International Child Health Care: A Manual for Hospitals Worldwide

Contents......Page 4
Contributors......Page 13
Preface......Page 18
Foreword......Page 20
Introduction......Page 22
SECTION 1: Philosophies of care: hospital facilities, services and their organisation......Page 24
1.1 The UN Convention on the rights of the child – 1989......Page 26
1.2 Hospital non-clinical support services and facilities......Page 27
1.3 UNICEF/WHO baby friendly hospital initiative (BFHI)......Page 31
1.4 Child friendly healthcare......Page 33
1.5 Ethical systems within the hospital......Page 35
1.6 Prevention of hospital-acquired infection......Page 39
1.7 Nursing and sick children......Page 42
1.8 Other “work-related” issues for healthcare staff......Page 43
1.9 Fundamental needs of sick children and their families......Page 45
1.10 Continuing medical education (CME) for healthcare professionals......Page 48
1.11 Essential imaging facilities......Page 50
1.12 Essential operating theatre resources......Page 52
1.13 Paediatric anaesthesia......Page 54
1.14 Safe paediatric and neonatal transfusion practice......Page 60
1.15 Essential laboratory services for sick and injured children in hospital......Page 64
1.16 Management of drugs......Page 67
1.17 Essential equipment, supplies and drugs for treating children in hospital......Page 69
1.18 Records, history taking and examination......Page 83
1.19 Essentials of triage and paediatric life support......Page 85
1.20 Cardiorespiratory arrest......Page 88
1.21 Intraosseous infusions for circulatory collapse......Page 93
1.22 Resuscitation of the newborn......Page 94
1.23 Anaphylactic shock......Page 98
1.24 Self-instructional educational programmes in neonatal resuscitation and perinatal care......Page 100
1.25 Intensive/high-dependency care of critically ill and injured children......Page 103
1.26 Non-invasive respiratory support......Page 107
1.27 Pain control in children......Page 110
1.28 Palliative care for the dying child......Page 118
1.29 Immunisation......Page 131
1.30 Recognition of vulnerable children and the management of child ill-treatment and abuse......Page 134
1.31 Facilities for children with special needs and learning difficulties......Page 136
SECTION 2: Presenting symptoms and clinical signs of illness and aspects of management......Page 140
2.1 Abdominal pain......Page 142
2.2 Anaemia......Page 144
2.3 Diarrhoea......Page 146
2.4 Jaundice......Page 147
2.5 Lymphadenopathy......Page 148
2.6 Fits, faints and apparent life threatening events (ALTE)......Page 149
2.7 Generalised oedema......Page 150
2.8 Rash......Page 151
2.9 Respiratory distress......Page 152
2.10 Vomiting......Page 153
2.11 Wasting/failure to thrive......Page 155
2.12 Headaches......Page 156
2.13 Limp, joint pains and swelling......Page 158
2.14 Fever of unknown origin......Page 159
2.15 Cough, wheeze and stridor......Page 161
Difficult Breathing......Page 164
Upper Airway Obstruction......Page 165
Convulsion......Page 166
Shock......Page 167
Abdominal Pain......Page 168
Neonatal Jaundice......Page 169
Jaundice......Page 170
Vomiting......Page 171
Anaemia......Page 172
Fever......Page 173
Coma......Page 174
SECTION 3: Management of system and organ dysfunction......Page 176
3.1 Acute respiratory infection......Page 178
3.2 Physiotherapy for suppurative lung disease......Page 184
3.3 Asthma......Page 186
3.4 Cystic fibrosis......Page 189
3.5 Cardiac problems......Page 193
3.6 The child in shock......Page 207
3.7 Medical renal problems......Page 211
3.8 Vesicoureteric reflux......Page 226
3.9 Acute liver failure......Page 227
3.10 Chronic liver disease......Page 231
3.11 Endocrinology......Page 236
3.12 Hypoglycaemia......Page 245
3.13 Psychiatric disorders......Page 247
3.14 Grief and loss in war affected societies......Page 252
3.15 Vitamin and mineral deficiencies......Page 260
3.16 Severe malnutrition......Page 264
3.17 Acute upper airway obstruction......Page 276
3.18 Tonsillitis, otitis media and mastoiditis......Page 280
3.19 Sleep related upper airway obstruction......Page 282
3.20 Anaemia......Page 284
3.21 Iron deficiency anaemia......Page 287
3.22 Sickle cell disease......Page 289
3.23 Haemolytic anaemias......Page 293
3.24 Blood clotting disorders......Page 296
3.25 Acute diarrhoea......Page 298
3.26 Post-infectious persistent diarrhoea......Page 306
3.27 Upper gastroenterological disorders......Page 310
3.28 Inflammatory bowel disease......Page 312
3.29 Gastrointestinal bleeding......Page 315
3.30 Malabsorption and coeliac disease......Page 317
3.31 Constipation......Page 319
3.32 Connective tissue disorders......Page 321
3.33 The treatment of children with cancer......Page 325
3.34 Eye disorders......Page 337
