A paediatric vade mecum 14th Edition by Timothy Barrett, Anthony Lander, Vin Diwaker 1444165356 9781444165357
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ISBN 10: 1444165356
ISBN 13: 9781444165357
Author: Timothy G Barrett, Anthony D Lander, Vin Diwaker
A complete revision of this successful pocketbook, the fourteenth edition of A Paediatric Vade-Mecum provides the junior doctor and trainee grade paediatrician with invaluable information on the diagnosis and management of illness in children, and with practical evidence-based advice for the safe and effective management of the sick child.
Table of contents:
Section 1 Acute paediatrics
1 Resuscitation
Introduction
BASIC LIFE SUPPORT (see Figure 1.2)
Glasgow Coma Scale or Avpu Score
Airway
Breathing
Circulation
The Choking Child
Advanced Life Support
Two Basic Types of Laryngoscope
Cricothyroidotomy
Cardiac Monitoring
Asystole and Pulseless Electrical Activity
Ventricular Fibrillation and Pulseless Ventricular Tachycardia
Drugs
Atropine
Sodium Bicarbonate
Post-Resuscitation Stabilization
Prognosis
Endotracheal Tubes
Intra-Osseous Needles
Anaphylaxis
Assess ABC
Further management
Burns and Scalds
Assessment of the Burn (see also Table 1.3)
Resuscitation Fluid Regime
Monitoring
Further Assessment
Admission
Respiratory Tract Burns
Near Drowning • 23
Respiratory Tract Burns
Near Drowning
Prognosis
Survivors
Electrical Injury
Mechanism Of Injury
Electrothermal Burns
High-Voltage Contact (many kV)
Management
Other Complications
Hypothermia
2 Cardiology
Congenital Defects in the Newborn
Acyanotic Congenital Heart Conditions
Cyanotic Congenital Heart Conditions
Diagnosis
Management
Cardiac Failure
Dysrhythmias
Antibiotic Prophylaxis
3 Child abuse and protection awareness
Child Protection
Medical Examination
Physical Abuse
Photography
Investigations
Haematological investigations
Radiology
Other investigations
Presentations Highly Suggestive of Physical Abuse
Sexual Abuse
Examination
Prophylaxis Against Pregnancy
Investigations
Sexually transmitted disease
Gonorrhoea
Chlamydia
Genital herpes
Anogenital warts HPV
Trichomonas vaginalis
Other organisms
Forensic testing
Emotional Abuse
Neglect
Other Forms of Abuse
Abuse Prevention
4 Endocrinology
Adrenocortical Failure
Congenital Adrenal Hyperplasia
Addison’s Disease
Steroid Replacement in Stress/Surgery
Ambiguous Genitalia
History and Examination
Investigations
Diabetes Insipidus
Diabetic Ketoacidosis
Emergency Management in A&E
Full Clinical Assessment and Observations
Management
Fluids
Bicarbonate
Potassium
Insulin
Continuing Management
Cerebral Oedema
Management of cerebral oedema
Diabetes Mellitus without Ketoacidosis
Blood Glucose Management
Diet
Management of Hypoglycaemia
The Known Diabetic
Management of Severe Hypoglycaemia
The Poorly Feeding Neonate
Management
The Neonate with Hypoglycaemia
5 Fluid and electrolyte therapy
Deficits
Assessing Deficits
Sodium
Hypernatraemia (Plasma Sodium Level >150 mmol/l)
Hyponatraemia (Plasma Sodium Level <130 mmol/l)
Treatment
Potassium
Chloride
Correction of Acidosis (see Table 5.4)
Fluid and Electrolytes in Surgical Patients
Post-Operative Management
Surgery in the Neonatal Period
Postoperative Fluids
6 Gastrointestinal and liver problems
Gastrointestinal Bleeding
Upper Gastrointestinal Bleeding
Evaluation and diagnosis
Assessment
Laboratory tests
Massive Upper Gastrointestinal Bleeding
Investigation
Lower Gastrointestinal Bleeding
Assessment
Infants
Children
Management
Medical therapy
Prolonged Neonatal Jaundice
The Jaundiced Child
Acute Hepatitis
Chronic Hepatitis
Jaundice with Abdominal Pain, Hepatomegaly
Intermittent Jaundice
Acutely Unwell Infant with Hepatic Dysfunction
Galactosaemia
Acute Liver Failure
Supportive treatment prior to transfer
Management of the Patient with Chronic Liver Disease
Nutritional support
Ascites and fluid retention
Variceal bleeding
Pruritus
Acute Gastroenteritis
References
7 General paediatrics
Bell’s Palsy
Ear, Nose and Throat Problems
Earache
Otitis Externa
Acute Otitis Media
Acute Sinusitis
Tonsillitis
Quinsy
Foreign Bodies
Nasal Fracture
Epistaxis
Rashes
Reflux, Crying and Colic
Gastro-Oesophageal Reflux
Management
Crying in Infants
Infant Colic
Urinary Tract Infection
Definition
Methods of Urine Collection
Initial Management
Follow-up of Children with Proven Infection
8 Haematology
Haemostatic Disorders
Thrombotic Disorders
Haemorrhagic Disorders
Presentation
