So you’re new to PEM…
When I started my first A&E job, I thought the children’s area looked fun but then I saw the small, slightly sticky humans that inhabited it and ran the other way – what am I supposed to do with anyone that small?
The prospect of caring for children in the emergency department can be daunting but the reality is often more enjoyable and rewarding than you’d imagine. To help with the nerves, we’ve complied a list of “must reads” for anyone starting in the ED this summer.
Minor injuries
X-ray interpretation via Don’t Forget the Bubbles
These handy guides from the team at DFTB are invaluable – they cover interpretation of the common x-rays you’ll be requesting and any important injuries. They’re worth a read in full but are equally useful as a quick reference guide when you’re puzzled on the shop floor – is that a growth plate or a fracture?
Soft Tissue Injuries of the Hand via RCEM Learning
Hand injuries are a really common presentation to the emergency department and need careful assessment. This e-learning module from RCEM learning takes around 45 minutes and covers everything you need to know. I can’t recommend it enough.
Head injury: assessment and early management CG176 via NICE
Kids are composed of a large head perched on a small body. Couple that with a sense of fearlessness and still developing coordination, you’ve got the perfect recipe for falling on your head. You will see hundreds of children with head injuries so knowledge of this guideline is essential. Need the answers now? We’ve got your back.
Our minor injuries series is growing all the time and well worth a look. The one page summaries provide an accessible guide for the management of a range of common “minors” presentations. I’m not even going to apologise for the shameless self promotion.
Intranasal analgesia via Pediatric EM Morsels
If you don’t routinely treat children then the use of intranasal analgesia has probably passed you by. This short article covers the what, why and how of intranasal fentanyl and is a must read. If you’ve got time, First10EM have a much more in depth article about paediatric pain management that covers the full range of options.
Illnesses
Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management CG84 via NICE
A very wordy NICE guideline that gives you an overview of how to assess and manage the child with diarrhoea and vomiting. There are some notable differences between adults and children so its worth a read if you can bear it. If you’re looking for a shorter version, we’re working on our own handy guide…
Assessing (de)Hydration in Children via RCEM learning
This blog complements the guidelines above. It’s a pragmatic and realistic look at assessing and managing dehydration in the emergency department because most children weren’t weighed the day before they got ill and calculating the percentage of dehydration is enough to make anyone tear their hair out.
Fever in under 5s: initial assessment and management CG160 via NICE
This guideline is long but will inform of a lot of your practice, particularly over the winter months when it feels like every febrile child in the world is sitting in your waiting room. If you’re looking for something a bit more accessible, we covered the guideline with a series of infographics. Click here
Being asked to look at a rash is one of the things that makes my heart sink – everything looks like an erythematous maculopapular rash to me. This blog (with pictures) takes you through the common and important rashes you’ll come across in your time in the ED.
How to hold a child and examine their throat via Rolobotrambles
You don’t know the meaning of feisty until you’ve tried to examine the throat of an unrestrained, febrile 2 year old who doesn’t have time for your rubbish. This brief video will show you how a child should be held so you can get the most out of your examination (and avoid being kicked in a special place).
And finally…
We asked our Twitter followers for their top tips for doctors who are #newtoPEM
Got your own tips? Found something useful that you’d like to share with other new docs? Tweet them using the #newtoPEM hashtag…