not medical advice by Camille

Paeds remote assessment

camca — 2020-04-08 14:52:30 UTC

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

c_gajria — 2020-04-09 13:45:55 UTC

Q+As

2020-06-22 10:13:00 UTC

Ealing refs

camca — 2020-08-07 20:19:40 UTC

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

2020-08-24 15:25:16 UTC

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

camca — 2020-11-11 09:40:27 UTC

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

REGO https://referrals.management/livezilla/knowledgebase.php?article=e5ccdb1fdff7e850350cb1c46f22a7ed

c_gajria — 2020-11-18 11:35:38 UTC

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

camca — 2021-01-12 14:22:39 UTC

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?

PIMS

camca — 2021-01-15 22:38:32 UTC

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.

c_gajria — 2021-02-07 14:51:18 UTC

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

07810 794718 St Marys Rapid access

2021-02-08 17:15:34 UTC

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

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

2021-02-08 17:16:20 UTC

2021-02-08 17:34:55 UTC

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

2021-02-08 17:35:03 UTC

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

c_gajria — 2021-02-11 18:52:43 UTC

https://dftbskindeep.com/about/

vaccine

c_gajria — 2021-02-20 19:09:29 UTC

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.

2021-02-25 21:40:29 UTC

Dear Patient,Your 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

language line

2021-03-29 16:29:09 UTC

0800 169 2879 code 285384

https://www.uhdb.nhs.uk/shared-care-pathology-guidelines

c_gajria — 2021-05-18 17:32:44 UTC

mental health not CAHMS

2021-06-03 15:42:27 UTC

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

https://www.lawskills.co.uk/articles/2014/11/how-to-get-a-mental-capacity-assessment/

c_gajria — 2021-06-14 15:16:22 UTC

anosmia

2021-07-19 11:59:22 UTC

https://abscent.org/

c_gajria — 2021-09-13 20:05:57 UTC

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

c_gajria — 2021-09-28 21:19:47 UTC

c_gajria — 2021-09-28 21:20:21 UTC

c_gajria — 2021-09-28 21:20:46 UTC

path test intervals

c_gajria — 2021-09-30 20:35:02 UTC

c_gajria — 2021-10-02 16:48:04 UTC

paeds medicines

2022-07-18 08:53:49 UTC

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

*not medical advice* by Camille