Paediatrics - Queensland Health - Queensland Government

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Respiratory problems Schedule 4 Roxithromycin DTP IHW / SM R&IP / IPAP Authorised Indigenous Health Workers and Isolated Practice Area Paramedic must consult MO / NP Scheduled Medicines Rural & Isolated Practice Registered Nurses may proceed 564 Form Strength Tablet for suspension Tablet 50 mg 150 mg 300 mg Route of administration Oral Controlled copy V1.0 Recommended dosage Child 4 mg / kg / dose bd to a max. of 150 mg bd Duration 10 days Provide Consumer Medicine Information: should be taken on an empty stomach, 15 minutes before food; ensure course is completed Management of associated emergency: consult MO [1] 5. Follow up Review next day, if not improving consult MO If antibiotics have been given for sore throat: - - review in 2 weeks - - ask about sore joints, chest pain, breathlessness and check urinalysis - - consult MO if symptoms persist see Rheumatic fever or if abnormal urinalysis see Acute post streptococcal glomerulonephritis 6. Referral / consultation Consult MO as above or if symptoms persist despite symptomatic treatment If recurrent tonsillitis (>6 episodes per year) MO may consider prolonged course of prophylactic penicillin or referral to ENT specialist for consideration for tonsillectomy / adenoidectomy Pertussis (whooping cough) Recommend If adults and teenagers present with pertussis ask about young babies at home as pertussis is a particularly severe disease in infants < 12 months of age It is important to explain that coughing may continue for 6 - 8 weeks after treatment and may recur with the next URTI. The recurrence will not last long In Queensland free pertussis vaccine is now available for birth parents, foster parents, adoptive parents, grandparents of babies < 6 months of age and other adults in a household with a baby < 6 months of age [2] Background Pertussis (whooping cough) is still common Incubation period is on average 7 - 10 days Pertussis is a prolonged illness and can be complicated by apnoea in infants, pneumonia, hypoxic brain injury, seizures or lead to chronic lung disease Related topics Immunisation program URTI Primary Clinical Care Manual 2011
Respiratory problems 1. May present with • URTI symptoms • Cough (typically paroxysmal i.e. intermittent episodes of prolonged coughing followed by the characteristic inspiratory ‘whoop’ as the child catches his / her breath) • Vomiting, typically after an episode of coughing • Cyanosis, typically during an episode of coughing • Young babies usually do not have the characteristic whoop but are likely to be very distressed by coughing and vomiting. They can develop apnoea (stop breathing) and become cyanosed during a coughing bout • Adults usually have a persistent troublesome cough only, without a whoop. A cough of several weeks duration, that is worse at night, in an adult, is pertussis until proven otherwise 2. Immediate management • If severe consult MO immediately 3. Clinical assessment • See Upper respiratory tract infection • The ‘whoop’ can be characteristic but may not always be present. The child may not be distressed in periods between paroxysms of coughing, with few clinical signs, however the overall impression is of a sick child • Check vaccination status. See Immunisation program 4. Management • Consult MO who may advise: -- evacuation / hospitalisation if young child (< 6 months) or if symptoms are significant, appropriate tests to confirm diagnosis - serum for IgA and / or nasopharyngeal aspirate / swab for PCR testing and / or MC/S -- antibiotics may shorten the length of the illness if given early and will also reduce infectivity to others. Person can be considered not infective after 5 days of treatment. It is important to explain that coughing will continue for 6 - 8 weeks, and may recur with the next URTI. The recurrence will not last long -- household and child care contacts may require prophylactic antibiotics to prevent further clinical cases of pertussis -- advise to avoid contact with other individuals, especially young children and infants until at least 5 days of antibiotics have been received [3] -- consult Public Health Unit for advice 5. Follow up If not evacuated / hospitalised review daily, at least initially 6. Referral / consultation Consult MO on all occasions whooping cough is suspected Primary Clinical Care Manual 2011 Controlled copy V 1.0 565
Page 1 and 2: Section 6 Paediatrics
Page 3 and 4: Paediatric presentation History and
Page 5 and 6: Paediatric presentation Presentatio
Page 7 and 8: Paediatric presentation Standard cl
Page 9 and 10: Paediatric presentation Physical ex
Page 11 and 12: Child with fever Fever is usually a
Page 13 and 14: Child with stridor Stridor is a har
Page 15 and 16: Any history of significant trauma?
Page 17 and 18: Meningitis Meningitis Recommend Co
Page 19 and 20: 6. Referral / consultation Consult
Page 21: Respiratory problems • For the ch
Page 25 and 26: Respiratory problems 4. Management
Page 27 and 28: Child < 3 months Contact MO immedia
Page 29 and 30: Immune complications Acute post st
Page 31 and 32: Immune complications Schedule 4 Ben
Page 33 and 34: Immune complications Acute rheumat
Page 35 and 36: Immune complications Australian gui
Page 37 and 38: presence of RHD Place person on Re
Page 39 and 40: Ear problems • Clean the ear usin
Page 41 and 42: Ear problems Acute otitis media (A
Page 43 and 44: Ear problems Schedule 4 Roxithromyc
Page 45 and 46: Ear problems 4. Management • Give
Page 47 and 48: See Simple analgesia back cover Ear
Page 49 and 50: Ear problems 6. Referral / consulta
Page 51 and 52: Ear problems 5. Follow up Children
Page 53 and 54: Ear problems Ear discharge in the p
Page 55 and 56: Ear problems 4. Management • Cons
Page 57 and 58: Ear problems Schedule 4 Flumethason
Page 59 and 60: Ear problems Foreign body / insect
Page 61 and 62: Gastrointestinal problems Acute gas
Page 63 and 64: Gastrointestinal problems 4. Manage
Page 65 and 66: Gastrointestinal problems • Bottl
Page 67 and 68: Gastrointestinal problems Nutrition
Page 69 and 70: 5. Follow up Review 1 - 2 days aft
Page 71 and 72: Gastrointestinal problems Intestin
Page 73 and 74:
Gastrointestinal problems Schedule
Page 75 and 76:
Gastrointestinal problems 4. Manage
Page 77 and 78:
Gastrointestinal problems Intussusc
Page 79 and 80:
Gastrointestinal problems • Perfo
Page 81 and 82:
Gastrointestinal problems Backgroun
Page 83 and 84:
Schedule 2 Folic Acid Gastrointesti
Page 85 and 86:
Urinary tract problems References 1
Page 87 and 88:
Urinary tract problems ○ where no
Page 89 and 90:
Bone and joint problems 3. Clinical
Page 91 and 92:
Abuse and neglect 2. Immediate mana
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Paediatrics - Queensland Health - Queensland Government

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