Paediatrics
Paediatrics
Paediatrics tests care from the newborn period through adolescence, with heavy weighting on IMCI, neonatal problems, growth, and common infections.
Core rules and concepts
- IMCI danger signs: unable to drink or breastfeed, convulsions, lethargy or unconsciousness, chest indrawing, stridor in a calm child, and severe malnutrition.
- Neonatal jaundice: measure bilirubin; treat with phototherapy or exchange transfusion by age-specific thresholds; risk factors include prematurity, haemolysis, and sepsis.
- Growth: use WHO charts; weight-for-age, length/height-for-age, and weight-for-length; MUAC <11.5 cm indicates severe acute malnutrition in children 6–59 months.
- Diarrhoea: ORS and zinc; continue feeding; antibiotics only for dysentery or cholera.
- Fever in a young infant under 3 months is a sepsis screen until proven otherwise.
Worked example
A 2-month-old has a temperature of 38.5 °C, poor feeding, and lethargy. This is a red flag. Perform a full sepsis workup including blood culture, urine, and lumbar puncture; start empirical antibiotics after cultures; admit. Do not treat as simple malaria or send home with antipyretics. The reasoning is age and toxicity, not the height of fever alone.
Traps
- Missing danger signs because the child is not crying.
- Using adult blood pressure thresholds.
- Assuming all fevers are malaria.
- Giving antibiotics for simple acute watery diarrhoea.