Women and Children First?

Cite this article as:
Davis, T et al.. Women and Children First?, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18694

There is an unwritten rule amongst the team at DFTB – equity and equality for all. As conference organizers we have always been proud to have equal gender representation throughout our events – both in terms of keynote speakers and sessional speakers. We took a look at the data to see how common this was in the field of paediatrics. You can see that report here.

Vascular Access: Amanda Ullman at DFTB18

Cite this article as:
Team DFTB. Vascular Access: Amanda Ullman at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18669

We were pleased that Amanda Ullman took up our offer to speak at DFTB after the great post she and the Vascular Access Management Service wrote for us on management of paediatric central access devices. This talk comes complete with trigger warnings. We’ve all been in the situation when we have been confronted with doughy armed toddlers and no sign of a vein in site. The parents, and that patient, are relying on you to get it right.


Given the prime directive of physicians of Primum Non Nocere (First Do No Harm) it is worth considering if we should be cannulating the child in the first place. In a study by Holloway et al. (2017) they found that 22% of PIVCs were unused after insertion. With a success rate of around 60% in our well children, we really to sway the odds further in our favour.

But is also worth considering the flipside – cannulation may be less painful than heel prick for blood sampling in neonates. Amanda asks us to consider if you are the right person to put in that cannula. Should you just ‘give it a go anyway’? Have you been up half the night and can barely focus? Have you just missed you last six cannulae and have something to prove?

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

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Selected References

Deitcher SR, Gajjar A, Kun L, Heideman RL. Clinically evident venous thromboembolic events in children with brain tumors. The Journal of pediatrics. 2004 Dec 1;145(6):848-50.

Hollaway W, Broeze C, Borland ML. Prospective observational study of predicted usage of intravenous cannulas inserted in a tertiary paediatric emergency department. Emergency Medicine Australasia. 2017 Dec;29(6):672-7.

Kleidon TM, Cattanach P, Mihala G, Ullman AJ. Implementation of a paediatric peripheral intravenous catheter care bundle: A quality improvement initiative. Journal of paediatrics and child health. 2019 Jan 31.

Stolz LA, Cappa AR, Minckler MR, Stolz U, Wyatt RG, Binger CW, Amini R, Adhikari S. Prospective evaluation of the learning curve for ultrasound-guided peripheral intravenous catheter placement. The journal of vascular access. 2016 Jul;17(4):366-70.

Takashima M, Schults J, Mihala G, Corley A, Ullman A. Complication and failures of central vascular access device in adult critical care settings. Critical care medicine. 2018 Dec 1;46(12):1998-2009.

Ullman AJ, Cooke M, Kleidon T, Rickard CM. Road map for improvement: point prevalence audit and survey of central venous access devices in paediatric acute care. Journal of paediatrics and child health. 2017 Feb;53(2):123-30.

Varicella and NSAIDs – are you too chicken to prescribe?

Cite this article as:
Alasdair Munro. Varicella and NSAIDs – are you too chicken to prescribe?, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18763

Jaxon is a 3-year-old boy, brought to the ED by his mother with chickenpox because of decreased oral intake. On examination he has a rash consistent with chickenpox, but no red flags. He is febrile and looks uncomfortable, and you note his heart rate is high. You go to prescribe paracetamol, but his mum has given him four doses in the past 24 hours already. You wonder if you can prescribe ibuprofen instead, but your colleague warns against it.

pHirst Aid – Management of Chemical Attacks in Children

Cite this article as:
Anna Dobbie. pHirst Aid – Management of Chemical Attacks in Children, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18552

Chemical attacks (or acid attacks as they are colloquially known) are increasing. The latest numbers show the UK has one of the highest rates of violent acid attacks per capita in the world. The latest figures released report 601 attacks in the UK in 2016 but 400 in first 6 months of 2017. London has emerged as a hot-spot for acid attacks in recent years and it is thought that many attacks still go unreported.

Gender Identity: Stephen Stathis at DFTB18

Cite this article as:
Team DFTB. Gender Identity: Stephen Stathis at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18596

Associate Professor Stephen Stathis has fellowships in both paediatrics and psychiatry. As Medical Director of the Child and Youth Mental Health Services in Brisbane, Australia. He heads up the gender dysphoria service at Queensland Children.s Hospital and in this talk he expands the DFTB queericulum.

In 2017 Aidan Baron started a conversation about the challenges and rewards of communicating with all colours of the LGBTQIA+ rainbow. In this talk Stephen talks about the development of gender expression and helps clarify some of the misunderstandings about being gender diverse. By improving our knowledge, allowing these conversations to take place, we hope we can provide a safe environment for children to be able explore their concerns, without fear of judgement.

 

 

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families. Tickets for DFTB19, which will be held in London, UK, are now on sale from www.dftb19.com.

 

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

 

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ConSEPT and EcLiPSE – Levetiracetam versus Phenytoin for Status Epilepticus

Cite this article as:
Roland D, Davis T. ConSEPT and EcLiPSE – Levetiracetam versus Phenytoin for Status Epilepticus, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18696

This week sees the publication of two hugely anticipated randomised controlled trials both published in the Lancet simultaneously which DFTB have been given exclusive access to.  

Fever under 60 days of age

Cite this article as:
Alasdair Munro & Damian Roland. Fever under 60 days of age, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18571

Prompted by Tessa’s Top 5.5 Papers in PEM presentation at RCEM, Alasdair Munro kicked off an exciting twitter debate with the question…Would you do a full septic screen on a baby under 60 days with a fever?

Many of us will be familiar with the mantra that all children under 3 months get a full septic screen and antibiotics. It feels like we are over-treating, but this is a high risk group so is there any other way?

An aboriginal perspective of teen pregnancy: Cally Jetta at DFTB18

Cite this article as:
Team DFTB. An aboriginal perspective of teen pregnancy: Cally Jetta at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18537

Aboriginal and Torres Strait Island teenagers have a fertility rate four times higher than the general population (57/1000). This disparity is even higher in Western Australia where, in 2014, there were 88 births per 1000 in the Aboriginal and Torreds Strait Islander population compared to just 15 per 1000 in the general population.

Cally Jetta administers the Blackfella Revolution Facebook page – an Aboriginal activism and educational forum that encourages and supports education and understanding.  In this talk she shares her experience and the voices of some brave young women.

 

 

 

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families. Tickets for DFTB19, which will be held in London, UK, are now on sale from www.dftb19.com.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

 

iTunes Button

 

Braithwaite J, Hibbert PD, Jaffe A, White L, Cowell CT, Harris MF, Runciman WB, Hallahan AR, Wheaton G, Williams HM, Murphy E. Quality of health care for children in Australia, 2012-2013. Jama. 2018 Mar 20;319(11):1113-24.

McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. New England journal of medicine. 2003 Jun 26;348(26):2635-45.

Nolan T, Resar R, Haraden C, Griffin F, Gordon A. Improving the Reliability of Health Care. Institute for Healthcare Improvement 2004.

O’Brien M. Leading Reliability Improvement for Safer Healthcare. The Cognitive Institute, 2015.

 

An approach to irritability and pain in the severely neurologically impaired child.

Cite this article as:
Henry Goldstein. An approach to irritability and pain in the severely neurologically impaired child., Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18178

Logan is a 6yo who is presented to ED by his mother, one Tuesday evening as “just not himself“. Logan is well known to your local paediatric team for management of his GMFCS 5 spastic quadriplegic cerebral palsy. He has a long list of comorbidities, frequent hospital attendance and multiple unplanned admissions for, variously, aspiration pneumonia, seizures or irritability ?cause.

Bubble Wrap PLUS – April 2019

Cite this article as:
Anke Raaijmakers. Bubble Wrap PLUS – April 2019, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18568

Welcome to April’s Bubble Wrap Plus, our monthly paediatric journal club provided by Professor Jaan Toelen & his team of the University Hospitals in Leuven (Belgium). This comprehensive list of ‘articles to read’ comes from 34 journals, including Pediatrics, The Journal of Pediatrics, Archives of Disease in Childhood, JAMA Pediatrics, Journal of Paediatrics and Child Health, NEJM, and many more.

This month’s list features answers to intriguing questions (and maybe answers) such as: ‘Do pediatricians follow guidelines when managing status epilepticus in children?’, ‘Does antibiotic prophylaxis for UTI lead to fewer non-UTI infections?’, ‘Is intranasal fentanyl safe for procedural pain management in neonates?’ and ‘Does the early or late introduction of allergens change the development of atopic disease?’.

You will find the list broken down into four sections:

1.Reviews and opinion articles

Helicobacter pylori Infection.

Crowe SE. N Engl J Med. 2019 Mar 21;380(12):1158-1165.

Evaluation of the child with global developmental delay and intellectual disability.

Bélanger SA, et al. Paediatr Child Health. 2018 Sep;23(6):403-419.

Closing the Disclosure Gap: Medical Errors in Pediatrics.

Lin M, et al. Pediatrics. 2019 Mar 13.

Why, when, and how to give surfactant.

Jobe AH. Pediatr Res. 2019 Mar 12.

The pathogenesis and management of renal scarring in children with vesicoureteric reflux and pyelonephritis.

Murugapoopathy V, et al. Pediatr Nephrol. 2019 Mar 7.

Communication with children and adolescents about the diagnosis of a life-threatening condition in their parent.

Dalton L, et al. Lancet. 2019 Mar 16;393(10176):1164-1176.

Communication with children and adolescents about the diagnosis of their own life-threatening condition.

Stein A, et al. Lancet. 2019 Mar 16;393(10176):1150-1163.

Paediatric sarcoidosis.

Nathan N, et al.Paediatr Respir Rev. 2019 Feb;29:53-59.

Human milk as “chrononutrition”: implications for child health and development.

Hahn-Holbrook J, et al.Pediatr Res. 2019 Mar 11. 

2. Original clinical studies

Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016.

Norman M, et al. JAMA. 2019 Mar 26;321(12):1188-1199.

Management of status epilepticus in children prior to medical retrieval: Deviations from the guidelines.

Uppal P, et al. J Paediatr Child Health. 2019 Mar 28.

What Do NICU Fellows Identify as Important for Achieving Competency in Neonatal Intubation?

Brady J, et al.Neonatology. 2019 Mar 19;116(1):10-16.

Achieving Procedural Competency during Neonatal Fellowship Training: Can Trainees Teach Us How to Teach?

Marrs LK, et al.Neonatology. 2019 Mar 19;116(1):17-19.

Impact of Trimethoprim-sulfamethoxazole Urinary Tract Infection Prophylaxis on Non-UTI Infections.

Desai S, et al.Pediatr Infect Dis J. 2019 Apr;38(4):396-397.

Sleep Problems in Children With Autism and Other Developmental Disabilities: A Brief Report.

Valicenti-McDermott M, et al.J Child Neurol. 2019 Mar 17:883073819836541.

A Validated Scale for Assessing the Severity of Acute Infectious Mononucleosis.

Katz BZ, et al.J Pediatr. 2019 Mar 7.

Effect of Sustained Inflations vs Intermittent Positive Pressure Ventilation on Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants: The SAIL Randomized Clinical Trial.

Kirpalani H, et al. JAMA. 2019 Mar 26;321(12):1165-1175.

High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years.

Brustad N, et al. JAMA. 2019 Mar 12;321(10):1003-1005.

High-Dose Vitamin D Supplementation Does Not Prevent Allergic Sensitization of Infants.

Rosendahl J, et al. J Pediatr. 2019 Mar 19. pii: S0022-3476(19)30245-8.

Timing of introduction of allergenic solids for infants at high risk.

Abrams EM, et al. Paediatr Child Health. 2019 Feb;24(1):56-57.

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods.

Greer FR, et al. Pediatrics. 2019 Mar 18. pii: e20190281.

Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): a randomised controlled, open-label, blinded-endpoints, phase 3 trial.

Hamada H, et al. Lancet. 2019 Mar 16;393(10176):1128-1137.

Pediatric Celiac Disease and Eosinophilic Esophagitis: Outcome of Dietary Therapy.

Patton T, et al. J Pediatr Gastroenterol Nutr. 2019 Mar 26.

Host and Bacterial Markers that Differ in Children with Cystitis and Pyelonephritis.

Shaikh N, et al. J Pediatr. 2019 Mar 21. pii: S0022-3476(19)30027-7.

Montelukast and Neuropsychiatric Events in Children with Asthma: A Nested Case-Control Study.

Glockler-Lauf SD, et al. J Pediatr. 2019 Mar 21. pii: S0022-3476(19)30198-2.

Physical Fitness, Physical Activity, and the Executive Function in Children with Overweight and Obesity.

Mora-Gonzalez J, et al. J Pediatr. 2019 Mar 19. pii: S0022-3476(18)31745-1.

Does discharging clinically well patients after one hour of treatment impact emergency department length of stay for asthma patients.

Lenko D, et al. J Paediatr Child Health. 2019 Mar 20.

Characterization of Esophageal Motility in Infants with Congenital Diaphragmatic Hernia using High Resolution Manometry.

Rayyan M, et al. J Pediatr Gastroenterol Nutr. 2019 Mar 5.

Effect of metronome guidance on infant cardiopulmonary resuscitation.

Kim CW, et al. Eur J Pediatr. 2019 Mar 8.

Expressions of Gratitude and Medical Team Performance.

Riskin A, Bamberger P, et al. Pediatrics. 2019 Mar 7.

A cohort study of intranasal fentanyl for procedural pain management in neonates.

McNair C, et al. Paediatr Child Health. 2018 Dec;23(8):e170-e175.

Traumatic brain injury in young children with isolated scalp haematoma.

Bressan S, et al. Arch Dis Child. 2019 Mar 4.

Association of Atopic Dermatitis With Sleep Quality in Children.

Ramirez FD, et al. JAMA Pediatr. 2019 Mar 4:e190025.

3. Guidelines and best evidence

Prevention of Drowning.

Denny SA, et al.Pediatrics. 2019 Mar 15.

Lack of Sleep and Sports Injuries in Adolescents: A Systematic Review and Meta-Analysis.

Gao B, et al. J Pediatr Orthop. 2018 Nov 28.

Guidelines for vitamin K prophylaxis in newborns.

Ng E, et al. Paediatr Child Health. 2018 Sep;23(6):394-402.

School, child care and camp exclusion policies for chickenpox: A rational approach.

Bridger NA. Paediatr Child Health. 2018 Sep;23(6):420-427.

4. Case reports

An 11-Month-Old Male With Acute-Onset Left-Sided Facial Paralysis.

Posa M, et al.Clin Pediatr (Phila). 2019 Mar 22:9922819837354.

A Lower-limb Skin Lesion in a 10-year-old Girl.

Koirala A, et al. Pediatr Infect Dis J. 2019 Apr;38(4):e79.

Exercise-Induced Purpura in Children.

Paul SS, et al.Pediatrics. 2019 Apr;143(4).

 

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!

Please join us for our next #DFTB_JC on twitter…The DFTB/ADC Journal Club is a monthly collaboration between @DFTBubbles and @ADC_BMJ featuring a FREE access article from the latest issues of Archives of Disease of Childhood.

Married to the Mob: Clare Dimer at DFTB18

Cite this article as:
Team DFTB. Married to the Mob: Clare Dimer at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18327

Clare Dimer is a senior social worker in WA’s Department of Health. In this talk she talks of the challenges faced by indigenous Australians today.

At the beginning of the 18th century there were over 250 languages spoken in Australia. By the start of this century only 150 are in daily use.  Language and culture pay a huge part in healthcare and an understanding of this should helps inform how we – as doctors, nurses, social workers – can help our indigenous patients.

 

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story’ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families. Tickets for DFTB19, which will be held in London, UK, are now on sale from www.dftb19.com.

 

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

 

iTunes Button

 

Braithwaite J, Hibbert PD, Jaffe A, White L, Cowell CT, Harris MF, Runciman WB, Hallahan AR, Wheaton G, Williams HM, Murphy E. Quality of health care for children in Australia, 2012-2013. Jama. 2018 Mar 20;319(11):1113-24.

McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. New England journal of medicine. 2003 Jun 26;348(26):2635-45.

Nolan T, Resar R, Haraden C, Griffin F, Gordon A. Improving the Reliability of Health Care. Institute for Healthcare Improvement 2004.

O’Brien M. Leading Reliability Improvement for Safer Healthcare. The Cognitive Institute, 2015.