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Clinical Practice Guidelines

  • Seizures acute management
    www.rch.org.au/clinicalguide/guideline_index/Seizures_acute_management/
    of absence seizures or myoclonic jerks, nocturnal events Developmental history   Examination Full …Seizures acute management …Clinical Practice Guidelines : Seizures acute management …
  • Stroke
    www.rch.org.au/clinicalguide/guideline_index/Stroke/
    or symptoms^  Altered mental state^  Signs of raised intracranial pressure^  New onset seizures associated … considering treatment Treat recurrent or prolonged symptomatic seizures. See Afebrile seizures Avoid … radiologically confirmed arterial stroke with absence of haemorrhage Pediatric NIH Stroke Scale score ≥4 and <24 …
  • Von Willebrand Disease vWD
    www.rch.org.au/clinicalguide/guideline_index/Von_Willebrand_Disease_vWD/
    structure and function of vWF, several variants Variable bleeding pattern Type 3 (rare) Near absence of vWF … reports of hyponatraemia and seizures. Relatively contraindicated in children with previous seizure …
  • Head injury
    www.rch.org.au/clinicalguide/guideline_index/Head_injury/
    haematoma (occipital, parietal or temporal) in child <2 years Severe mechanism Post-traumatic seizure Loss … sustained Presence of amnesia Post injury seizure Examination Neurological examination, including signs … or absence of risk factors (as described below) Indications for neuroimaging may be present on initial …
  • Lumbar puncture
    www.rch.org.au/clinicalguide/guideline_index/Lumbar_puncture/
    Note: a bulging fontanelle in the absence of other signs of raised ICP is  not  a contraindication … episodes New focal neurological signs or seizures Seizure within previous 30 min and/or ongoing decreased … conscious state following a seizure INR >1.5 or platelets <50 x 10 9 /L for child on anticoagulant …
  • Salicylates poisoning
    www.rch.org.au/clinicalguide/guideline_index/Salicylates_Posioning/
    , hyperventilation >300 mg/kg Severe symptoms: Acidosis, seizures, hyperthermia Features on examination Resp … : Hyperventilation - not always present in children, absence does not exclude significant toxicity. CVS: Dehydration … - careful assessment should be performed. CNS: Agitation, lethargy, seizures, coma Other …
  • Hypoglycaemia
    www.rch.org.au/clinicalguide/guideline_index/Hypoglycaemia/
    hypoglycaemia Recurrent hypoglycaemia Unexplained hypoglycaemia (absence of prolonged fast or intercurrent … apnoea, lethargy, seizures, hypotonia, jitteriness, poor feeding, a high pitched cry, altered behaviour … Episodes suggestive of hypoglycaemia e.g. undiagnosed seizure disorder Insulin dependent diabetes mellitus …
  • Drowning
    www.rch.org.au/clinicalguide/guideline_index/Drowning/
    in children who are competent swimmers, for example: seizures hypoglycaemia arrhythmias and Long QT Syndrome … Chest X-ray findings do not correlate with clinical outcomes Altered mental state in the absence …
  • Bier block
    www.rch.org.au/clinicalguide/guideline_index/Bier_block/
    can be early signs. Severe toxicity may cause seizures, methaemoglobinaemia, cardiovascular … tourniquet pressure Start a timer Squeeze the cuff to observe pressure oscillations Confirm absence of radial …
  • Febrile child
    www.rch.org.au/clinicalguide/guideline_index/Febrile_child/
    absence) of a clinically obvious focus In infants <3 months of age, hypothermia or temperature instability … of febrile seizures; the appearance of the child is the most useful indicator  Background Definition of fever … or prolonged seizures Other Non-blanching rash Fever for ≥5 days Swelling of a limb or joint Non-weight bearing …