3.35 Trachoma......Page 342
3.36 Coma......Page 344
3.37 Epilepsy......Page 349
3.38 Management of prolonged seizures......Page 353
3.39 Neuropathies......Page 354
3.40 Guillain–Barré syndrome......Page 356
3.41 Muscular dystrophies......Page 358
3.42 Breath-holding spells......Page 360
3.43 Migraine......Page 361
3.44 Neurosurgical disorders......Page 363
3.45 Orthopaedic problems other than injuries......Page 367
3.46 Developmental disorders and learning difficulties in children attending hospital......Page 372
3.47 Skin diseases......Page 381
3.48 Neonatal medicine......Page 385
3.49 Surgical problems......Page 405
SECTION 4: Infectious diseases and individual infections......Page 416
4.1 Bacterial meningitis......Page 418
4.2 Sexually transmitted diseases......Page 423
4.3 Diphtheria......Page 426
4.4 Leprosy......Page 429
4.5 Leptospirosis......Page 431
4.6 Meningococcal disease......Page 433
4.7 Pertussis......Page 438
4.8 Streptococcal disease......Page 439
4.9 Tetanus......Page 441
4.10 Tuberculosis......Page 444
4.11 Typhoid and paratyphoid......Page 449
4.12 Other bacterial infections and diseases......Page 453
4.13 Acute encephalitis......Page 455
4.14 Chickenpox......Page 459
4.15 Dengue......Page 461
4.16 Acute hepatitis......Page 466
4.17 Herpes virus infections......Page 468
4.18 Human Immunodeficiency Virus infection in children......Page 469
4.19 Measles......Page 477
4.20 Mumps......Page 480
4.21 Poliomyelitis......Page 481
4.22 Rabies......Page 483
4.23 Viral haemorrhagic fevers......Page 486
4.24 Yellow fever......Page 490
4.25 African trypanosomiasis......Page 491
4.26 Leishmaniasis......Page 493
4.27 Malaria......Page 496
4.28 Helminth infections: “worms”......Page 500
4.29 Hydatid disease......Page 503
4.30 Schistosomiasis......Page 505
4.31 Rickettsial diseases......Page 508
4.32 Scrub typhus......Page 510
4.33 Other infections caused by parasites......Page 511
SECTION 5: Injuries......Page 514
5.1 Childhood accidents and their prevention......Page 516
5.2 Child ill-treatment and abuse......Page 518
5.3 Wounds......Page 523
5.4 Life-threatening trauma in children......Page 526
5.5 Head injuries......Page 533
5.6 Fractures......Page 536
5.7 Spinal cord injuries......Page 541
5.8 Landmine injuries in children......Page 544
5.9 Gunshot wounds......Page 546
5.10 Ingestion burns......Page 549
5.11 Management of burns......Page 550
5.12 Poisoning......Page 555
5.13 Envenoming......Page 560
5.14 Drowning and near drowning......Page 564
5.15 Heat stroke......Page 566
SECTION 6: Procedures......Page 568
6.1 Assessing nutritional status and growth......Page 570
6.2 Restraining children for procedures......Page 575
6.3 Systems to minimise errors in drug/infusion administration in hospital......Page 576
6.4 Giving injections......Page 578
6.5 Peripheral venous cannulation......Page 579
6.6 Central venous cannulation......Page 580
6.8 Umbilical vein catheterisation......Page 582
6.10 Intraosseous needle insertion......Page 584
6.12 Insertion of a chest drain......Page 585
6.13 Intubation......Page 586
6.14 Creation of an emergency surgical airway......Page 588
6.15 Needle pericardiocentesis......Page 589
6.16 Intracardiac injection of drugs in the resuscitation of the neonate......Page 590
6.18 Non-invasive ventilatory support......Page 591
6.20 Incision and drainage of abscess......Page 595
6.21 Liver biopsy......Page 596
6.23 Lumbar puncture......Page 597
6.24 Suprapubic aspiration of urine......Page 598
6.25 Microscopy of the urine......Page 599
6.26 Handwashing......Page 603
SECTION 7: Appendix......Page 604
7.1 Fluid and electrolyte management......Page 606
7.3 WHO Treatment Plan A: home therapy to prevent dehydration and malnutrition......Page 608
7.4 History and examination sheet for severe malnutrition......Page 610
7.5 Formulas and recipes for severely malnourished children......Page 612
7.6 Examples of care charts......Page 614
7.7 Estimating body surface area......Page 616
7.8 Normal values for vital clinical signs and laboratory measurements......Page 617
7.9 Clinical tests for brain stem death......Page 619
7.10 Low cost technology for neonatal care......Page 620
7.11 Life support training courses: equipment list......Page 621
7.12 Example of a programme used for a one day paediatric pain management course......Page 623
7.13 Example of vital signs nursing chart......Page 624
7.14 Example of feeding and progress chart......Page 625
A......Page 626
B......Page 628
C......Page 629
D......Page 631
E......Page 633
F......Page 634
H......Page 635
I......Page 637
L......Page 638
M......Page 639
N......Page 640
O......Page 641
P......Page 642
R......Page 643
S......Page 644
T......Page 646
U......Page 647
W......Page 648
Z......Page 649