Andrew Tagg

Needle in a haystack: how to identify the sick febrile child

Emergency Department, Sydney Children’s Hospital, Sydney, New South Wales, Australia, Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, School of Medicine, University of Queensland, Brisbane, Queensland, Australia, Emergency Department, Logan Hospital, Logan City, Queensland, Australia, and Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia

Paediatric resuscitation: Always breathe carefully.

Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia, Emergency Department, Sydney Children’s Hospital, Sydney, New South Wales, Australia, Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, School of Medicine, University of Queensland, Brisbane, Queensland, Australia, and Emergency Department, Logan Hospital, Logan City, Queensland, Australia

Spoonful of sugar: Improving the palatability of emergency department visits for children and their families

Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, School of Medicine, University of Queensland, Brisbane, Queensland, Australia, Emergency Department, Logan Hospital, Logan City, Queensland, Australia, Emergency Department, Sydney Children’s Hospital, Sydney, New South Wales, Australia, and Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia

Making a difference: pragmatic paediatric pain management

One of the great rewards of paediatric emergency medicine is the opportunity to manage the pain of a suffering child and in doing so provide welcome relief to a family in distress. Although there is no single analgesic recipe that is appropriate for all clinical situations, there is a toolbox of interventions that allows us to reduce the pain in the vast majority of illnesses, injuries and medical procedures to a level that most children and families find acceptable. The present paper aims to open that toolbox, explore its contents and demonstrate that, while many children still suffer from under-analgesia in EDs, the solutions to this disservice are not intimidating.

No need to strain: A practical approach to paediatric constipation

Ben LAWTON, Tessa DAVIS, Henry GOLDSTEIN and Andrew TAGG Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, Emergency Department, Logan Hospital, Brisbane, Queensland, Australia, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia, Royal London Hospital, London, UK, Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia, and Adult Retrieval Victoria, Melbourne, Victoria, Australia

Walking in circles: The limping child

Accident and Emergency, Chelsea and Westminster Hospital, London, UK, Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia, Emergency Department, Logan Hospital, Brisbane, Queensland, Australia, LifeFlight, Brisbane, Queensland, Australia, and Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia

Syncope: Not for the faint hearted.

Like many paediatric emergency presentations, the assessment of syncope involves filtering the rare and life threatening from an overwhelming benign majority. 15–25% of the population will suffer a syncopal episode at some point in childhood or adolescence, which contrasts reassuringly with a rate of sudden cardiac death of less than 0.6–8.5 per 100000 patient years. After clarifying some definitions, the present paper discusses red flags from the history and examination of a post-syncopal child, and then contrasts these with a benign case. We finally discuss a type of syncope unique to children – breath-holding spells.

Sticks and stones may break some bones.

Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia, Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, School of Medicine, University of Queensland, Brisbane, Queensland, Australia, Emergency Department, Sydney Children’s Hospital, Sydney, New South Wales, Australia, and Emergency Department, Logan Hospital, Logan City, Queensland, Australia

Baby steps: understanding normal baby behaviour

Children under 1year of age are over represented in presentations to the ED. The presentations are often mild, non-specific, or non-emergent, especially in the neonatal period. As well as identifying an unwell infant, a key challenge for emergency clinicians is to give practical and evidence-based advice for parental questions. This article reviews common problems for the well infant in the first 6months of life, including typical infant behaviour and development, the parent-child bond, and red flags to help identify an ‘at risk’ mother-child dyad. We will also review the evidence around sleeping patterns, feeding and constipation. First-line advice for these topics is often nebulous and nonspecific rather than pragmatic.

Easing the wheeze

Emergency Department, Lady Cilento Children’s Hospital, Brisbane, Queensland, Australia, School of Medicine, University of Queensland, Brisbane, Queensland, Australia, Emergency Department, Footscray Hospital, Melbourne, Victoria, Australia, Emergency Department, Logan Hospital, Logan City, Queensland, Australia, and Emergency Department, Sydney Children’s Hospital, Sydney, New South Wales, Australia