We had two kids consecutive weeks when I did Paeds who were sent in with
petechiae on one leg only.
First we looked at and sent home having decided that the nappy had been
too tight on that leg (it was very tight). The second one I saw with a
different Reg who did the full works of the wheelbarrow - well all but
the LP - nothing came of it. We didn't give penicillin.
Surely the penicillin thing in part depends on how far away your nearest
Paed unit is and how you send them in. If its 5 minutes away and they go
by ambulance then by the time you have found your penicillin, a needle
and a syringe and given it to them they could have been in hospital
anyway. If the unit is 30 minutes away, its rush hour and you are
sending with the parents then they need an injection.
Are you going to discuss how you get these patients to hospital as well?
Worth thinking about - if it is septicaemia and they go off being stuck
in traffic in a car with mum on her own is not ideal.
I am SO glad I am not working at the moment!
In message <[log in to unmask]>
, Paul Bromley <[log in to unmask]> writes
>Had one of these in the surgery last week as did my partner and a
>further one today. Last week - child had been wretching, hence this
>may have been the cause. Today however - kid had not. He was apyrexial
>and nothing else could be found and looked well and was well. As I say
>- no coughing, vomiting or wretching.
>
>I sent him to paediatrics, as I always do, despite thinking not
>meningococcal. I do this because 20 years ago had such a kid one
>Thursady evening that I thought was completely innocent and this did
>turn out to be meningococcal.
>
>What do the panel think? More importantly, would you give penicillin
>to these kids?? Asking the latter as I discussed this with my partner
>and our Nurse Prcatitioner last week. NP asked what she should do if
>we were not here. I said that medicolegally and clinically the kids
>should be given penicillin if I half suspected Meningococcus. We were
>going to discuss as a significant event and thrash out whether to have
>a protocol to force us to give penicillin.
>
>
>
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Pork
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