The doctor will (1) ask you a few questions (2) take your blood pressure (3) perform additional examinations (4) order a blood test (5) depending on your blood pressure may ask you to come back and have it rechecked before starting treatment.

This is what I have seen written on the wards when it comes to managing a patient’s pain:

1. Regular paracetamol 1g PO qid maximum 4g/24

2. Add an NSAID if there is no contraindications, i.e. ibuprofen 200-400mg PO tds to qid maximum 2400mg/24. However, I don’t see NSAIDs written up too often.

3. PRN Oxycodone 2.5-5mg 2-hourly maximum 30mg

4. Make sure you document in notes especially if starting on oxycodone. Need to consider constipation, nausea/vomiting, and respiratory depression as side effects.

10-15% of children will have a repeated seizure. However, there’s no increase risk of mortality or development of epilepsy.

Parents must stay calm, don’t stick fingers in child’s mouth, place them on flat surface away from danger, don’t dip child in bath to cool them, jsut remove clothing, call ambulance if seizure lasting >5mins. Follow-up with physician.

When did the jaundice develop? Extent of jaundice? Is the baby feeding, dehydrated, sick, lost significant weight? Is the baby full term? Was there trauma during birth? What are the mother’s and baby’s blood groups? Is the baby passing pale stools and dark urine? Did the baby’s siblings have similar problems? Is there a family history of haemolytic disease?

Initial Investigations:

FBC, UEC, LFT, CRP, Blood cultures, Urine MCS, Bilirubin (unconjugated/conjugated)

Then consider:

TFT
Alpha-1-antitrypsin
G6PD
Viral Serology
Abdominal USS

Causes of Unconjugated Hyperbilirubinaemia:

Physiological
Breast Milk Jaundice
Sepsis
GI Obstruction
Hypothyroidism

Causes of Conjugated Hyperbilirubinaemia:

Hepatitis
Biliary Atresia