management and prognosis of these conditions are discussed in the context of guidance from the National Institute for Health and Care Excellence. The article includes two case studies that illustrate different presentations and the challenges that nurses who manage children in EDs are likely to come across in clinical practice.
Nursing management of childhood chickenpox infection
Chickenpox is an extremely contagious infectious disease caused by varicella zoster virus (VZV). It is a common childhood illness characterised by an itchy vesicular rash and fever, which usually resolves spontaneously without medical intervention. Serious, and rarely fatal, complications can occur, including pneumonia, central nervous system infection, overwhelming secondary bacterial infections, especially with Group A streptococcus, and necrotising fasciitis. Therefore it is crucial that emergency department (ED) nurses can recognise the signs and symptoms that indicate deterioration. This article reviews best practice management of children with chickenpox, gives up-to-date guidance on the safe use of antipyretics, the avoidance of ibuprofen and discusses immunisation against VZV. It also includes implications for nursing practice and a case study that illustrates some of the challenges that ED nurses may encounter.
Recognition and management of eating disorders in children and young people
Eating disorders form a group of mental health conditions characterised by abnormal eating habits and are associated with high mortality rates. This article provides nurses working in various settings with evidence-based strategies to identify, manage and refer children and young people with eating disorders. It explores what eating disorders are, and their association with physical and psychiatric co-morbidities. Eating disorders have a significant effect on children and young people’s health and development, and nurses have a vital role in managing them. This article presents a case study that illustrates some of the challenges nurses may experience when managing children and young people with eating disorders.
Recognition and nursing management of sepsis in early infancy
Neonatal sepsis describes serious bacterial or viral infections that manifest in the first 28 days of life, causing significant morbidity and mortality. Although most babies with early-onset neonatal sepsis are born and managed in hospital, some are born in the community, or discharged early from postnatal wards. Consequently, emergency department (ED) nurses and other healthcare professionals need to be able to identify and treat these infants effectively to improve long-term outcomes. This article discusses neonatal sepsis, including causative organisms, types of neonatal sepsis and why neonates are vulnerable to infection. The National Institute for Health and Care Excellence 2012 and 2014 guidance is also discussed in relation to management of neonatal sepsis and a case study is included to illustrate some of the challenges that ED nurses may encounter.
Dangers of a gluten-free diet for children who do not have coeliac disease
'Going gluten free' is a phrase heard often in the 21st century, but a study defined by the National Institute for Health and Care Excellence looks at the health effects it can have on children who do not have coeliac disease.
A clinical companion to the NICE guide on bronchiolitis
The authors discuss the realities of clinical practice and the evidence behind common interventions for bronchiolitis
Nursing management of reflex anoxic seizures in children
Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy. Nurses working in EDs are among the first healthcare professionals to see children in acute settings and should therefore be aware of RAS, the presenting features and management options. This article discusses the epidemiology, pathophysiology and management of RAS, includes an illustrative case study and discusses the role of ED nurses.