For everyone asking what to use if macrogols not tolerated in children:
1) Guile and persistence with macrogols which includes support and encouragement for the adults to stick with it
2) A stimulant laxative such as sodium picosulphate or senna

We are looking for a lead nurse for our amazing children's emergency department here ED NNUH
If you would like to be the person who leads a fantastic team in a paediatric ED to be proud of please apply here:
jobs.nhs.uk/candidate/joba…

Question for clinical supervisors: What do you find is the harder situation to manage and achieve positive change in your supervisees?

‘So why didn’t you think this baby was ill?’ Decision-making in acute paediatrics

'Essentially, every benign diagnosis has an evil twin, and it is often very difficult to tell them apart'

ep.bmj.com/content/edprac…

#DFTB23 HT Edward Snelson

Come and join the Paediatric Emergency Medical team ED NNUH
It's a great place to live and work.
Will you be out new Senior Clinical Fellow in our excellent emergency department?
jobs.nhs.uk/candidate/joba…

Do you know what barriers people with learning disability face when accessing healthcare?

Did you know autistic people face huge health inequalities?

Would you like to make a difference to your most vulnerable patients?

Join us RCEM Events

rcem.ac.uk/events/learnin…

Twitter brain - genuine question:
Ho does cow's milk protein get into human breast milk?

Excellent PEM Simulation day today. With lots of interaction & great participation from all faculty and attendees.
Poor Bobby had a rough day though….
Amazing skills from our nursing team.
Thanks Edward Snelson Catherine Thomas Beth

I am not a nurse
I stand with nurses
They must not be silenced
We who stand with nurses must not be silent

Management of buckle fractures has progressed from Plaster of Paris (POP) & follow up to essentially no treatment or follow-up.

Convincing clinicians to treat an off-ended radial # with just a POP is going to be an order of magnitude greater implementation challenge

#PEM23

Who am I treating with the High Flow I'm recommending because I'm not treating length of stay! (and therefore unlikely to be protecting against collapse)

[A note of caution: PARIS-2 study for children 1-4 so didn't cover 'typical' child with bronchiolitis]

#PEM23

'Time to change the reference ranges of children's physiological observations in emergency care?'

Our study’s 5th centile was higher at nearly every age than equivalent APLS centile
(cohort of 191292 children in General Emergency Departments)

onlinelibrary.wiley.com/doi/10.1111/jp…

UKHSA have released an update on the situation with Group A Strep

I have summarised it in my newsletter which you can read below

SF cases probably not too useful anymore given explosion in awareness

iGAS continues to increase

alasdairmunro.substack.com/p/update-on-gr…

I hope that you find the latest #gppaedstips post both useful and timely. As the UK seems to have all but run out of oral antibiotics, what is the deal with group A strep in children at the moment?
gppaedstips.blogspot.com/2022/12/group-…
#FOAMed

News stories and recent guidance regarding Group A Strep in children have certainly changed lots of things for clinicians who treat children. What has actually changed about the medical assessment and treatment?
gppaedstips.blogspot.com/2022/12/group-…
#FOAMed

Using traffic lights to assess the unwell child?
The challenge is that they change constantly so a snapshot isn't the whole picture.

Here's what to do with changing lights:
gppaedstips.blogspot.com/2022/11/unders…

#FOAMed #FOAMped #FOAMgp

Primary care colleagues: you see a 2 year old with a febrile illness. Signs and symptoms of URTI. No red flags. Pulse 160 temp 39.5. Miserable and refusing fluids but active and interactive. No medication for 6 hrs.
What do you do?
(*Reassess phone or f2f)

Possibly the most relevant thread I have ever read. Thank you Nick. We feel grief and feel guilty for feeling it. We feel like crying and that we shouldn't.
I don't have the answers either but I also find that my colleagues always see me through.

What kind of person forgets a baby in the back of their car?

The wealthy do it. And the poor, and the middle class. Parents of all ages and ethnicities do it. Mothers are just as likely to do it as fathers.

It’s happened to a paediatrician.

rolobotrambles.com/cognitivedecei…

. BCIS president ballot now open! Some great candidates inc Dr Clare Appleby clare appleby, 1st female BCIS officer & 1st female to run for president! #trailblazer