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GPs are confronted with a huge amount of information related to Covid 19. This website has been set up by GPs for GPs. It is designed for use in clinic to help free up time for patient care.

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GPs are confronted with a huge amount of information related to Covid 19. This website has been set up by GPs for GPs. It is designed for use in clinic to help free up time for patient care. Search by keyword, or category name

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Dear Patient,Your <insert name of practitioner> should have all the necessary skills and expertise to determine whether it is safe to carry out your procedure if they have been trained to the required competence to carry it out. Their uncertainty as to whether the procedure they are offering is safe is deeply concerning from a safety point of view and we are minded to refer the issue to the regulator to ensure the service they are offering is safe.We hope you understand we are unable and unwilling to provide vicarious immunity to other professionals as a substitute to their proper training, indemnity and safeguards. We therefore strongly recommend you discuss with your <insert practitioner as to whether they are competent to safely carry out the procedure. Your safety is our number one priority.Sincerely

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https://what0-18.nhs.uk/professionals/gp-primary-care-staff/clinical-pathways/clinical-pathways-remote-assessment

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Liza's notes from the sats talk everyone is talking about

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Liza's notes from the sats talk everyone is talking about

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Aiming for wider national roll out of home monitoring Sats 92% or less (rested, sitting upright and normal baseline sats) 1 in 3 chance doing very badly (ICU/death)1% increase in mortality for each day you do not attend hospital 93-94%- call 111 or GP Baseline is important to know about – didn’t talk about what kind of percentage drop to be concerned about with COPD slides from webinar will be available here. Lots of other resources too:www.ahsnnetwork.com/covid-oximetryUseful guidance document: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0445-remote-monitoring-in-primary-care-jan-2021-v1.1.pdfHSJ remote training covid- worth looking at https://training.hsj.co.uk/covid-early-warning-system-saves-livesR Rate app for people checking their own resp rate (android only) ?medtimer for apple Use resting sats after sitting and doing nothing for a few mins. Didn’t mention much about destaturations after sit/stand or 40 steps. What to do if sats previously low but better when you assess them: check batteries! Look at the trend – which way is it going?

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If 5-15mg Pred & gets COVID: 10mg TWICE DAILY (avoid adrenal crisis) Fluconazole weekly maintenance 6/12 for RVVC 600mg Aspirin 2 years in Lynch Syndrome

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https://www.nwlondonccgs.nhs.uk/professionals/referral-guidelines-and-clinical-documents

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baby that needs bt

call EALING HOSPITAL 020 8967 5000 ext 5682                                              Paediatric department to book an appointment.  Pt must have bt forms before they arrive

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https://www.rcpch.ac.uk/resources/pims-covid-19-linked-syndrome-affecting-children-information-families

Early recognition continues to be challenging in children due to atypical presentations and are usually
non respiratory.
We continue to see PIMS cases at
Northwick Park as before, almost 1-2 per week.

Cohort of patients seen at NPH have either all or some of the following features:

7-8 yrs and above.
High grade temperature for more than
3 -5days with no focus.
Fever and unusual rashes (vasculitic ).
Children with features of acute abdomen and especially appendicitis/ acute gastroenteritis
Features of  Kawasaki disease.
Febrile child with conjunctivitis.
We are keeping low threshold to do bloods in such children (PIMS bloods)

Most of them are previously fit and well but there is strong history of either having had COVID or been exposed to COVID about 3-4 weeks prior to the presenting PIMS symptoms.
At the time of presentation with PIMS symptoms they are COVID antibody positive but are antigen negative, indicating the symptoms are immune mediated and not due to acute infection.
In this second wave we are also seeing more Infants with COVID, fortunately they get better without any complications or PIMS features.

Among the complicated PIMS cases:

We had one child with COVID chest who is very unwell and is currently on ECMO for the last 10 days at GOSH. This child also has a background of brittle asthma/ ? recurrent wheeze under investigation.
We had two or three of them needing ionotropes due to cardiac dysfunction.
We have also had few children with acute abdomen mimicking appendicitis but had normal appendix at surgery.
Ileocolitis is a very common presenting symptom in PIMS mimicking appendicitis.

In this second wave we are also seeing more Infants with COVID, fortunately they get better without any complications or PIMS features.

I would keep a low threshold to refer if they fall into any of the above categories.

As thIs disease keeps evolving with new features there is a constant update regarding the management on the RCPCH website.
I hope this helps.

