Paediatrics
Paediatrics
The paediatric station tests assessment of infants and children, communication with caregivers, growth and development, and recognition of serious illness. Examiners expect you to use the paediatric assessment triangle, weight-based prescribing, and the New Zealand immunisation schedule. Safeguarding and cultural safety are integral, not add-ons.
Core rules
- Appearance, work of breathing, circulation to skin: if abnormal, escalate immediately.
- Fever under 3 months is a red flag: full sepsis screen and empiric antibiotics after cultures.
- Dehydration: use clinical signs and weight loss; give ORS if mild, IV 10–20 mL/kg boluses if shocked.
- Croup: barking cough, stridor; give dexamethasone; nebulised adrenaline for severe distress.
- Always calculate doses by current weight and check maximum doses.
Worked example
A 2-year-old has a barking cough, inspiratory stridor at rest, and mild sternal recession. Reasoning: paediatric assessment triangle shows increased work of breathing but normal appearance/circulation; diagnose croup; give oral dexamethasone 0.15–0.6 mg/kg; observe; add nebulised adrenaline if stridor persists at rest; do not prescribe antibiotics.
Traps
Using adult doses, failing to weigh the child, missing non-accidental injury patterns, and reassuring without checking observations.