The Royal New Zealand College of Urgent Care

Could it be Sepsis? A Mother's Story The Podcasts of the Royal New Zealand College of Urgent Care · Episode

Steroids in preschool wheeze. The controversy continues. Remember this is ED based and so how does it correlate to Urgent Care practice? Do we routinely prescribe prednisolone? When should we prescribe prednisolone? I think we still have questions.

Steroids in preschool wheeze Discover the causes and solutions for preschool wheeze in children. Find out how to manage and prevent wheezing in young kids.

Very hard condition to diagnose as it is so very rare. Hello team. I had a case of this last year so really interesting to have someone post about it as well.

Sternal Osteomyelitis Demystifying sternal osteomyelitis: What you need to know about this rare cause of acute chest pain in children.

NG tubes. Are they useful? Probably not. Which is great to avoid arguments with surgeons. If a surgeon wants an NG do it yourself... Thus no point of doing it in ED or urgent care. https://youtu.be/ofG2j7Eawos?si=2cbwOQ9rs_Ekv7tC

More about laceration repair. How far apart should sutures be? Have you ever wondered? Has anyone ever looked? https://first10em.com/suture-spacing/

Everybody loves a good name. So who has heard of Purple Urine Bag Syndrome. Not me! So what is it.
https://journals.lww.com/em-news/fulltext/2024/05000/symptoms__confusion,_fever.7.aspx

So this is a bit of an update from RCEM on paediatric lacerations. In urgent care we have our limitations. We do not usually use ketamine that is reserved for hospital practice. But there are a couple of points in here that are interesting.
1. The use of LAT, this is often called topicaine in New Zealand. I find it really good for facial lacerations.
2. I have never though to much about LAT/topicaine for finger lacerations and it is interesting. Raed the reference about myth busting for fingers and adrenalin.
3. Play therapy. Well we don't have play therapist at my work but distraction therapy and device therapy can really get you over the line.
https://www.rcemlearning.co.uk/foamed/paediatric-wound-management/

Interesting that this has popped up in the newshub website. Phenergan and all sedating antihistamines have a warning from medsafe to absolutely not use in under 6's. This comes from 2013 so it 11 years and still somehow we have to keep warning parents to not use sedating antihistamines. i have in the past experienced severe sedation and apnoea with phenergan in patients.
https://www.newshub.co.nz/home/new-zealand/2024/05/parents-warned-to-stop-giving-promethazine-to-young-children-after-risky-side-effects.html
Link to article.
https://www.medsafe.govt.nz/profs/puarticles/mar2013childrenandsedatingantihistamines.htm #:~:text=Key%20Messages&text=Sedating%20antihistamines%20are%20contraindicated%20in%20children%20less%20than%20six%20years,respiratory%20depression%2C%20coma%20and%20death.
Link to medsafe

I saw this the other day. Pun intended since it's an ophthalmology condition. To be honest I did not get the diagnosis right but I am happy . It looked for all the world like orbital cellulitis and so was referred in and staying in eye ward on IV antibiotics. This review comes from paediatric website but eyes are eyes all the same.

Dacryocystitis What do you know about dacryocystitis and blocked tear ducts?

One of the most interesting question in the college MSFS asked of colleagues is "is able to say 'No'". Geuss which question has the lowest score in all the MSFS's that I have read? Why is that? Is it a good thing? Is it healthy for your mental health? Does this contribute to burnout?

The Art of Saying No Can you do my on-call shift tomorrow? er...er...er