• Benzodiazepine poisoning
    www.rch.org.au/clinicalguide/guideline_index/Benzodiazepine_poisoning/
    is rare, and should prompt a search for other toxic substances. Close observation and supportive care are … paracetamol Examination CNS depression Neurologic – confusion, dysarthria, nystagmus, lethargy, ataxia … discharge when Normal GCS after 4 hours observation Child able to ambulate Assessing risk and connecting …
  • Risperidone Poisoning
    www.rch.org.au/clinicalguide/guideline_index/Risperidone_Poisoning/
    such as arrhythmias and neurological instability including CNS depression, seizures and extra pyramidal symptoms … patients those with an overdose in the presence of cardiovascular or neurological disease Consult Victorian … . Consider discharge when Normal GCS Normal ECG  Period of observation   Warn that extrapyramidal movements …
  • Urinary Incontinence - Daytime wetting
    www.rch.org.au/clinicalguide/guideline_index/Urinary_Incontinence_-_Daytime_wetting/
    dysraphism/tethered cord  Neurology - assessment of lower limbs, observation of gait  Management … of evaluation of daytime incontinence is to distinguish neurological and anatomical causes from functional …
  • Supracondylar fracture of the humerus - Emergency Department
    www.rch.org.au/clinicalguide/guideline_index/fractures/Supracondylar_fracture_of_the_humerus_Emergency_Department/
    radiological assessment).  These must always be managed by orthopaedics Observation overnight Fracture clinic … examine for associated injuries.  A thorough neurological examination including screening of the median … in forearm and or elbow skin puckering or anterior bruising open injury neurological injury 5. What …
  • Positional plagiocephaly
    www.rch.org.au/clinicalguide/guideline_index/Positional_plagiocephaly/
    craniosynostosis Place infant on parent’s lap with examiner standing at the infant’s back Observe head from above … protuberance (‘bump’) on the opposite ‘normal’ side Turn infant so their back is to parent’s chest Observe …, and neurological examination to exclude other conditions associated with plagiocephaly Severity Severity assessment …
  • The limping or non-weight bearing child
    www.rch.org.au/clinicalguide/guideline_index/Child_with_limp/
    Key points Most children presenting with a limp do not require investigation Observing the child's … for other abnormal joints Neurological exam including tone, power, and reflexes and neurovascular assessment … observational study , Emergency Medicine Journal, 42:360–366 Queensland Emergency Care Children Working Group …
  • Prolonged fever
    www.rch.org.au/clinicalguide/guideline_index/Prolonged_fever/
    presentation If the child is stable, observation and investigation prior to commencing antibiotics is preferred … infections should be considered Examination Neurological: change in personality, unexplained lethargy … or confusion, meningism or focal neurological findings Cardiac: new murmur may suggest endocarditis Respiratory …
  • Acute behavioural disturbance: Acute management
    www.rch.org.au/clinicalguide/guideline_index/Acute_behavioural_disturbance__Acute_management/
    neurology, acute pain, altered conscious state or evidence of a toxidrome A more comprehensive examination … assessment scale An alert child should have 30 minutely observations for 2 hours post sedation medication … An agitated child needs continuous clinical observation and regular vital signs A child with altered conscious …
  • Clavicle fractures - Emergency Department
    www.rch.org.au/clinicalguide/guideline_index/fractures/Clavicle_fractures_Emergency_Department/
    of the clavicle, and a history of a fall.  Toddlers and infants may present having been observed not using the arm … and potentially significant injuries are identified. !   Careful neurological examination should be performed …
  • Anaemia
    www.rch.org.au/clinicalguide/guideline_index/Anaemia/
    for observation. Frequent heart rate monitoring is required to identify tachycardia which may indicate a further … methylmalonic acid Treatment must be commenced urgently, particularly if neurological symptoms or regression …