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How to survive your first neonatal job 如何度过你的第一份新生儿工作
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-02-01 DOI: 10.1016/j.paed.2024.11.005
Nisha Aggarwal, Qasim Malik, Asad Abbas
{"title":"How to survive your first neonatal job","authors":"Nisha Aggarwal,&nbsp;Qasim Malik,&nbsp;Asad Abbas","doi":"10.1016/j.paed.2024.11.005","DOIUrl":"10.1016/j.paed.2024.11.005","url":null,"abstract":"<div><div>This article serves as a guide to navigating any clinician's first neonatal job, offering practical tips across all areas including neonatal intensive care, the special care baby unit and the postnatal ward. Whilst it focuses on the training landscape for paediatricians in the UK, it may be more widely applicable. It emphasizes the importance of prioritizing patient care through effective teamwork, communication, and regular check-ins with colleagues, especially during high-pressure situations such as births. Key practical skills, including airway management, blood gas interpretation, and procedural training, are discussed, along with strategies for obtaining workplace-based assessments. Importantly, the piece reinforces the value of support systems available to trainees, including mentorship from senior colleagues and interdisciplinary collaboration. Ultimately, whilst aneonatal rotation can be daunting, it offers invaluable opportunities for professional growth, equipping trainees with essential skills and knowledge to navigate the challenges of neonatal care confidently.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 2","pages":"Pages 68-70"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of heart murmurs in paediatrics: a lost skill in the era of echocardiography? 儿科心脏杂音的评估：超声心动图时代的失传技能？
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-02-01 DOI: 10.1016/j.paed.2024.11.003
Titilayo Ogunlana, Moustafa Eldalal, Paraskevi Mikrou
{"title":"Evaluation of heart murmurs in paediatrics: a lost skill in the era of echocardiography?","authors":"Titilayo Ogunlana,&nbsp;Moustafa Eldalal,&nbsp;Paraskevi Mikrou","doi":"10.1016/j.paed.2024.11.003","DOIUrl":"10.1016/j.paed.2024.11.003","url":null,"abstract":"<div><div>Heart murmur is the commonest reason for referral to paediatric cardiology services. Although congenital heart disease (CHD) is common, affecting between 6 and 10 in 1000 live births most heart murmurs are innocent. This is particularly likely in the absence of any cardiac symptoms. When a murmur is heard, it is important to be able to determine which children need urgent assessment by specialist services and which ones can safely wait for a more routine evaluation. Appropriate information and sensible reassurance should be offered to parents. A good clinical assessment, as outlined in this article, will enable Paediatricians with expertise in Cardiology (PECs) and Paediatric Cardiologists (PCs) to safely triage patients and ensure services do not become overwhelmed with demand. This article aims to provide a structured approach to all health professionals who encounter paediatric patients with heart murmurs.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 2","pages":"Pages 53-56"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A guide on how to approach neonatal hypercalcemia 如何处理新生儿高钙血症的指南
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-02-01 DOI: 10.1016/j.paed.2025.01.001
Sarah Reynolds, Owen Bendor-Samuel, Taffy Makaya, Jean Yong, Catherine Quinlan
{"title":"A guide on how to approach neonatal hypercalcemia","authors":"Sarah Reynolds,&nbsp;Owen Bendor-Samuel,&nbsp;Taffy Makaya,&nbsp;Jean Yong,&nbsp;Catherine Quinlan","doi":"10.1016/j.paed.2025.01.001","DOIUrl":"10.1016/j.paed.2025.01.001","url":null,"abstract":"<div><div>Neonatal hypercalcemia although often mild and benign has the potential to be a serious condition. There are a wide variety of causes which differ from those seen in children and adults. We present a brief overview of its presentation, common and serious ‘not to be missed’ causes and management. Our aim is to provide a guide of how to approach neonatal hypercalcemia for the paediatrician or other healthcare professional caring for newborn infants.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 2","pages":"Pages 57-64"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A pragmatic approach to paediatric postural orthostatic tachycardia syndrome (POTS) 小儿体位性心动过速综合征（POTS）的实用治疗方法
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-02-01 DOI: 10.1016/j.paed.2024.11.002
Michael Harris