History
Investigation
Tests
Basic screen
Disseminated intravascular coagulation (DIC)
Tests
Management
Congenital Bleeding Disorders
Haemophilia A
Management of severely affected patients (f VIII < 0.02 units/ml)
Management of mildly affected patients
Haemophilia B
von Willebrand’s disease
Other factor deficiencies
Platelet function defects
Immunization
9 Infections
Meningococcal Disease
Clinical Features
Investigations
Antibiotics
Circulatory Support
Bicarbonate
Cautions
Lumbar Puncture
Prophylaxis
Prognosis
Bacterial Meningitis
Lumbar Puncture
Treatment
Infection Control and Prophylaxis for Contacts
Meningococcal infection chemoprophylaxis
Indications for chemoprophylaxis
Vaccination
Haemophilus Influenzae Type b (Hib) Infection Chemoprophylaxis
Chickenpox Contacts
Epidemiology
Control Measures
Administration of VZIG
Aciclovir Prophylaxis
Hiv
Clinical Features
Diagnosis
Treatment
Control of Methicillin-Resistant Staphylococcus Aureus
Sources and Routes of Spread of MRSA
Control measures outside hospital
Control measures in hospitals
Isolation
Identification and Management of Carriers
Tests for Clearance of MRSA Carriage
Respiratory Syncytial Virus Infection: Diagnosis and Control in Hospitals
Control Measures
Isolation
Cohort isolation
Identification of Patients With RSV
Immunization
Tuberculosis
Pathogenesis and Clinical Presentation
Diagnosis
Notification and Treatment
Control of Tuberculosis in Hospitals
Control of Tuberculosis Outside Hospitals
Pyrexia of Unknown Origin
Causes of PUO
Investigation Of PUO
Temperature pattern
History
Physical examination
Laboratory investigations
Management of PUO
References
10 Inherited metabolic disorders
Introduction
Clinical Features
Urgent Investigations
Laboratory Features: ‘Clues’
Management of the Acute Situation
Management of Hyperammonaemia
Emergency Specimen Collection in Suspected IMD
Urine
Blood
Skin (for fibroblast culture)
If indicated, tissue samples (liver, heart muscle, skeletal muscle)
Cerebrospinal fluid
11 Neonatology
Resuscitation of the Newborn Infant
Intubated infant who is pink but not breathing
Intubated infant who is not pink
Failure to Respond to Resuscitation
Meconium-Stained Liquor
Examination of the Newborn Infant
Assessment at Birth
Neonatal Examination
Observations (before undressing)
Head/face
Upper body
Lower body
Congenital dislocation of the hip (CDH)
Records
Abnormality at Birth
Feeding
Breastfeeding
Bottle-Feeding
Screening for Hypoglycaemia
Preterm Babies
Ill Babies
Vitamins and Supplements
Jaundice
Physiological Jaundice
Management of Hyperbilirubinaemia
First-Day Jaundice
Investigations
Exchange Transfusion
Pathological or Prolonged Jaundice
Neurological Problems
Neurological Assessment
Convulsions
Management of convulsions
Investigation
Drug Withdrawal
Opiate withdrawal
Fluid Management in the Neonate
Fluid Volumes
Electrolytes
Treatment of Hyperkalaemia in the Neonate
Acute illness in the Newborn
Infection
Systemic Infection, Early Onset
Symptoms
Investigations
Late-Onset Infections (>48 h)
Treatment
Early onset
Late onset
Superficial Infections
Skin, nares, umbilicus and nailfolds
Eyes
Mouth and groin
Congenital Viral Infections
Human immunodeficiency virus (HIV)
Management
Antenatal management
Postnatal management
Hepatitis B
Schedule of immunization
Hepatitis B immunoglobulin (HBIG)
Hepatitis C
Screening of infants born to HCV-positive mothers
Cytomegalovirus
Toxoplasma
Herpes simplex virus
Varicella
Thermal Care
Management of Hypothermia
12 Neurology and neurosurgery
Head Injury
Physiological Differences between Children and Adults
Causes of Head Injury
Presentation
Examination and Management
Indications for Skull X-Ray
Other important points
Management of Raised ICP
Do not forget
Hydrocephalus/Blocked Shunt
Hydrocephalus
Normal anatomy and physiology of CSF flow
Causes of Hydrocephalus (see Table 12.1)
Presentation
Investigation
Treatment
Prognosis and Complications
Suspected Blocked Shunt
Convulsions, Epilepsy, Syncope and Breath-Holding
Management: General Principles
Treatment
Anti-epileptic drug (AED) choice
AED escalation for outpatients
13 Oncology
Febrile Neutropenia
Management of Febrile Neutropenia
Management of Febrile Non-Neutropenic Oncology Patients
Investigations
Respiratory Infections in the Immunocompromised
Oncological Emergencies
Superior Mediastinal Syndrome (SMS)
Inferior Vena Cava Obstruction
Tumour Lysis Syndrome
Who is at Risk?
