14.02.2018 Views

2017 HCHB_digital

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

CONTINUING OTC EDUCATION<br />

Well Child Programme<br />

All New Zealand children, from birth to five years, are entitled to participate in the free Well<br />

Child programme (www.wellchild.org.nz), a package of 12 core health contacts plus a general<br />

practitioner check at six weeks, corresponding to the six-week immunisations.<br />

Pharmacy staff should encourage customers with young children to fully access this programme,<br />

particularly those servicing low socioeconomic areas, as good health in a child's early years sets<br />

the foundation for a life-long good health and well being.<br />

Observation and assessment of the child's health and development is undertaken during each<br />

visit, as well as discussions about breastfeeding, immunisations, and safe sleeping practices. Any<br />

concerns about a child's vision and hearing can also be investigated further.<br />

Well Child also serves to provide support to the baby's mother, and can help with bonding<br />

problems, parenting skills, mental health concerns, income or housing issues, or alcohol or<br />

substance misuse disorders.<br />

• displaying and discussing information on the relative risks and benefits of<br />

immunisation<br />

• informing customers about current epidemics and checking their immunisation status.<br />

Some immunisations can cause pain and fever. While the use of paracetamol<br />

or ibuprofen to relieve pain or discomfort immediately prior to or following<br />

vaccination is not contraindicated, experts do not recommend that pain-relieving<br />

medicines be routinely used as use has been associated with a lower immune<br />

response. However, if a child is distressed by fever, discomfort or pain following<br />

immunisation, they may be given.<br />

Report any suspected adverse reactions to vaccines to the Centre for Adverse<br />

Reactions Monitoring (for details about how to report see Medicines Safety,<br />

page 183).<br />

Initial assessment<br />

The majority of children who are unwell, look unwell, but it can be difficult to tell<br />

whether a child is seriously ill or not. Always encourage caregivers with unwell<br />

children to talk to the pharmacist, unless they have already seen a doctor and are<br />

comfortable with looking after the child.<br />

Any child with difficulty breathing, with a blue tinge around the lips or tongue,<br />

having difficulty feeding or refusing to drink, who is overly sleepy or floppy, feels<br />

cold to the touch, is not urinating, or is under three months old and looks unwell<br />

needs urgent medical attention.<br />

Always be mindful that most childhood diseases are contagious, and<br />

pharmacy staff are at high risk of exposure to some of these conditions that<br />

are still prevalent in the community, particularly during epidemics. Unimmunised<br />

pharmacy staff without natural immunity to common infections need to be<br />

particularly careful, and should be encouraged to bring their immunisation status<br />

up to date.<br />

Refer to a<br />

PHARMACIST/DOCTOR<br />

Refer all children with suspected infectious diseases to a pharmacist<br />

for further advice and evaluation.<br />

For each infectious disease on the following pages, guidance is<br />

offered on when pharmacists should refer customers to their doctor.<br />

General management advice<br />

Children should remain at home until they are no longer infectious (see<br />

individual conditions on the following pages). If possible, infected children<br />

should be kept away from pregnant women, newborn babies or any person who<br />

is immunocompromised (eg, with cancer, HIV, organ transplant recipients) until<br />

they are no longer infectious. Advise parents or caregivers to:<br />

• observe their child frequently and seek urgent medical advice if they are<br />

worried or the child seems in distress<br />

• keep offering their child fluids to avoid dehydration. If their child refuses even<br />

small sips, they should seek medical advice urgently<br />

• wash and dry their hands frequently, especially before and after tending to a<br />

sick child<br />

• dress their child in light, loose-fitting clothing or pyjamas and encourage their<br />

child to rest in a half-darkened room<br />

• only administer pain relief, such as paracetamol, occasionally if needed to<br />

relieve a child’s discomfort (see Fever for more information)<br />

» Aspirin should not be given to children under 18 years (unless under<br />

medical advice) due to the risk of Reye’s syndrome (see Childhood Pain<br />

and Baby Teething for more information).<br />

• trim their child's fingernails short to discourage scratching which may lead to<br />

infection.<br />

Some diseases may require specific medicines prescribed by a doctor (see<br />

individual listings for details).<br />

Now you can complete<br />

your ENHANCE modules on<br />

your phone or tablet<br />

www.pharmacytoday.co.nz<br />

Page 25

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!