Monday, 22 July 2013

Spotting the sick child

There's alot of paediatrics in general practice, and one of the most important aspects is the ability to spot the sick child. Like most other skills in life, there is no substitute for experience, but web-based learning tools like the website, www.spottingthesickchild.com from NICE are very helpful indeed.

I was reminded of this recently when I telephoned the duty paediatrician at my local hospital to admit an acutely unwell child. The young paediatric SHO rather sternly asked me what I thought the diagnosis was. I had to say to her that I really didn't know, other than to say that I considered the child poorly enough to warrant urgent admission and assessment. And that it what matters most.

So whilst attending a GP update at Great Ormond Street recently I was gratified to hear my convictions confirmed when  the paediatric A and E consultant from UCLH told us, 'Dont worry about the diagnosis, worry about how sick the child is'. What a very useful mantra. He was also keen to point out that children decompensate quickly. Hence all the more reason to act quickly.


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