Common conditions- paediatrics

when do you offer treatment for headlice 

• Only treat if live lice are seen.

Headlice red flags and referal

• Red Flags: Secondary infection, treatment failure.

• Referral Timescale: 1-2 weeks.

Headlice production selection

• First Line: Dimethicone 4% (Hedrin) - physical insecticide.

• Alternative: Malathion (Derbac M) - chemical insecticide.

• No longer recommended: Permethrin.

• Non-chemical: Wet combing with conditioner.

what is chickenpox 

• Caused by Varicella Zoster virus.

• Incubation: 10-20 days.

• Rash: Red lumps -> vesicles -> crusts. Very itchy.

• Contagious until all lesions have crusted over.

Chickenpox red flags and referral

• Red Flags: Non-blanching rash (Glass Test), secondary infection, exposure in pregnant women.

• Referral Timescale: 1-2 weeks.

Chickenpox lifestyle advice 

Don't scratch, cut nails, cool baths, loose clothing, stay off school until crusted.

what analgesic should not be used in chickenpox

Ibuprofen as linked to severe necrotising of soft tissue

what is slapped cheek disease

• Caused by Parvovirus B19.

• Spread by coughs/sneezes.

• "Slapped cheek" rash on face.

• Only contagious before the rash appears.

Slapped cheek red flags and referrals

• Red Flags: Non-blanching rash, shortness of breath, extreme fatigue (especially in those with blood disorders).

• Referral Timescale: 3 weeks.

slapped cheek product selection

Products: Paracetamol, Ibuprofen, Moisturiser, Antihistamine.

slapped cheek lifestyle

• Lifestyle: Rest, fluids, hygiene. No need to stay off school/work after rash appears.

what is Hand foot and mouth disease

• Caused by Coxsackie virus.

• Spread via coughs, sneezes, poo, and blister fluid.

• Symptoms: Sore throat, fever, mouth ulcers, spots on hands/feet.

• Can be contracted more than once.

Hand, foot and mouth red flags and referral

• Red Flags: Severe headache/fever, confusion, seizures, dehydration.

• Referral Timescale: 7-10 days.

Hand, foot and mouth product selection

• Products: Paracetamol, Ibuprofen, ulcer gels/mouthwashes.

Hand, foot and mouth lifestyle advice

• Lifestyle: Cool fluids, soft foods, good hygiene. Can return to school when feeling well.

what is whooping cough

• Bacterial infection (Bordetella pertussis). A notifiable disease.

• Three phases: Catarrhal (cold-like), Paroxysmal (uncontrolled coughing, whoop, vomiting), Convalescent (improvement).

• Dangerous for babies under 6 months.

whooping cough red flags and referral

• Red Flags: Whooping sound, shortness of breath, vomiting after coughing, babies under 6 months, pregnancy.

• Refer immediately for antibiotics if within 3 weeks of symptom onset.

Whooping cough management

• Treatment: Macrolide antibiotics if early.

• Vaccination: 6-in-1 (babies), Pre-school booster, during pregnancy (16-32 wks).

• Isolation: Stay off until 48hrs after antibiotics start, or 3 weeks if untreated.

Symptoms of chicken pox

• Prodromal symptoms: fever, symptoms, sore throat  

• Rash typically on face and stomach – small red lumps which develop into vesicles which crush after 3-5 days

• Very itchy

Slapped cheek symptoms 

• Cold like symptoms in the days before the rash appears

• Low grade fever may be present

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Symptoms of hand, foot and mouth

• Sore throat

• Temperature

• No wanting to eat

• Mouth ulcers

• Raised spots on hands and feet