Management
Monitoring
Treatment of hyperkalaemia > 5 mmol/l
Treatment of hyperphosphataemia
Treatment of hypocalcaemia
Blasts: The Leukaemias
Indications for platelet transfusions
Brains: CNS Tumours
Treatment
Acute Sustained Hypertension
Causes
Treatment
Seizures
14 Poisoning
Management
History
Examination
Laboratory Investigations
Treatment
Supportive Management
Management of Arrhythmias
Management of Corrosive Injury
Follow-up of Deliberate Self-Harm
Management of Specific Poisons
Carbon Monoxide Poisoning
Sources of Carbon Monoxide
Pathophysiology
Clinical Presentation
Clues which suggest Domestic Carbon Monoxide Poisoning
Treatment
Paracetamol Poisoning
15 Renal medicine
Acute Renal Failure
Investigation
Management
Established ARF salt and water requirements
Nutrition
Drugs
Dialysis and Ultrafiltration
Diuretic Phase
Nephrotic Syndrome
Complications of Nephrotic Syndrome
Hypovolaemia
Intravascular coagulation
Peritonitis
Other infections
Haematuria
History and Examination
Investigations
Microscopy of fresh urine
Other tests
Radiology
As indicated
Further tests for glomerulonephritis
Hearing test
Renal biopsy
16 Respiratory medicine
Acute Dyspnoea
History
Examination
Investigation
Management
Acute Severe Asthma
Children Under 5 Years of Age
Management of a severe asthma attack
Children Aged 5–15 Years
Management of a severe asthma attack
Bronchiolitis
Croup and Stridor
Haemoptysis
Investigation and Management
Pneumonia and Empyema
Investigations
Is a chest X-ray helpful?
Which children require admission to hospital?
Management
At home
In hospital
Antibiotics
Oral vs. intravenous antibiotics
Choice of antibiotic
Are there any complications?
Empyema
Initial management of empyema
17 Rheumatology
Henoch–Schönlein Purpura
Diagnosis
Differential diagnosis
Investigations
Management
Kawasaki Disease
Diagnosis (see Figure 17.1)
Differential diagnosis
Management
Septic Arthritis and Osteomyelitis
Clinical Features
Differential Diagnosis
Investigations
Septic Arthritis
Osteomyelitis
Treatment
18 Sudden unexpected death in infancy
Guidelines for Laboratory Investigation
Types of Disorders
Blood
Urine (bladder stab)
Nasopharyngeal swab
Other swabs
Skin biopsy
Tests to be performed in all cases (i.e. specimens collected pre- or post-mortem)
Reporting Deaths to the Coroner
19 Surgery
Acute Abdominal Pain
Acute Appendicitis
Non-Specific Abdominal Pain and Mesenteric Adenitis
Intussusception
Meckel’s Diverticulum
Malrotation
Dental Trauma
Initial Management Of Paediatric Dento-Alveolar Trauma
Injury Classification
Telephone Advice
History on Presentation
Medical History
Examination
Radiographic Assessment
Treatment
Treatment in the permanent position
Crown fractures
Luxation injuries
Root fractures
Treatment in the primary dentition
Conclusion
Foreign Bodies
Foreign Bodies in the Ear Canal
Foreign Bodies in the Nose
Foreign Bodies in the Eye
Foreign Bodies in the Digestive Tract
Foreign Bodies in the Airway
Foreign Bodies in Wounds
Foreskin, Testes and Scrotum
Foreskin/Phimosis/Circumcision
Examination
Post-circumcision complications and management
Umbilical Hernias
Undescended Testes
Fractures: Acute Management
Fracture Patterns
Anatomical location
Configuration
Relationship of fracture fragments to each other
Relationship of fracture to adjacent bone
Management of Children’s Fractures
Examination
Analgesia
Investigation
Treatment
Non-operative treatment
Operative treatment
Disposal
Special Situations
Open fractures
Vascular injury
Neurological injury
Compartment syndrome
Non-Accidental Injury (see Table 19.1)
History
Examination
Hypertrophic Pyloric Stenosis
Fluid Resuscitation
Example
Minor Injuries
Golden Rules for Assessment
Lacerations
Management
Analgesia
Restraint
Wound cleaning and debridement
Hair removal
Wound closure
Superficial wounds
Deeper wounds
Special areas
Face
Ear and nose
Hands/digits/feet
Fingertip Injuries
Bites
Pulled Elbow
Toddler’s Tibial Fracture
