With an Open Mind for Learning and a Soft Spot for Paediatrics, this is Fontanelle. I'm Caroline Storey, a paediatric trainee in Wessex, and I'll be joined by wise friends, learned colleagues and leading lights from around the region and beyond to explore common presentations, sticky situations, what's fresh and new, and what's coming of age in paediatric medicine. So if you've got an open mind for learning and a soft spot for the world of paediatrics, you've come to the right place!
Respiratory tract infections in under 5s represent two thirds of all presentations to primary care and ED. But why do we see so many of them? What are parents looking for when they bring their children to see a doctor? Dr Sanjay Patel, consultant in paediatric infectious diseases, says the data tells us that parents are not seeking antibiotics, but rather reassurance that their child is well enough to be managed at home without antibiotics. With the emphasis in popular media on serious illness, health-seeking behaviour is going up year on year, with a 25% increase in activity for under 5s with RTIs annually. In our increasingly risk-averse society, there needs to be a seismic change in health seeking behaviour, if we are to avoid the dangers associated with inappropriate antibiotic use. Severity, not aetiology of respiratory tract infections should guide decision making around antibiotic use. Reference is made to the SCAN Guidelines, which can be found at www.nhsantibioticguidelines.org.uk the PIER Guidelines at www.piernetwork.org and the MicroGuide app. Changes to antibiotic policy aim to improve compliance and include use of Amoxicillin for all respiratory tract infections, with a BD dosing regime of 40mg/kg, as well as shortening the course from 10 to 7 days in tonsillitis. Scoring systems discussed include FeverPAIN for suspected Group A Strep tonsillitis. Pneumonia can be diagnosed based on fever, and respiratory distress, with auscultation providing little to support a diagnosis.
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I'm joined by Dr Sanjay Patel, consultant paediatrician and lead for Healthier Together, who describes the background and aims of this wonderful, innovative health education resource. Addressing the felt confusion and anxiety of parents, as well as the changing needs of our increasingly risk-averse society, this resource aims to deliver high quality and consistent information to parents and professionals, providing a safe way to identify the sickest patients whilst keeping the well children out of hospital. This podcast serves as an overview - stay tuned for more on the individual clinical pathways as seen on www.what0-18.nhs.uk
D&V, or gastroenteritis, can usually be managed safely at home by parents with appropriate advice and safety netting. To help provide that information, Phil Wylie, consultant paediatrician in Dorset County Hospital joins me to talk about red flags, recognising and treating dehydration (think 2ml/kg every 10 mins), shock, and long term sequelae such as transient lactose intolerance. With reference to Healthier Together pathways and parent information leaflets www.what0-18.nhs.uk Thanks Phil. Please go to iTunes to rate ⭐⭐⭐⭐⭐ and review. Any feedback, please email me at firstname.lastname@example.org
Dr Phil Parslow, Consultant Paediatrician with an interest in nephrology talks UTI - in primary and secondary care. Referencing Healthier Together www.what0-18.nhs.uk NICE Guidelines, InfoKid.org.uk and ERIC.org.uk. Thanks to Phil, please go to iTunes to rate ⭐⭐⭐⭐⭐ and review, and please send any feedback to me, Caroline Storey at email@example.com
Dr Sarah Williams, Consultant paediatrician with an interest in gastroenterology and nutrition, summarises her thoughts on important areas in nutrition such as managing patients in nutritional crisis, the importance of phosphate and tackling obesity. Reference is made to the very useful MARSIPAN Junior guidelines - See http://www.marsipan.org.uk Sarah spoke at the PIER Conference 2018 and I chatted to her between talks - Thanks Sarah.
In this episode, Dr Clare Hollingsworth, consultant general paediatrician, discusses our favourite topic for these winter months: bronciolitis. Reference is made to the Wessex Healthier Together material, an excellent resource for those in both primary and secondary care, which can be found here: https://www.what0-18.nhs.uk Other topics in WHT to be covered soon on the show.
Dr Dan Magnus, Paediatric Emergency Medicine Consultant at Bristol Children's Hospital came to the PIER Conference 2018 to talk about staff wellness and wellbeing. This was a tiny snapshot of some of the ideas he presented in his talk, but certainly gives you a taste of his motivation and ideas he's developing to help us all get involved in improving staff wellbeing. I'm definitely inspired, and am sure you will be too! You can check out his work at https://www.yougotthiswellness.com and find Dan at @drdanmagnus . And remember you don't need to set yourself on fire in order to keep others warm! Enjoy!
I caught up with Dr Mark Tighe, consultant paediatrician and associate editor of Archives of Disease in Childhood. He shared some golden nuggets from his recent talk at PIER 2018 about writing right for publication. There are some super useful tips and ideas here, on how to prepare material in a way which is likely to be accepted by journals, and hence read by colleagues, which is, of course the aim. Particularly as we're all so busy and suffer from the rather wonderful sounding affliction - Tsundoku - the art of buying books and journals, and never reading them!
In this episode I talk to Professor Mark Beattie at PIER 2018 about his keynote speech on Nutrition - Everyone's Business. He lays out the principles of nutritional requirements in various stages of illness and remission, using Crohn's as a model to illustrate these stages. He also shares his enthusiasm for PIER, innovation, social media and podcasting. Thanks Prof Beattie!
In this episode of Fontanelle, I'm super excited to be heading to the PIER Conference 2018 for two whole days of presentations, discussions and lively debate. We're recording as many of the talks as we can, and I'll be getting behind the scenes chat from organisers, speakers and delegates too. Let's share the information, knowledge and dynamic energy fuelling paediatrics in Wessex! #PIER2018