{"title":"A pragmatic approach to paediatric postural orthostatic tachycardia syndrome (POTS)","authors":"Michael Harris","doi":"10.1016/j.paed.2024.11.002","DOIUrl":"10.1016/j.paed.2024.11.002","url":null,"abstract":"<div><div>Postural orthostatic tachycardia syndrome (POTS) is a debilitating condition. It is now quite well-known but still poorly understood. The multi-system nature of the condition and the difficulty in treating it adequately are discouraging for health professionals and patients alike. Whilst there is no known associated mortality, it has considerable morbidity. Knowledgeable history taking is essential, diagnostic tests are simple, differential diagnoses are limited. Parental interactions and expectations are key in management. POTS provides an opportunity to combine the science and art of medicine with compassion and empathy. This article outlines a pragmatic approach to understanding, diagnosing and treating this condition. The physiology of standing is discussed, as are some of the putative pathophysiological mechanisms responsible for POTS. The importance of sub-typing POTS as an aid to considered management is explained. Treatment strategies ranging from conservative measures to medications are discussed. Practical, workable tips for managing this condition are provided.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 2","pages":"Pages 47-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oxygen therapy in preterm infants: past, present and future 早产儿氧疗的过去、现在和未来
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-01-01 DOI: 10.1016/j.paed.2024.10.001
Sanoj KM Ali, Peter A Dargaville, Samir Gupta
{"title":"Oxygen therapy in preterm infants: past, present and future","authors":"Sanoj KM Ali,&nbsp;Peter A Dargaville,&nbsp;Samir Gupta","doi":"10.1016/j.paed.2024.10.001","DOIUrl":"10.1016/j.paed.2024.10.001","url":null,"abstract":"<div><div>Oxygen is one of the most commonly used therapies in neonatology but the parameters of optimal oxygen for preterm infants have been debated for the past 50 years. The history of oxygen use in this population, as well as the results of clinical trials, have shown that liberal oxygen administration is associated with retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) whereas restrictive use results in increased mortality and neurodisability. Oxygen saturation (SpO<sub>2</sub>) continuously measured by pulse oximetry is the bedside tool used to guide the fraction of inspired oxygen (FiO<sub>2</sub>) delivered to preterm infants. Although evidence favours targeting predetermined SpO<sub>2</sub> ranges, achieving this goal consistently in clinical practice has been challenging due to intrinsic pulmonary immaturity, the need for respiratory support therapies and factors relating to the bedside caregivers’ ability to adjust FiO<sub>2</sub>. This review article focuses on the difficulties of titrating oxygen therapy in this vulnerable group and provides recommendations for best practice based on up-to-date evidence.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to survive and thrive on night shifts 如何在夜班中生存和发展
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-01-01 DOI: 10.1016/j.paed.2024.10.007
Katrina Roberts, Nicola Goodall
{"title":"How to survive and thrive on night shifts","authors":"Katrina Roberts,&nbsp;Nicola Goodall","doi":"10.1016/j.paed.2024.10.007","DOIUrl":"10.1016/j.paed.2024.10.007","url":null,"abstract":"<div><div>Nightshifts are often unavoidable in the career paths we have chosen as paediatric doctors and whilst we can't pretend it's all fun and games', there is something very satisfying when you get through a set of nights and look back on what you have accomplished with little support in numbers. Here we explore how we, as two paediatric doctors, have developed our own ways of tackling the dark side aiming to keep patient safety a priority and maintaining some sanity. There is now more support than ever to support doctors working nightshifts and we hope to share some tips and resources to make the transition from days to nights a little easier.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 36-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Probiotics in the NICU: a personal practice 益生菌在新生儿重症监护室：个人实践
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-01-01 DOI: 10.1016/j.paed.2024.10.006
Sybil Barr
{"title":"Probiotics in the NICU: a personal practice","authors":"Sybil Barr","doi":"10.1016/j.paed.2024.10.006","DOIUrl":"10.1016/j.paed.2024.10.006","url":null,"abstract":"<div><div>There is increasing interest in the use of probiotics in preterm infants in NICUs to reduce intestinal dysbiosis and subsequently reduce morbidity in these vulnerable neonates. However, heterogenicity of organisms used in various trials has meant definitive evidence is still not available to make strong recommendations and probiotic use remains varied.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 34-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unveiling the hidden risks: therapeutic creep in mild hypoxic ischemic encephalopathy 揭示潜在风险：轻度缺氧缺血性脑病的治疗蠕变
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-01-01 DOI: 10.1016/j.paed.2024.10.004
Aravanan Anbu Chakkarapani, S Meghana, Umamaheswari Balakrishnan
