That’s it really – it’s a very simple question. Does the time, effort and printing resources we use in creating asthma action plans have a measurable benefit in terms of stopping the kids getting as poorly? Or is it a job-creation scheme for these financially strapped times? […]
Category: archimedes
Give Aciclovir for herpetic gingivostomatisis
Does oral aciclovir improve clinical outcome in immunocompetent children with primary herpes simplex gingivostomatitis? A 3 year old previously well boy presents with a fever of 38.6ºc and several ulcers and erosions extending from his lips, along the tongue and cheek, to the back of the throat. The lesions have all appeared within the last […]
Q: Portacath or Hickman Line, madam?
A 6 year old girl with Acute Lymphoblastic Leukaemia presents with another episode of febrile neutropenia with positive blood culture from her Hickman line. On a ward round, her parents discuss that they would like her to have a Portacath device inserted so that she can go swimming and is more comfortable around her friends. […]
Q: How long do you wait to clamp a cord?
When I was doing neonates, it was considered good practice to get little babies spliced away from their Mother, given oxygen to breathe and wrapped up warm, all pretty damn quickly. I keep hearing rumours from my neonatally biased friends that perhaps there are other, better ways of doing things. So – how long do […]
Ask, and it might be given unto you.
The five steps of evidence based practice are commonly summarised as ‘Ask, Acquire, Appraise, Apply and Assess’. The first one of these – just asking a question – can prove terribly time consuming and difficult, but with a bit of dissection can be made much easier. The first step when deconstructing the anatomy of inquiry […]
Making science of art
In the window of the Wellcome Collection in London artists work to interpret and explain science: it’s an impressive experience to the irregular visitor. When faced with the presenting problems of a child & family, we are faced with trying to do the reverse. We have the sometimes inaccurate recollections of history, the variable responses […]
Q: Honey for neutropenia?
It’s my own question, this time, and throws up lots of annoying little things. The problem is straightforward: I’m a paediatric oncologist in my spare time, and was asked about the use of LifeMel honey to prevent infections. Now, being both an EBMer and a Physician, I said I didn’t know, but didn’t think it […]
Q: CPAP for Bronchiolitis?
It’s simple really – Autumn is approaching and most paediatricians are gathering their Virally Protective Hankies to ward off the germs they know they’ll be assaulted by. There’s heavy training in many departments for the new docs — “if it’s bronchiolitis clinically, don’t X-ray them, don’t bleed them, don’t IV them and don’t give them […]
Here’s one for free (really)
A blog post of questions that are calling out to be answered. Ever looked at the Archimedes section and thought “I wonder what I could write about?” or “I wish they’d look at this?” Here’s the space you were looking for. […]
Q: Is an OGTT good enough for CF diabetes testing?
Jamie, a 13-year-old girl with cystic fibrosis (CF), has been referred to the Paediatric Diabetes clinic because of an abnormal oral glucose tolerance test (OGTT) in her recent CF Annual Review. It showed impaired glucose tolerance. Continuous glucose monitoring system (CGMS) over three days showed normal fasting and pre-prandial glucose but frequent post-prandial glucose excursions […]