So it’s all ethical stuff at the moment. Does the following question reach a point where evidence no longer has a role? “A premature baby born at 24 weeks gestational age is admitted to the neonatal unit having been born apnoeic, floppy, blue and without a heart rate. After cardio-pulmonary resuscitation (CPR) with adrenaline in […]
Category: therapy
Q: Spandex on prescription?
Fast drying, figure hugging and a joy to not iron, lycra (R) has revolutionised my laundry life. There are potentially even greater benefits though, with the use of lycra suits being promoted for children with cerebral palsies. […]
Q: Glycerine to prevent neonatal feed intolerance?
Now, I am sadly passionate about constipation and the need to treat it effectively. Some would say this obsession is a bit too much to be healthy. But even I would only go so far as to say that effective evacuation only makes you feel better, rather than make a huge difference to whether you […]
Q: Caffeine and prematurity
Now, it’s been a while since I scared myself by visiting a NICU, but I do recall the liberal use of caffeine by the resident medical and nursing staff, both for themselves and their tiny patients. There have been may things said about the delightful methylxanthine (including this, this and this) but did you ever […]
Trials are not needed
Sometimes, EBM is accused of being slavishly devoted to the Randomised Controlled Trial. This is clearly garbage if you look to answer a question outside of therapeutics: see our Archi posts on diagnosis and prognostication, for example. But even within the setting of picking the right treatment for the patients you see, the RCT is […]
Q: Ritalin and epilepsy?
When faced with co-morbidities in paediatrics, many of us need to take a deep breath. It’s not really that often your off-the-street child has more than one diagnosis, is it? (And currently, you can take a 9:1 bet on the diagnosis being ‘bronchiolitis’.) So, when the question of treating a child with ADHD and epilepsy […]
Finding the question
It’s one of the tenets of the evidence-based practice process that questions are framed as ‘PICO’: patient, intervention, comparison and outcome. But what happens when the question is bigger than PICO? […]
Q: Pneumothorices and white rabbits?
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? […]
Should we give tamixofen for pubertal gynaecomastia?
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? […]
Monteleukast helps parents feel better
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? […]