Neonatal Surgical Conditions
Cystic Hygroma
Pierre Robin Syndrome
Oesophageal Atresia
Congenital Diaphragmatic Hernias
Gastrointestinal Problems
Intestinal atresias and stenoses
Duodenal atresia and duodenal stenosis (1 in 10 000 births)
Small-bowel atresias
Colonic atresias
Anorectal malformations
Meconium ileus
Anterior abdominal wall defects
Gastroschisis
Exomphalos
Necrotizing enterocolitis
Hirschprung’s disease
Malrotation and volvulus neonatorum
Biliary atresia
Intra-Abdominal Cysts of Ovarian Origin
Hypospadias/Epispadias/Bladder Exstophy
Pelvi-Ureteric Junction Obstruction
Posterior Urethral Valves
Inguinal Hernias
Section 2 Outpatient and specialty paediatrics
20 Child development
Overview of Key Stages of Development
Developmental Warning Signs
At any age
At 10 weeks
At 6 months
At 10 months
At 18 months
At 2 years
At 4 years
Speech Delay
Causes of Speech Delay
Indications for Referral to Speech and Language Therapy
At 18 months
At 2 years
At 2½ years
At 3 years
At 4 years
Delay in Walking
21 Dermatology
Blistering Diseases
Causes of Blisters in Children
Inflammatory causes
Drug reactions
Autoimmune causes
Genetic causes
History
Examination
Impetigo and Bullous Impetigo
Treatment
Staphylococcal Scalded Skin Syndrome (SSSS)
Treatment
Differential diagnosis
Scabies
Treatment
Erythema Multiforme
Treatment
Epidermolysis Bullosa
Diagnosis and management
Skin Care
Protection against blistering
Treatment of blisters
Eczema
Atopic Eczema
Seborrhoeic Eczema
Assessment of the Child With Eczema
History
Examination
Management Plan
Eczema Herpeticum
Management
Head Lice
Management
22 Education
Special Educational Needs (Education Act 1993)
Categories of Sen that require special provision
Statutory Assessment of Sen
23 Emotional and behavioural problems
Definition
Influences on Behaviour
Child
Parent(s)
Family
Wider context
Making an Assessment
Management
24 Endocrine and growth
Pituitary Disorders
Urgent Endocrine Investigations
Perioperative Care for Craniopharyngioma
Postoperative Care
Growth and Puberty Problems
Investigations for Growth Failure in Childhood
Additional Investigations in the Pubertal Age Range
Common Pubertal Problems (see Tables 24.1, 24.2, 24.3 and 24.4)
Precocious Puberty
Thyroid Disorders
Congenital Hypothyroidism
Lymphocytic Thyroiditis (Hypothyroidism)
Hyperthyroidism (Graves’ Disease)
Goitre
Thyroid Nodule
25 Gastroenterology
Recurrent Abdominal Pain
Irritable Bowel Syndrome
Non-Ulcer Dyspepsia
Abdominal Migraine
Management of Recurrent Abdominal Pain
Constipation
Causes of Constipation
History and Examination
History checklist
Examination
Investigations
Treatment of Constipation
Medication
Maintenance therapy
Prevent recurrence
Bowel cleansing regime prior to colonoscopy or colonic surgery
Hepatomegaly (see Table 25.3)
Splenomegaly
Causes of Splenic Enlargement
Investigations
Chronic Diarrhoea
History
Examination
Nutritional assessment
Specific Causes of Prolonged Diarrhoea (see Table 25.6)
Coeliac disease
Presentation in infancy
Presentation in older children
Diagnosis
Inflammatory Bowel Disease
Food Allergy and Intolerance
Diagnosis
Cow’s-Milk-Protein Intolerance
Lactose Intolerance
Toddler Diarrhoea (Chronic Non-Specific Diarrhoea of Childhood)
Chronic Infection
Persistent Diarrhoea
Management of Persistent Diarrhoea
Drugs used in chronic diarrhoea
26 Haematology
Anaemia
Investigation of Anaemia
Iron-deficiency anaemia
Tests
Further investigation
Microcytic hypochromic anaemia
Normocytic normochromic anaemia
Macrocytic anaemia
Leucoerythroblastic anaemia
Haemolytic Anaemias
History
Presentation
Investigation
Thalassaemias and Other Haemoglobinopathies
Investigation
Thalassaemia
Sickle-Cell Disease (see also Chapter 8)
Management of homozygotes (HbSS) and double heterozygotes (HbSC disease, HbS β thalassaemia)
HbC, HbD or HbE Disease
27 Nocturnal enuresis
Enuresis
Normal Voiding and Toilet Training
In the fetus
In the infant
