HSP Vasculitis with arthralgia, abdo pain, and or renal involvement. Purpura occurs in all patients. The rash is distinctive. Urinalysis is needed - manage with analgesia. Consider steroids.
A first episode of HSP usually resolves within 4 weeks with the rash being the last symptom to go. Joint pain usually resolves spontaneously within 72 hours and abdo pain in 24- 48 hours. Uncomplicated abdominal pain usually resolves spontaneously within 24-48 hours
Petechial Rash The flow chart on this website is useful for highlighting when to investigate but this one is probably the best. NICE say give ceftriaxone if: petechiae start to spread the rash becomes purpuric there are signs of bacterial meningitis there are signs of meningococcal septicaemia the child or young person appears ill to a healthcare professional A non specific viral illness is the most likely cause of the rash.
A BRUE or an ALTE needs thorough history taking and examination.
It is defined as:
“an episode that is frightening to the observer and that is characterized by some combination of apnea (central or obstructive), color change (usually cyanotic or pallid, but occasionally erythematous or plethoric) marked change in muscle tone (usually marked limpness), choking"
ie Apnoea, Looks Different, Tone different, Exhibits unconsciousness
From a medical point of view, it is worth remembering that especially in toddlers who have a low mass, one pill can kill. Especially: - Cardiac drugs - Antidiabetics - Antidepressents - Iron, vicks, pepto - bismul (contains salicylates)
From a mental health point of view - remember to complete all safeguarding paperwork, and encourage talking and communication.
Children’s mental health is a hugely increasing problem of our times. We see it in ED at its worst but remember all parents & carers have to consider their own & their kid’s mental health. Put this poster up in your ED - if it helps 1 family you’ve won #MentalHealthAwarnessWeekpic.twitter.com/boe6ufklSY