RESUMO
Eating disorder presentations in children and young people during the COVID-19 pandemic have increased, and this has become a common presentation to paediatric emergency departments (EDs). We cover a structured approach on identifying and managing these presentations within the ED including history taking, what to look for on examination, what investigations are needed and how to decide who requires admission to hospital.
Assuntos
COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos , Criança , Humanos , Adolescente , Pandemias , Encaminhamento e Consulta , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Serviço Hospitalar de EmergênciaRESUMO
A 13-year-old girl presents to the emergency department for the second time with an unresponsive episode. She has a GCS (Glasgow Coma Scale) score of 11 on arrival and all other observations are normal. The story is unclear, but there are ongoing safeguarding concerns and the family are known to social services. All investigations are normal. After a period of observation on the ward, her GCS returns to normal and she appears well. Both on the first presentation and this presentation ingestion of a toxin was suspected. However, this was denied by the patient and urine toxicology screen was negative. Does this rule out toxin ingestion? Will this change your management?
Assuntos
Distúrbios Induzidos Quimicamente/diagnóstico , Urinálise , Adolescente , Distúrbios Induzidos Quimicamente/urina , Serviço Hospitalar de Emergência , Feminino , Escala de Coma de Glasgow , Humanos , Sensibilidade e EspecificidadeRESUMO
A 3-month-old baby is brought to the paediatric emergency department by their parents because of a fever. You decide to check their inflammatory markers. Their C-reactive protein (CRP) level comes back as 20 mg/L. Does this affect whether or not you start antibiotic therapy? Does it influence your decision to admit or discharge the patient? CRP is a commonly used biochemical test and yet its use is constantly debated and challenged. We look at the current evidence and suggest the best way to use this test in clinical practice.
Assuntos
Proteína C-Reativa/análise , Tomada de Decisão Clínica , Antibacterianos/uso terapêutico , Infecções Bacterianas/sangue , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/tratamento farmacológico , Biomarcadores/sangue , Proteína C-Reativa/fisiologia , Febre/etiologia , Humanos , Inflamação/diagnóstico , PediatriaAssuntos
Exantema/etiologia , Criança , Tomada de Decisão Clínica , Humanos , Púrpura/etiologia , Sepse/diagnósticoRESUMO
Monogenic forms of diabetes (historically known as Maturity Onset Diabetes of the Young (MODY)) are caused by single gene mutations inherited in an autosomal dominant fashion that result in reduced pancreatic beta cell function. Children with these forms of diabetes may be misdiagnosed as having type 1 or 2 diabetes, which has important implications for treatment, genetic counselling, screening of family members and prognosis. Useful tools now exist to aid in their diagnosis and management. Here, we attempt to outline the clinical features that will help the physician make the differentiation from other diabetes subtypes.