Steps Involved in Achievement of Normal Conscious Bladder Control
Nocturnal Enuresis
Pathogenesis
History
Examination
Investigations
Treatment
Depends on age:
Conservative management
Behavioural modification/training
Drug therapy
28 Neurology
Headache
Causes
Idiopathic (primary) headaches
Other idiopathic headaches
Symptomatic (secondary) headaches
Diagnosis
Investigation
Indications for lumbar puncture
Management
Primary management
Secondary management (idiopathic headache or migraine-tension-type spectrum)
Gait Disorders
Non-Neurological GD
Mechanical
Bone
Joint
Blood
Other
Idiopathic gait disorders
Approach
Hemiplegia
Causes
Infarct
Haemorrhage
Trauma
Hypoxia
Infection
Inflammatory
Space-occupying lesion
Complex with epilepsy
Guillain–Barré Syndrome
Features required for diagnosis
Features that support the diagnosis
Features that cast doubt on the diagnosis
Differential diagnosis
Investigations
Lumbar puncture
Neurophysiology
MRI of the brain and spinal cord
Other investigations
Therapy
Immunotherapy
IVIG schedule
Plasmapheresis schedule
Corticosteroids
29 Respiratory including cystic fibrosis
Chronic Asthma
Incidence
Risk Factors
Genetic predisposition
Personal history of atopic diseases (e.g. eczema, hay fever, food allergy)
Gender
History
Examination (see Table 29.1)
Investigations
Treatment Aims
Treatment (see Figures 29.1 and 29.2)
Failure to respond to treatment
When to refer to a paediatrician with an interest in asthma
Education of patients/parents
Cystic Fibrosis
Diagnosis
Possible presentations of CF
Sweat test
Management
Chest exacerbation
Admission
Antibiotics
Abdominal pain
Management
Bowel obstruction or peritonism
Hyperglycaemia
30 Rheumatology
Painful Joints
Investigation of Painful Joints
Inflammatory symptoms
Mechanical symptoms
Psychosomatic/stress-related symptoms
Pain or Dysfunction in one or more Joints
Inflammatory:
Mechanical:
Psychosomatic/stress related:
History
Examination
Diagnosis
Juvenile Idiopathic Arthritis
Oligoarthritis
Polyarthritis
Systemic arthritis
Systemic Lupus Erythematosus
Investigations
Dermatomyositis
Back Pain
Investigations
Rheumatic Disease Investigations
Diagnostically Useful Investigations
Antinuclear antibodies
Rheumatoid factor
Immunoglobulins
Investigations for Monitoring Chronic Inflammation
C-reactive protein
Erythrocyte sedimentation rate and plasma viscosity
Full blood count
Section 3 Prescribing
31 Corticosteroids
Corticosteroid Cover for Operations
32 Oral sedation
Drugs
Assessment
Preparation
Fasting
Timing
Problems in Administration
Complications and Risks
Monitoring
Discharge of Ambulatory Patients
33 Pain in children
The Recognition and Assessment of Pain in Children
Analgesic Management
Paracetamol
Non-steroidal anti-inflammatory drugs
Morphine
Regional Analgesia
Topical Analgesia
Procedural Pain
34 The formulary
Section 4 Information and normal values
35 Reference values
Biochemistry: Reference Values
Blood Pressure: Normal Values
Cardiology: Electrocardiogram
Heart Rate Determination
QRS-Axis Determination
Cerebrospinal Fluid: Normal and Abnormal Values
Endocrine Values
Gastroenterology: Bowel Preparation for Endoscopy
Haematology: Normal Values
Respiratory Function Tests: Normal Values
Surface Area Nomogram
Calculation of body surface area for drug dose calculations other than cytotoxic drugs
Calculation of drug doses in obese children and where paediatric doses are not available
36 Child law
Principles of the Children Act 1989
Court Orders under the Children Act (relevant to child protection)
Children’s Rights
Gillick competence
The Dying Child
Therapeutic Options
Symptom Control
Pain Relief
Constipation
Agitation
Nausea and vomiting
Convulsions
Breathlessness
Finally
Bereavement Following the Death of a Child
Management
Giving Information
Managing Difficult Situations
Anger
Managing anger
Guilt
Shame
Self-Care
Multi-Agency Approach
Asking for a Post-Mortem
Mandatory Post-Mortems
Requested Post-Mortems
How Should the Family be told?
