Paediatric Minor Emergencies

James Bethel

Description

There is a dearth of written work relating specifically to the emergency care of the child. Why this should be the case is perhaps not as perplexing as it may initially appear: although children make up between 25% and 30% of the attendance of many emergency departments, constituting approximately 3.5 million attendances a year (Royal College of Paediatrics and Child Health (RCPCH) 1999, 2007), there has until recently been little specific provision made for them. Whilst not addressing all of the challenges it is hoped that this work will provide some of the necessary knowledge for emergency nurses and nurse practitioners, emergency care practitioners, medical care practitioners, physiotherapy practitioners, pre-hospital staff and medical staff working in emergency departments, minor injury units, walk-in centres, out of hours services and other emergency care settings, that will enable them to enhance the care of the child with minor injury or illness.

Sujets

• Médecine
• Child health nursing

Informations

• Publié par: M&K Publishing
• Date de parution: 30 juin 2008
• Nombre de lectures: 0
• EAN13: 9781907830358
• Langue: English

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Paediatric minor emergencies
James Bethel
Paediatric Minor Emergencies
James Bethel
ISBN: 978-1-907830-35-8
First published 2008
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British Library Catalogue in Publication Data
A catalogue record for this book is available from the British Library
Notice
Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the Publisher. Neither the publisher nor the author assume any liability for any injury and/or damage to persons or property arising from this publication.
The Publisher
The publishers have endeavoured to obtain permission for every image in this book prior to publication, however the formal requests for permission for images below were still pending at the time of printing. The full sources and copyright holders have been acknowledged in this text.
Page 134 – Table 15.2
A comparison of burns dressings
Source: British Medical Journal 2007
Page 191 – Figure 21.1
The herpes simplex virus
University of South Carolina, United States
( www.paediatrics.wisc.edu/education )
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Contents
About the author
Acknowledgements
Introduction
Part I Caring for children and adolescents
Chapter 1
A word about anatomical terminology
Chapter 2
A child's view of emergency care
Chapter 3
Pre-hospital care of children
Chapter 4
Communication, consent and advocacy
Chapter 5
Pain relief in children
Chapter 6
Child protection
Chapter 7
Care of the adolescent and young adult
Chapter 8
Safe discharge of children
Part II Minor injury
Chapter 9
Defining minor injury in the child
Chapter 10
Clinical examination
Chapter 11
Minor head injury
Chapter 12
Injuries of the upper limb
Chapter 13
Injuries of the lower limb
Chapter 14
X-ray requesting and interpretation
Chapter 15
Burns and scalds
Part III Minor illness
Chapter 16
Assessment of illness in the child
Chapter 17
Recognition of the unwell child
Chapter 18
Febrile convulsion
Chapter 19
ENT and respiratory illness
Chapter 20
Abdominal and genito-urinary illness
Chapter 21
Dermatological illness
Chapter 22
Musculo-skeletal illness
Chapter 23
Ophthalmic complaints
References
Index
About the author
James Bethel FFEN, RGN, BSc (Hons) Clinical Practice, ENB Higher Award, Post Graduate Certificate in Learning and Teaching in Higher Education, Post Graduate Award Emergency Care, Emergency Nurse Practitioner, is a Senior Lecturer in Emergency Care at the University of Wolverhampton and Honorary Nurse Practitioner in the emergency departments of Walsall Hospitals NHS Trust and Dudley Group of Hospitals. Prior to this he worked in various roles as a nurse manager and lead nurse in emergency services. He has worked in emergency care since 1986 in emergency departments in Birmingham, the Black Country, Shropshire and Staffordshire.
James developed a particular interest in the emergency care of children when working as a lead nurse in Birmingham. During this time he developed a paediatric-specific, academically accredited training course for nurse practitioners. This was marketed, as part of a training module, to staff from emergency departments, minor injury units and NHS walk-in-centres in Birmingham, the Black Country, Shropshire, Staffordshire, Herefordshire, Leicestershire, Worcestershire and Warwickshire.
He is now module leader for emergency care courses at Wolverhampton University, including modules concerning the emergency practitioner care of minor injury and illness. He has also developed work pertinent to the emergency care needs of children. He is a Fellow of the Faculty of Emergency Nursing, chair of the Midlands Emergency Care Group, sits on the editorial board of the Emergency Nurse journal and is a member of the steering committee of the Royal College of Nursing Emergency Care Association. He also holds honorary status as a nurse practitioner in the emergency departments of Walsall Hospitals NHS Trust and Dudley Group of Hospitals where he works on a regular basis to support emergency care students and maintain clinical competence.
Acknowledgements
The inspiration for writing this book came from all the children I have dealt with in emergency care settings during the 21 years of my career so far. Their humour, vulnerability, courage and honesty provide a never-ending challenge in the workplace and truly help me to enjoy my work. I would also like to thank my employer, the University of Wolverhampton, for providing me with support and encouragement during the writing of this book. Most of all I thank my wife, Rachael, and my children, Georgia and Patrick, for tolerating my behaviour over the years and supporting me in developing my work.
‘Play is the work of the child’
Friedrich Froebel (1782-1852)
Introduction
There is a dearth of written work relating specifically to the emergency care of the child. Why this should be the case is perhaps not as perplexing as it may initially appear: although children make up between 25% and 30% of the attendance of many emergency departments, constituting approximately 3.5 million attendances a year (Royal College of Paediatrics and Child Health (RCPCH) 1999, 2007), there has until recently been little specific provision made for them. (The figure of 3.5 million does not include attendance by children at minor injury units or NHS walk-in centres.) The Healthcare Commission, an inspectorate body tasked with the monitoring of quality standards within the National Health Service of the United Kingdom (UK), has recently reported that although 1.8 million children attended mixed adult and paediatric emergency departments in 2006 almost one in five of these departments still failed to provide adequate life support resources for children at night. It also found that many nursing and medical staff had not undertaken child protection training, a recommendation of Lord Laming subsequent to the Victoria Climbié abuse enquiry (Department of Health 2003). Staff were not always able to detail effective communication strategies when caring for children (Healthcare Commission 2007).
The Healthcare Commission, and various bodies concerned with the provision of healthcare to children in the UK, have concluded that a lack of resources makes current aspirations for service provision unattainable. It advocates the reconfiguration of paediatric services such that those children requiring specialist care may access regional centres of excellence rather than the local district general hospital. It is envisaged that these centres would have all the necessary resources to manage the care of severely ill or injured children. Children requiring care for minor injury or illness would continue to be treated more locally in units that would not now be required, or expected, to provide specialist care for children as this would now be the task of the regional centre. Thus the available paediatric expert resources would be utilised in a more effective manner (Healthcare Commission 2007, RCPCH 2007). This recommendation broadly mirrors those recently made for the reconfiguration of all emergency services by the Department of Health (2006a). Thus in the future it may be that children with minor injuries and illnesses will be cared