Fever is one of the most common acute presenting complaints in Paediatrics, with 20-40% of parents reporting at least one episode per year. Assessment and diagnosis can be difficult when covering a broad spectrum, from self-resolving mild upper respiratory tract infections to severe bacterial infections leading to sepsis. Research around this area often focuses on differentiating bacteria from viral infections, ensuring appropriate antibiotic prescribing, and separating those who can recover at home with paracetamol from those who require admission for more intensive observation and management ..read more

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital).  This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. This month’s Bubble Wrap Plus provides answers to intriguing questions. A large cohort study from S ..read more

With millions of journal articles published yearly, it is impossible to keep up. Our team has scoured the literature, so you don’t have to—or it might spark an interest in reading the full article. This time, the PEM MSc team from QMUL, in association with DFTB, are taking over….. If you or your team are interested in an individual or joint review, please contact Dr. Vicki Currie at @DrVickiCurrie1 or vickijanecurrie@gmail.com. Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures ..read more

Carly is a 9-month-old who was brought in by her parents because she had been unsettled and not feeding well for a day. At triage, she has a pulse of 277 and is brought straight to resus. What happens in a normal heart? The sino-atrial (SA) node is the pacemaker of the heart. It is situated in the right atrium and generates an electrical impulse that conducts through the whole heart and causes it to contract. The impulses from the SA node travel to the atrioventricular (AV node). The AV node slows the current (0.1-second pause) and then allows it to pass through the ventricles (via the&nbs ..read more

You are called to the postnatal ward to review a 22-hour-old infant with feeding difficulties. On examination, two bluish, soft swellings are located medially to the inner canthus on both eyes. The infant is unsettled but has a mild fever. What do you do? What is dacryocystitis? Dacryocystitis is an inflammation of the lacrimal sac. This oval-shaped structure receives tear drainage from the eye and sits in a groove formed by the lacrimal bone and frontal process of the maxilla. The lacrimal sac is not the same as the lacrimal gland. This exocrine gland produces tears and is located within ..read more

When does respiratory failure become PARDS, and how should we manage it? Peter, a 2-month-old boy, is admitted to the paediatric ward on high-flow nasal oxygen with presumed bronchiolitis. Over the day, his oxygen requirement dramatically increased to the point of requiring intubation.  He is transferred to the regional PICU, where ventilation becomes increasingly challenging, with high airway pressures and poor oxygenation. You spend a challenging night responding to ventilator alarms and dramatic desaturations. During the morning handover, the PICU consultant suspects PARDS, and you ..read more

Conservative versus liberal oxygenation targets in PICU Every year in the UK, about 14,000 children needing intubation and ventilation are taken care of in children’s intensive care units, and they often receive supplemental oxygen as part of their treatment. Despite this, data regarding optimum SpO2 targets within PICU are scarce.  Recent studies, in both adults and children, highlight the potential harms of exposure to a high fraction of inspired oxygen (FiO2). In 2017, however, a retrospective analysis found that more than a quarter (26%) of saturation recordings were in the 99-100% r ..read more

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital).  This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. In this month’s list of the journal club, we would like to draw your attention to some studies that ..read more

Your paediatrics clinical rotation is dawning upon you. For some of you, this may be the start of the happiest 1-2 months of your medical degree. For others, it may seem like just another placement to get through. For some, however, this rotation may seem daunting. Though an interest in paediatric medicine goes a long way towards shaping an enjoyable and fruitful paediatric rotation, there are several aspects of this rotation which set it apart from other specialities.  Paediatrics is not all about parenting children and surviving their tantrums. Medicine is intertwined with comfort, care ..read more

There has been a notable shift in paediatric admissions in Ireland. This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. Whilst paediatric social admissions (PSA) are not a novel concept, they have gained increased attention and significance in recent years. A paediatric social admission is one where a child is admitted to the hospital but not for a medical reason. They often have complex care needs secondary to their m ..read more