What Should the Family be told?
Consent to a Post-Mortem Examination
Organ Donation
Criteria for Suitability for Organ/Tissue Donation
Approaching Relatives
When
Where
Who
How
Brainstem death
Helpful phrases
Questions you may be asked
Something to Remember
Contacts
Useful Information for Professionals
Information Leaflets for Families
37 Cultural awareness
Communication
Plan ahead
Extended family system
Childbirth
Breastfeeding
Child-rearing
Childcare: parenting issues
Modesty
Diet
Religious beliefs
Ablutions and toilet
Visitors
Time management
Bereavement
Conclusion
38 How to read a paper
Why are you reading?
Best Sources of Paediatric Evidence
Research requires extensive literature searches
Critically appraise the papers
Useful References
Useful Websites
39 Immunization
Vaccines
Contraindications to Vaccination
General contraindications
Contraindications to live vaccines
Notes
Immunoglobulins
Human Immunoglobulins and Indications for their use
Human normal immunoglobulin
Hepatitis B immunoglobulin
Tetanus immunoglobulin
Varicella zoster immunoglobulin
Rabies immunoglobulin
40 Nutrition
Nutrition for Healthy Children
Introduction
Nutritional Requirements
Energy
Protein
Fluid
Breast Milk
Infant Formula
Long-chain polyunsaturated fatty acids (LCPs)
Nucleotides
β-carotene
Follow-On Formula
Unmodified Cow’s Milk
Weaning
Preterm Nutrition
Preterm milks
References
41 Surgical issues
Informed Consent
Providing Information
Giving Consent
Preoperative Assessment and Preparation
Assessment
Preparation
Preoperative Fasting
Preparation for Anaesthesia
Examination
Investigations
Premedication
Analgesia
Consent and marking
Cancellation of cases
Specific Circumstances
Antibiotic prophylaxis
PICU beds
Diabetes mellitus
Asthma
Heart murmurs
Reasons to Call the Anaesthetist
Management of Diabetes during Surgery
Emergency Surgery
Major Elective Surgery (First on Morning List)
Preoperative management
Postoperative management
Major Elective Surgery (First on Afternoon List)
Preoperative management
Postoperative management
Minor Surgery (First on Morning List)
Preoperative management
Postoperative management
Minor Surgery (First on Afternoon List)
Preoperative management
Postoperative management
Maintenance Fluids, Insulin Infusions and Hypoglycaemia
Maintenance Fluid Infusion Guide
Maintenance Insulin Infusion Guide
Management of Hypoglycaemia (Blood Glucose Concentration of 2mmol/l or Less)
Appendix 1
Urti
Appendix 2
Starvation guidelines for elective surgery
Appendix 3
Sickle screening
42 Useful websites and addresses
Organizations
Doctors.net.uk
Patient Information
Contact a family
Evidence-Based Medicine
NHS R&D centre for evidence-based medicine
School of health and related research (ScHARR)
Evidence-Based on Call
Books, Journals and Internet Resources
British medical journal
Archives of disease in childhood
Pediatrics
Pedinfo
The best of the pediatric internet
Medline
Omni
Pubcrawler
Guidelines
Pier (Paediatric Information and Education Resource)
Resuscitation guidelines
National institute for clinical excellence (NICE)
Section 5 Dictionary of eponymous syndromes and diseases
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