# data[].attributes.body
Always look in the throat (apart from if you are suspecting Epiglottitis!)

Quinsy red flags: hot potato voice, dysphagia, trismus

Perform the examination and understand who to discuss with to escalate or de-escalate concerns (antibiotics are not a given and may need discussion)

Positioning is key to examining ENT!

# data[].attributes.body
There should almost never be anything that surprises you during your examination - a thorough history is the key

A thorough systems examination will help make a rounded and safe assessment of the child

Even after the course you will continue to learn and develop these skills

Recognise and understand what 'normal' looks and sounds like, and then you can escalate concerns when things seem different!

# data[].attributes.body
Consider what the parent feels their child's modified baseline to be!

Empower the parent: they may be the expert for their child...BUT...remember a thorough approach to assessment so you don't miss something

More holistic approach: consider communication, psychosocial and medical issues with each consultation

# data[].attributes.body
5 area model: Environment, feelings, thoughts, behaviours, physical reactions

Take a step back and think about what informs our decision making process

Always explore the parents agenda

Think about how they are thinking, not just how they are feeling

# data[].attributes.body
Safeguarding is EVERYBODY's business. Try to see things through the eyes of the child!

Community care means continuity, so children may disclose things to you.

Communication and documentation are both really important with issues around safeguarding.

Remember to look after yourself too!

# data[].attributes.body
Lots of babies get 'a little bit jaundiced', but a significant minority can become very unwell and need early recognition and treatment.

You need to understand and ask about red flags to catch those that are severely unwell

Keep a consistent message about time under the lights and terminology used with parents.

Phototherapy at home can make a significant impact to the holistic care of families (especially just after giving birth, it's perhaps kinder on Mum too!)

# data[].attributes.body
MDT working is vital to providing holistic care for families with chronic illnesses

Educating the family and the child is important and longitudinal (advice and help may change with time)

Chronic illness can be a significant burden to families

# data[].attributes.body
Remember the key players in fluid balance: stretch receptors, the heart, the kidney

Thorough assessment of fluid balance is useful: re-assessment will help direct management

When considering managing kidney problems:
- Daily weights
- Regular BP
- Regular U&E's
- Strict input/output monitoring

# data[].attributes.body
Rashes are tricky - don't try and diagnose it, try and describe it!

Describing a rash: Location? Symmetry? Colour? Shape? Texture?

# data[].attributes.headline
Antimicrobial stewardship (AMS) and pOPAT

# data[].attributes.subject
Antimicrobial stewardship (AMS) and pOPAT

# data[].attributes.body
AMS is everyone's responsibility, but as a nurse you have a privileged position to be an advocate and make a difference

AMS helps prevent antimicrobial resistance, ultimately saving lives!

Emphasis on clinical assessment rather than blood tests

# data[].attributes.body
Constipation can contribute significantly to disease burden in children.

Always important to look at the child as a whole - are they growing and developing normally?

Abdominal pain is really difficult to deal with - a prolonged period of observation and REPEAT examination may be really useful

The power of a thorough history should not be under-estimated!

# data[].attributes.body
All have the potential to make change, and change comes from inspirational leaders (YOU!) with a quality improvement mindset!

QI best applied in complex situations where the problem isn't fully understood, where there isn't one single answer.

Think about what your EPN skills can mean for YOU and for YOUR TEAM :)

# data[].attributes.body
More regular intermissions? short music breaks/ photos and other stuff even for a minute as helps relax the mind and recharge

Try and get interaction between candidates- involve them in answering questions from other candidates maybe?

# data[].attributes.body
Formative work to enhance your learning and confidence

Use a reflective cycle to structure your reflective assignment

Key points:
1. Communicate ideas
2. Critical insight
3. Engagement in literature
4. Referencing

Drop-in sessions for more information and discussion later in the course

# data[].attributes.body
Decision making is key to your assessment: where does this child need to receive their care?

After SBAR, utilise a confident pause to allow the recipient the chance to ask questions or think through an answer

Scoring systems are good to guide care but ALWAYS trust your gut instinct (or that of the parent)

# data[].attributes.body
People still die from asthma: prevention is the best form of treatment!

Health promotion is more accessible in the home environment compared to hospital, use this to your advantage

Brown inhaler = steroid
Purple inhaler = steroid + LABA

Aim to keep children on the LOWEST amount of treatment possible to maintain control

# data[].attributes.body
Generate a sense of urgency as part of the 'S'

You do NOT need a diagnosis to have an effective handover

Gut feeling is really important

Preparation and practice is key to successful SBAR

# data[].attributes.body
Look at trends in observations not just a one off reading

Persistent tachycardia without an obvious cause can be an early sign of sepsis

Disease processes are not static - things can change so reassessing the situation is important

The A to E approach is a systematic approach to the acutely unwell child - you will die fro a lack of A before a lack of C so always start with Airway!

# data[].attributes.body
Emphasis on building confidence, nurse empowerment, being a role model, teaching best practice, understanding clinical decisions and being able to enact them

Change requires stakeholder engagement and passion

All members of the team help drive change

Remember Ben and his Biblical fish!

# data[].attributes.body
Structure is useful to be thorough, but build confidence and develop your own mantra!

Keep an open mind throughout the history, don't focus down too much too early!

Perhaps ask about an advanced care plan or a treatment passport for complex children

The second person to take a history can often get more information, so be thorough :)