11 Oct, 09 | by Bob Phillips
Not just Alice in Wonderland, it seems, but a bunch of our colleagues are chasing fluffy-tailed bunnies in their treatment of pneumothorax. Oxygen - in high concentrations - is used by some people to treat spontaneous, non-tension, pneumothorax. But why?
6 Sep, 09 | by Bob Phillips
Well, the media has occasional frenzies over the rising tide of male ‘boob jobs’, but to the average paediatrician it’s the rare adolescent that can’t take his T-shirt off because of pubertal breast enlargement that causes real concern. How should such a potentially disabling and yet ultimately short-lived problem be addressed?
2 Aug, 09 | by Bob Phillips
A premature baby born at 24 weeks gestational age is admitted to the neonatal unit having been born in poor condition and receiving cardio-pulmonary resuscitation (CPR) with adrenaline in the delivery room. Considering the available evidence, is the use of CPR at delivery of extremely premature infants associated with very poor outcomes such that CPR in these infants may be inappropriate? Does the administration of CPR provide these infants with a chance of survival free of disability?
12 Jul, 09 | by Bob Phillips
Well, it does, doesn’t it? There’s nothing much you can actually do for recurrent/intermittent viral wheezers, but if you stick them on a few granules of monteleukast in their yoghurt, at least it seems like we’re doing something. Or am I behind the times and there’s great evidence of it’s effectiveness?
7 Jul, 09 | by Bob Phillips
Now if you ask me, the idea of treating a penicillin-resistant organism with penicillin seems faintly ridiculous… like an iron with drawing pins on the sole plate. Either the bug is resistant (which to me means it resists dying when I use the drug) or it isn’t (so it will die) but it seems that this may not be as straightforward as it seems.
7 Jul, 09 | by Bob Phillips
It’s an interesting question, and one which may not concern us in the next twenty years (if vaccination programmes are effective and maintained). But until we can eradicate HPV, what should we recommend to mothers who are infected?
24 Apr, 09 | by Bob Phillips
You have a 7 year old in the ED that needs sutures to a wound inflected when he and his twin were playing Pirates of the Caribbean with kitchen knives … he’s not the sort of chap that will lie still while you stitch him up … so what would you use to keep him down? more…
4 Apr, 09 | by Bob Phillips
Does having the a worried mum or fretful dad in the room with you make a lumbar puncture less likely to succeed? It’s an interesting question, and one that has been posed following an evening on call in Yorkshire. What’s the opinions of folk out there - and any evidence that you can quote to substantiate them?
2 Apr, 09 | by Bob Phillips
Have you (yet) had a parent ask for a referral for tongue tie division to assist with a poorly feeding baby? What is the right answer to this question; more…
2 Apr, 09 | by Bob Phillips
Have you ever been involved with a debate with a partner or colleague, travelling from one place to another, and when the course they took has got you to the destination safely, they turn to you and say “So, [add endearment here], you see my way was right.”? If you have, I doubt that you took the opportunity to explain that they may be suffering from a methodological reasoning problem, of which the conterfactual argument and the possibility of differential verification bias may be important to consider. more…
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