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 […]
HPV – do infected mothers need caesarean section?
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? […]
Q: Midazolam or Ketamine
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 […]
Q: Parental presence and lumbar punctures
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 […]
Q: Tongue tie division for breastfeeding?
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; […]
Why (wo)men always think they are right.
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 […]
Relativist or absolute certainty?
If you were offered a choice of medication to treat an ailment you were suffering from, and you’d asked about how effective they were (and there’s a huge chunk of the population that wouldn’t, and would be happy to just do as they are told), then what information would you like? […]
Q: Do written asthma plans reduce asthma admissions?
That’s it really – it’s a very simple question. Does the time, effort and printing resources we use in creating asthma action plans have a measurable benefit in terms of stopping the kids getting as poorly? Or is it a job-creation scheme for these financially strapped times? […]
Give Aciclovir for herpetic gingivostomatisis
Does oral aciclovir improve clinical outcome in immunocompetent children with primary herpes simplex gingivostomatitis? A 3 year old previously well boy presents with a fever of 38.6ºc and several ulcers and erosions extending from his lips, along the tongue and cheek, to the back of the throat. The lesions have all appeared within the last […]
Q: How long do you wait to clamp a cord?
When I was doing neonates, it was considered good practice to get little babies spliced away from their Mother, given oxygen to breathe and wrapped up warm, all pretty damn quickly. I keep hearing rumours from my neonatally biased friends that perhaps there are other, better ways of doing things. So – how long do […]