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1. NHS England and NHS Improvement vaccine infographics https://drive.google.com/drive/folders/1lSrPUaVSXEbTVqTr1l8iiJ8vcwAAHuX_?usp=sharing

2. PHE leaflets in different languages

https://www.gov.uk/government/publications/covid-19-vaccination-guide-for-healthcare-workers

https://www.gov.uk/government/publications/covid-19-vaccination-what-to-expect-after-vaccination

https://www.gov.uk/government/publications/covid-19-vaccination-a-guide-for-social-care-staff

3. PHE link to resources - https://coronavirusresources.phe.gov.uk/covid-19-vaccine/resources/

4.  There is a section on Commslink which includes social media assets designed for communicating with BAME audiences including, infographics, quote cards and video. The direct link is: https://future.nhs.uk/CommsLink/view?objectId=24858064

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Landline for St Marys Paediatric advice on their website is 020 3311 6224

St Marys:

Paediatric registrar bleep 1202
Orthopaedic SHO bleep 1515
ENT SHO bleep 1311
Surgical SHO bleep 1518

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07796 705699  Northwick Park hospital.  As I remember St Marys was the better of the two for answering the phone

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07796 705699  Northwick Park hospital.  As I remember St Marys was the better of the two for answering the phone

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explained babies do vomit esp after feeds and abx, of course he can't answer without seeing him but as nothing changed since discharge a few minutes ago. if worried they can go back like anyone.
posseting or reflux after feeds is normal - more than 50%-  esp in premature babies.
sit up  after feeds, wind them properly, dads better. tilt cot slightly e.g. with towel roll

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explained babies do vomit esp after feeds and abx, of course he can't answer without seeing him but as nothing changed since discharge a few minutes ago. if worried they can go back like anyone.
posseting or reflux after feeds is normal - more than 50%-  esp in premature babies. 
sit up  after feeds, wind them properly, dads better. tilt cot slightly e.g. with towel roll 

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https://dftbskindeep.com/about/

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Vaccination is one of the safest and most effective medical interventions known to man.

In people in your age range, for every 100 people who get Covid Xx will die and Xx-xx will develop long Covid symptoms which can be incredibly disabling and which we don’t know how to treat or how long they last.

The vaccine gives you X% (depending on which one they’re offered) protection against severe Covid 14-21 days after your first dose.

[ if Oxford vaccine I add: In the Oxford trial there were 12,000 patients, none of whom were admitted to hospital with Covid from 3 weeks after their first jab]

The second jab gives a stronger immune response, which means you reduce your risk of getting Covid at all and reduce your risk of passing it on to others, especially people you live with.

So overall the vaccine is a lot safer than Covid, and helps protect you and people around you, and is our best chance at getting things back to normal.

Depending on the patient I sometimes add something like:

There’s a lot of misinformation and some outright lies on the internet about the vaccine, including rubbish about microchips, so if there’s anything specific you’ve heard that’s putting you off I’m happy to discuss that.

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0800 169 2879 code 285384

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https://www.westlondon.nhs.uk/our-services/child-and-adolescent/camhs/how-we-help/camhs-helpline#:~:text=Call%200800%20328%204444%20and,holidays%20from%20midday%20to%208pm

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https://abscent.org/

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Dear patient,

Following our referral to a secondary care department, we have received a reply from the department stating that our referral has been rejected with advice only. I enclose our original referral letter to them as well as their reply to us. If you are not satisfied with the secondary care department’s reply I would encourage you to discuss this with the patient advice and liaison service (PALS) by ringing XXXX and raising your concerns with them.

PALS act as a liason service between yourself as the patient and the department which you have a query with. Unfortunately, this is a regional issue and many departments are now choosing to reject referrals and only issue guidance for the GP. The particular consultant that makes these decisions will have considered the full medico-legal ramifications of rejecting a GP’s referral when they made the rejection decision.

Yours sincerely

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GP Update on Ealing Community Post-Covid Rehab Pathway

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Urgent mental health support for children young people and families

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https://www.medicinesforchildren.org.uk/advice-guides/giving-medicines/

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Skip to content

This section provides videos and information about how to give different formulations of medicines to your child.

Contact and NHS helplines

If your child is seriously ill, telephone 999 (UK only) or 112 for emergency help.

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How to give different types of medicines

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Skip to content This section provides videos and information about how to give different formulations of medicines to your child. If your child is seriously ill, telephone 999 (UK only) or 112 for emergency help.