ABSTRACT
Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury. Management and prognosis of these conditions are discussed in the context of guidance from the National Institute for Health and Care Excellence. The article includes two case studies that illustrate different presentations and the challenges that nurses who manage children in EDs are likely to come across in clinical practice.
Subject(s)
Emergency Nursing , Emergency Service, Hospital , Lower Extremity , Movement Disorders/diagnosis , Movement Disorders/nursing , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/nursing , Nursing Diagnosis , Child , HumansABSTRACT
The National Institute for Health and Care Excellence (NICE) ( 2015 ) defines bronchiolitis as a lower respiratory tract infection affecting children under two years, peaking between three and six months. It affects about one in three infants in the first year of life, making it the most common respiratory infection in infants ( NICE 2015 , 2016 ). Of these infants, 2-3% will require admission to hospital ( NICE 2016 ). Respiratory syncytial virus (RSV) is the most common organism detected in the nasopharyngeal aspirate in hospitalised infants, although other viruses such as rhinovirus, parainfluenza virus, influenza virus, adenovirus and human metapneumovirus are increasingly being recognised ( Paul et al 2016 ). As most infants with bronchiolitis are managed at home, the data available from the literature is not reflective of the true incidence and may represent only the 'tip of the iceberg'.
Subject(s)
Bronchiolitis/diagnosis , Bronchiolitis/drug therapy , Bronchiolitis/physiopathology , Guidelines as Topic , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Respiratory Syncytial Viruses/drug effects , Respiratory Syncytial Viruses/pathogenicityABSTRACT
Public Health England (PHE) figures show that there were four times more measles cases in the second quarter of 2016, representing 167 new confirmed infections, than in the same period last year.
Subject(s)
Disease Outbreaks/statistics & numerical data , Emergency Nursing/standards , Measles/diagnosis , Measles/epidemiology , Practice Guidelines as Topic , Public Health/statistics & numerical data , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , United Kingdom/epidemiologyABSTRACT
Parents of newborns can be reassured if healthcare professionals are aware of benign neonatal sleep myoclonus (BNSM) so it is not mistaken for epilepsy.