childhood Flashcards
Who may be involved in the care of an acutely ill child?
parents and carers, reception staff, practice nurses, nurse practitioners, midwife, health visitors, school nurses and teaching staff, ambulance service and hospital paediatrics
what are the 3 steps involved in examination of a child?
The steps involved in the examination of a child can be divided into history
examination - basic tests, temp check, obs, o2 saturation
and clinical tests - physical examination tests, ascultations
Why is child health an important aspect to consider in primary care and as a GP? (4 marker)
- Childhood is a time of huge development and change therefore there are many opportunities for health promotion and early intervention
- Having regular contact throughout childhood with primary care allows the formation of a longitudinal relationship to be built
- There are various settings for intervention to take place throughout childhood which could be beneficial
- Also important to monitor and learn how a child responds to an illness – learning aspect since there is a range of illnesses common in children
Name 3 key child health professions/players.
- GPs
- Midwife
- Nurses
- Health Visitors
- Dentists
- Paediatricians
- Teachers/ School Staff
Why is safeguarding a key element of a child’s health?
- Ensures that all children grow up in the same circumstances with consistent safe and effective care
- Enables children to have the best outcome by taking action
- Protects children from maltreatment that can impair a child’s health or development
What is special about child health?
Time of huge development and change
Opportunities for health promotion and early intervention
Regular contact with primary care, longitudinal relationship
Spectrum of health care practitioners
Spectrum of settings for intervention
Range of illness in children
How children respond to illness
who is involved when a child is born? at birth
Neonatal check- paediatrician or midwife Other health care practitioners at hospital Care passed to Primary Healthcare Community Midwife Health Visitor GP and practice team
What happens during 8 week baby check?
Performed at the GP surgery usually with first immunisations (GP/Practice Nurse)
Head to toe examination (aided by history):
Head, eyes, palate
Tone, heart, chest, abdomen
Genitalia, anus, hips, femoral pulses
Spine, arms and hands, legs and feet, skin
To detect medical problems and provide early diagnosis
Improve outcome and plan services
Who are some health professionals that may become involved in the care of a child?
Eyes (red reflex)- ophthalmology
Palate – maxillo facial surgeon
Heart (murmur)- cardiac sonographer/ cardiologist
Hips (clicking)- ultrasonographer/ physio/ orthopaedic surgeon
Feet (talipes)- physio/ orthopaedics
Suspected Down’s syndrome (facial features, palmar crease, murmur) - paediatrician
What is the PCHR?
Personal child health record. aka ‘red book’
given to new parents soon after birth by health visitor
What are the sections in the redbook?
- Child and family details
- Information and advice
- Immunisations
- Screening and routine
- Your child’s firsts and growth charts
Whats involved in child health surveillance?
Health and development review: 8 week and 2 years
School height, weight check, vision and hearing
Flu immunisation at school
Dental check ups
Health visitor, GP, Practice Nurse, Dentist, School nurse
What is safeguarding children defined as?
-protecting children from maltreatment
-preventing impairment of children’s health or development
-ensuring that children grow up in circumstances consistent with the provision of safe and
effective care
-taking action to enable all children to have the best outcomes
who is involved in safeguarding?
All staff within health services have a key role to play in safeguarding and promoting the welfare
of unborn babies, children and young people
what are the nice guidelines of when to suspect child maltreatment?
listen and observe seek an explanation record consider, suspect or exclude child maltreatment record.
why is herd immunity important?
It is more difficult for diseases to spread between individuals if large numbers are already
immune, and the chain of infection is broken
What are some measures being taken to improve vaccine uptake
Empowering people - engage patients and public in their own healthcare needs
Communications and education - Profile of the immunisation programmes accross the life course, education of general population including health literacy in schools
Evidence based - Targeted interventions for specific communities who are unserved by vaccination services, Access to good quality online training
Technology - To effectively utilise new vaccines as they become available, to enable diff forms of delivery
What are 3 posibble outcomes to vaccine uptake measures
1) Improved patient experience and empowerment, measured through the MIMO and patient feedback
2) Increased uptake and coverage across London
3) Responsible, flexible and integrated services to maximise coverage across programmes, measured through coverage rates.
What are some barriers to success in vaccine uptake measures?
Compliancy amongst health proffesionals to dicuss immunisations
Vaccine hesitancy
Shortage of vaccination appointment slots
Highly mobile population
Variation in uptake by practice and across london
Shortage of trained immunisation workforce
what are some effects of hpv?
cervical cancers
cancer of anus, penis, mouth and throat in men
hpv vaccine is free! in sexual health and HIV clinics
what are some policy issues in health promotion and early intervention?
childhood obesity
sugar intake
healthy eating
exercise
How Primary Care fits in with these policy
issues
pportunistic advice when attend for acute/chronic illness.
Present facts/ information with a non-judgmental approach e.g. measure weight and advise
on what a healthy weight is.
Offer support
Offer follow up
Health promotion literature- leaflets, posters, web links
Website: information, videos
Limitations of primary care with policy issues
10 minute consultation
Many children are not seen at the GP surgery for many months at a time.
Numerous roles of the Primary Healthcare team, and is this one of their roles?
what is autism
Autism is a lifelong developmental disability that affects how people perceive the world
and interact with others.
Autistic people see, hear and feel the world differently to other people.
what are some examples of accute ilnesses?
conjuctivitis - eye infection urti thyrotoxicosis - overactive thyroid purpuric rash Injuries - cuts infections tonsilitis/tonsil stones asthma?
common acute ilness in primary care?
Feverish illness accounts for 40% of new episodes children consulting
Infections account for 29% of paediatric consultations
Serious infections account for <1% of infections presenting to primary care
What are some non-infective causes of acute ilness?
V: Vascular I: infective/inflammatory T: traumatic A: autoimmune M: metabolic I: iatrogenic/idiopathic N: neoplastic C: congenital D: degenerative/developmental E: endocrine/environmental F: functional
Who may be involved in care of the acutely ill child?
Parents and carers • Reception staff • Practice nurse • Nurse practitioner • Midwife • Health visitor • School nurse or teaching staff • Ambulance service • Hospital paediatrics
how to manage clinical uncertainty in accutely ill child?
History g Examination g Additional tests g Guidelines g Parental concern g Clinician impression
what is one the most common diseases in early infancy and childhood?
acute otitis media
Current NICE guidelines
management acute otitis media
in primary care.
Developed by panel of convened independent experts, with consultation with stakeholders
”for most people advise a no antibiotic prescribing strategy or a delayed antibiotics strategy”.
Offer reassurance Antibiotics make little difference to symptoms.
May have adverse effects
Contribute to antibiotic resistance
Safety net if condition worsens or non response to treatment
