Paediatrics - Queensland Health - Queensland Government

Respiratory problems
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Mild pneumonia
• MO may advise:
-- chest x-ray if available
-- oral or IM antibiotics
-- antibiotics may not be indicated if typical of viral infection or bronchiolitis
• Encourage rest and increase oral fluids
• Treat fever with regular paracetamol to make more comfortable
Moderate / severe pneumonia
• Give O to maintain O saturation >95% (if not already in place). If > 95 % not
2 2
maintained consult MO. See O delivery systems
2
• Give oral fluids as tolerated
• MO may advise:
-- insert IV cannula - if possible take blood cultures prior to commencing
antibiotics
-- IV fluids - it is usual to start with normal saline or Hartmann’s solution; MO will
advise quantities and rate
-- to commence IV antibiotics
• Evacuation / hospitalisation
• Give analgesia
See Simple analgesia back cover
5. Follow up
Patients with mild pneumonia who are not evacuated / hospitalised should be
reviewed daily
Consult MO if the patient is not improving
See next MO clinic
6. Referral / consultation
Consult MO on all occasions pneumonia is suspected
Some children with pneumonia will require a paediatric referral
References
1. Therapeutic Guidelines. Pharyngitis and/or tonsillitis. 2010 [cited 2011 January].
2. Queensland Health, Expansion of Free Pertussis Vaccine Program, in Immunisation Program. 2011:
Brisbane.
3. Therapeutic Guidelines. Pertussis. 2010 [cited 2011 March].
4. Therapeutic Guidelines. Acute epiglottitis (supraglottitis). 2010 [cited 2011 March].
5. The Royal Children’s Hospital. Croup (Laryngotracheobronchitis). 2009 [cited 2011 March ].
Controlled copy V1.0
Primary Clinical Care Manual 2011