2017 HCHB_digital
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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 />
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