Paediatrics


View the latest children’s guidelines and information essential to paediatric emergency practice.

 

Paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. In New South Wales (NSW) Australia the age limit of such patients ranges from birth to16 years of age.

Within Emergency departments in NSW Paediatric’s can represent between 20-30% of daily presentations.

It’s an old saying in medical management of paediatric patients that “Kids are not just small adults”. They are a diverse group of people. They vary enormously in weight, size, shape, intellectual ability and emotional response. At birth a child is on average 3.5kg, 50cm long individual with small respiratory and cardiovascular reserves and an immature immune system. They are capable of limited movement, exhibit limited emotional responses and are dependant upon adults for all there needs, Fourteen or more years later the adolescent is 50kg, 160cm tall and looks like an adult.

The key differences to consider in children are;

1. Weight

2. Anatomical- size and shape

3. Physiological – cardiovascular, respiratory, immune function

4. Psychological – intellectual ability and emotional response.

Competent management of the ill or injured paediatric patient who may fall anywhere between the two extremes requires a knowledge of the anatomical, physiological and emotional differences, and the strategies on how to deal with them.

Paediatric Emergency care also involves a holistic approach rather than just patient only orientated care. Parents, carers and sibling should always be considered with any treatment or intervention. Just remember the one who knows them best is the one who can advise you what is or is not normal.

In 2004 The NSW Department Of Health with the assistance of both the Clinical Excellence Commission & The NSW Child Health Network began the implementation of the Acute Paediatric Clinical Practice Guidelines that apply to all facilities where paediatric patients are managed.

The clinical practice guidelines have been prepared for the NSW Health Department by an expert clinical reference group, This was under the auspice of the Statewide Paediatric Steering Committee.

The guidelines produced cover the most common paediatric presentations to Emergency departments. Since 2009 the publication of the revised & updated Acute Paediatric Clinical Practice Guidelines have taken place.

Since the Garling report was published in 2008, the management of Paediatric services in NSW has undergoing major changes, with all paediatric services soon to fall under the NSW KIDS banner. This has will see the merger of both tertiary referral hospitals in Sydney (Westmead & Randwick).

In non-tertiary referral centre’s help is just a phone call away with NETS (newborn and emergency transport service) being the emergency service for sick or injured babies, infants and children needing transfer to a specialist perinatal or paediatric centre.

Originally established in 1979, NETS incorporated various hospital-based services to become a single statewide service in 1995.

Today, NETS provides a service to over 250 hospitals in NSW, the ACT and beyond. NETS is staffed by a dedicated team of doctors, nurses, ambulance drivers, technical and support staff who maintain a 24 hour a day; 7 day-a-week service. Specialist transport nurses in the Clinical Coordination Centre are the front line of the Service; taking calls from hospitals small and large. They link the caller with a NETS retrieval specialist to give advice and chair a discussion with specialists from a wide range of tertiary hospitals.

The NSW Health Department Website CIAP has valuable Paediatric resources, some of which have been recent additions or hard to find, here is a list of some valuable resources within the website;

• PEMSOFT can be found in the Clinical Decisions Support folder.

• Paedaitric Pharmacopoeia can be found in the Medicine Information folder.

• The NSW Acute Paediatric Clinical Practice Guidelines can be found in the Clinical Guideline folder.

• Children’s Hospital @ Westmead Handbook can be found in the online books folder.

• Paediatric Emergency Journal can be found in the Online Journal folder – Full CIAP Journal List.

Paediatric Clinical Guidelines:

Click below to read interesting journal articles: