Examining for a cleft palate

A 6 week old baby is referred with poor feeding. On examination you notice a cleft palate that has been previously undetected at the earlier babychecks. What is the best way to examine newborns in order to detect all cleft palates? The RCPCH and NICE have released a joint consensus guideline (October 2014) on best…

Appendectomy or antibiotics?

Appendicitis is a common diagnosis in ED, and once it is confirmed clinically or on ultrasound, the patient usually goes pretty quickly to theatre for an appendectomy. But is a course of antibiotics just as effective as taking these kids to theatre?

Finger Tips

4 year old Dudley is brought into your emergency department by his hysterical mother. In between breathless sobs she tells you how she accidentally slammed the car door shut on his hand.  She is convinced he has lost a finger given how much he is screaming.

Torn frenulum

Marcus, 15, looks very embarrassed as he is brought into the fast track cubicle by his mother. His shuffling gait and poor eye contact suggest he has a ‘personal problem’ but he doesn’t want to discuss it until his mother leaves.

Minor burns

Jasmina, a five old girl, is brought in by her mother after a Sunday afternoon barbecue.  Having had very little for breakfast she became very excited when the burgers came out and reached out to grab one from the grill burning her hand.  Bottom line Simple first aid is often forgotten and cold running water…