Journal of paediatrics and child health
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J Paediatr Child Health · Apr 1994
Case ReportsUse of nasal mask CPAP instead of tracheostomy for palliative care in two children.
Nasal continuous positive airways pressure (nCPAP) is recommended in children for the treatment of obstructive sleep apnoea which persists following adenotonsillectomy. Nasal CPAP was successfully used in the palliative care of two severely disabled children with upper airway obstruction as an alternative to tracheostomy. ⋯ There was also an unexpected benefit of reduced airway problems in the awake state in these children. Nasal CPAP is an effective form of treating upper airway obstruction for palliative care in association with other major disabilities.
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J Paediatr Child Health · Apr 1994
Practice Guideline GuidelineA national policy on asthma management for schools. The Asthma Special Interest Group, Thoracic Society of Australia and New Zealand.
Since asthma is the most common chronic illness in childhood, many of the problems associated with this condition will impact on the child's education. Because of widespread concerns regarding the management of asthma in schools, a subcommittee of the Thoracic Society of Australia and New Zealand, Asthma Special Interest Group, was convened to draw up national guidelines for school staff in order to provide optimal management of asthma in the school setting. We used current medial literature and the clinical experience of the authors who have dealt with children and adolescents suffering from asthma in the hospital, community and school environment. A number of issues had been identified, including: the availability of an asthma first aid kit; correct use of bronchodilator aerosols by puffer and spacer devices; and clear instructions as to when to notify parents and when to call an ambulance to the school.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Paediatr Child Health · Apr 1994
Lumbar punctures in suspected bacterial meningitis: too many or too few?
Children aged 1 month to 14 years admitted to the Royal Alexandria Hospital for Children during a 10 month period with suspected meningitis were studied prospectively. The aims were to determine how often lumbar puncture (LP) was delayed or never done, in relation to the outcome of all children, in order to determine the risks of LP and the risks of not doing LP. Of 218 children with suspected meningitis, LP was performed immediately in 195 (89.4%). ⋯ There were only minor adverse effects of immediate LP. Delayed LP probably resulted in failure to identify the organism in one child with bacterial meningitis, but did not adversely affect outcome in any child. Of the six children in whom LP was never performed, in only one was no final diagnosis reached.(ABSTRACT TRUNCATED AT 250 WORDS)