{"title":"Unveiling the hidden risks: therapeutic creep in mild hypoxic ischemic encephalopathy","authors":"Aravanan Anbu Chakkarapani,&nbsp;S Meghana,&nbsp;Umamaheswari Balakrishnan","doi":"10.1016/j.paed.2024.10.004","DOIUrl":"10.1016/j.paed.2024.10.004","url":null,"abstract":"<div><div>Hypoxic-ischemic encephalopathy (HIE) in neonates, particularly near-term and term infants, presents significant risks to survival and neurodevelopmental outcomes. Mild HIE, comprising about 50% of HIE cases, has traditionally been seen as lower risk compared to moderate and severe HIE. However, emerging research suggests that mild HIE can lead to similar adverse outcomes to more severe cases, including brain injury and neurodevelopmental impairment. Therapeutic hypothermia (TH), a proven intervention for moderate to severe HIE, has been largely excluded for mild HIE management due to a lack of robust evidence. This gap has led to a phenomenon known as therapeutic creep, where interventions like TH are extended to milder cases without solid guidelines, raising concerns about its appropriateness and efficacy. This short article discusses the possible limitations of this approach and highlights why evidence from new research is urgently required.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 23-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of occupational therapy and physiotherapy in the neonatal unit 职业治疗和物理治疗在新生儿病房中的作用
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-01-01 DOI: 10.1016/j.paed.2024.10.003
Lucy Robertshaw, Stacey Dobbin
{"title":"The role of occupational therapy and physiotherapy in the neonatal unit","authors":"Lucy Robertshaw,&nbsp;Stacey Dobbin","doi":"10.1016/j.paed.2024.10.003","DOIUrl":"10.1016/j.paed.2024.10.003","url":null,"abstract":"<div><div>A neonatal intensive care unit (NICU) is an area within a hospital designed for newborns and infants born early (before 37 weeks gestation), infants with a low birth weight and/or with a medical condition requiring specialist doctor and nurse care. Approximately 1 in 7 infants require this specialist input. An addition to this, was the evolution of developmental services and neonatal therapists since the 1970s; this was due to the increasing awareness that infants and children may present with developmental challenges and special educational needs following prolonged neonatal intensive care stays. Therefore, developmental care on the NICU needs to be considered as important alongside medical interventions. There is a significant difference between the environment of the NICU and the uterine/womb experience. The role of the neonatal and developmental professionals, alongside the medical staff, such as an occupational therapist (OT) or physiotherapist (PT) is to help bridge this gap by considering and adapting the environment to promote optimal conditions to support brain development, including appropriate sensory and movement experiences, as well as supporting and coaching parents/carers to care for and nurture their newborns’ development from birth.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 16-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comprehensive insights into neonatal seizure: etiologies, diagnostic tools, management and future directions 全面的见解到新生儿癫痫：病因，诊断工具，管理和未来的方向
Paediatrics and Child Health (United Kingdom) Pub Date : 2025-01-01 DOI: 10.1016/j.paed.2024.10.005
Aravanan Anbu Chakkarapani, Ishita Singh, Umamaheswari Balakrishnan
{"title":"Comprehensive insights into neonatal seizure: etiologies, diagnostic tools, management and future directions","authors":"Aravanan Anbu Chakkarapani,&nbsp;Ishita Singh,&nbsp;Umamaheswari Balakrishnan","doi":"10.1016/j.paed.2024.10.005","DOIUrl":"10.1016/j.paed.2024.10.005","url":null,"abstract":"<div><div>Neonatal seizures are a neurological emergency, particularly prevalent in very low birth weight (VLBW) infants, with incidences ranging from 58/1000 live births in VLBW to 1–3.5/1000 in term infants. These seizures are often linked to hypoxic–ischemic brain injury, intracranial haemorrhage, arterial ischemic stroke, or infection. The diagnosis relies heavily on electroencephalography (EEG) due to the high incidence of electrographic-only seizures. Common aetiologies such as hypoxic ischemic encephalopathy (HIE), hypoglycemia, stroke, and hypocalcemia significantly impact neurodevelopment and seizure recurrence. This short article discusses the causes, diagnosis and management strategies of neonatal seizures, offering practical advice on how to best manage symptomatic and subclinical seizures in babies of various gestation. It highlights the gaps in our knowledge and suggests what further research is essential to refine treatment protocols and improve prognoses for affected neonates.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 28-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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