There is nothing like the thought of dealing with a shocked neonate to strike the fear of the almighty into the most experienced doctor. If you are lucky enough to have Kath Browning Carmo on speed dial then you may be a little more relaxed but if you don’t, here she is to offer some words of comfort.
Ari Horton is many things – an advocate for kindness, a Cordon Bleu trained pastry chef and, just very occasionally, a paediatric cardiologist. Andrew Tagg remembers the day Ari found his calling. Working as a paediatric ED resident in Melbourne’s inner west he came to present a patient. He could barely sit still and his grin threatened to infect the fishbowl as he announced, “I found a murmur!”
We may not all be as acoustically gifted as Ari but that thing we wield around our necks is not just for listening for wheezes or for distracting toddlers.
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?
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.
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.
Dr Andrew McDonald worked as a paediatrician for many years before entering the world of politics. In his years as Shadow Minister for Health he continued to practice one day a week. In both roles he saw the impact that socio-economic status has on health and continues to do what he can to make difference. Why should those that need access to excellent health care not be afforded more healthcare resources? If you can afford to pay you can get in to see a private paediatrician in a week but if you are relying on the public system it is a matter of months. Andrew McDonald challenges the audience to think on this, and who they are really helping.
It can be hard to stand up to the status quo but if you are serious about helping people you must.