The Foundation Years最新文献

This article describes the priorities in management of children and young people presenting with the oft-quoted triad of fits, faints and funny turns. It emphasizes the importance of getting an accurate history, and outlines the various diagnostic possibilities.

Substance misuse and intoxication is a growing problem In children and young people; the rates of substance use in this age group in the UK are the highest in Europe. This article explores the common substances of abuse, their clinical presentation and general principles of management. More information can be accessed from any good textbook of psychiatry.

A Foundation Doctor working in a Paediatric or Accident and Emergency department will definitely encounter children with breathing difficulties, and most of these children will have upper or lower respiratory tract illnesses, few of which may present as potentially life-threatening emergencies. It is important to remember that young children and infants may develop respiratory failure more readily than older children and adults. Some of the common respiratory conditions presenting with breathing difficulty in infants and children are bronchiolitis, croup and acute asthma. The diagnosis of all of these is clinical. This article discusses how to use the A-B-C-D-E approach when faced with a child with breathing difficulty while waiting for senior help. The clinical features of croup, bronchiolitis and acute asthma and their management are discussed, highlighting important ‘dos and don’ts’.

Hip pain is a common complaint in both children and adolescents. The diagnostic challenge lies not only in the difficulties of history and examination in the paediatric population, and that hip pathology can be referred from other sites, but also that the differentials are broad. Although an accurate history and clinical evaluation are vital in narrowing this wide differential, imaging plays a key role in establishing an accurate diagnosis. The various imaging modalities available, together with the common causes of non-traumatic hip pain within the paediatric population, are reviewed in this article.

This article gives a brief history of safeguarding and promoting the welfare of children, and an overview of recognition and referral of child protection concerns. The reader is advised to refer to Trust and Local or National child protection procedures for further management.

Abdominal pain is a very common presenting complaint in the Paediatric age group. It is important to remember that like any other problem in paediatrics, different age groups have differing common presentations and causes. A systematic approach to the problem with good history taking and clinical examination goes a long way in management.

One convenient method of classification is acute, chronic and acute-on-chronic abdominal pain.

This article gives you a practical approach to abdominal pain in children and also gives you the most common causes in each group.

The other important clinical scenario is gastroenteritis and management of dehydration. I have tried to keep the management as practical as possible, but it is always important to remember to ask for appropriate advice from seniors when in doubt. Also, remember to refer to the local guidelines on the unit.

This article explores history taking, identifying risk factors and general principles of management of young people presenting with deliberate self-harm. This article explores the risk factors which are associated with deliberate self-harm and their importance in assessment and management. The reader is advised to refer to more detailed texts, national and international guidelines for further information.

The management of the acutely injured child can be a daunting task for any junior doctor. This need not be the case if a calm and methodical approach is employed throughout the assessment. The principles of taking a complete history, including the mechanism of injury, will provide indicators as to the pattern of injury, and a thorough examination will confirm your suspicions. The incidence of fractures in children is twice that of adults¹ therefore any doctor working in an emergency environment needs to be confident in dealing with the injured child. Paediatric trauma personnel should also have knowledge of advanced paediatric life support, which is beyond the scope of this article and should be read further elsewhere.