Dr Oliver Anglin NCL amp Camden Dr David Masters Haringey Dr Punit Sandhu Enfield Dr Joanna Yong Barnet Dr Isobel El Shanawany Islington Childhood Rashes Wednesday 14 th July 1300 to 1400 ID: 932973
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Hosted by NCL Training Hub in partnership with NCL CCG CYP Clinical Leads Dr Oliver Anglin (NCL & Camden)Dr David Masters (Haringey) Dr Punit Sandhu (Enfield)Dr Joanna Yong (Barnet)Dr Isobel El-Shanawany (Islington)
Childhood RashesWednesday 14th July – 13.00 to 14.00
Slide2Welcome
Covid-19 Paediatric updatesItemSpeakersWelcomeDr David Masters
GP &
CY&P Clinical Lead - Haringey
RSV Bronchiolitis Surge
Dr Justin Daniels
Consultant Paediatrician NMUH and Honorary Senior Lecturer UCL
Secondary Care Clinician, Brighton and Hove CCG Board
Childhood rashes
Dr Justin Daniels
Consultant Paediatrician NMUH and Honorary Senior Lecturer UCL
Secondary Care Clinician, Brighton and Hove CCG Board
Slide3Housekeeping
Do keep your camera off to allow presenters to be visible. Feel free to use the chat for any questions/ thoughts you have during the session Do stay on mute to reduce any background noise when others are speaking Q & A
Questions will be addressed after the speaker presentations
Slide4RSV – here it comes / here it isJuly 2021Justin DanielsConsultant Paediatrician NMUH
Slide5What are we worried about?We have an RSV surge every yearLast year we didn’tLots of unexposed kidsRule of 2sIts started!!!The shortage of anaesthetists – Covid, elective work, RSV, ITU
Slide6Nice Guideline
Slide7apnoea (observed or reported)child looks seriously unwell to a healthcare professionalsevere respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minutecentral cyanosispersistent oxygen saturation of less than 92% when breathing air
Slide8Consider referral:a respiratory rate of over 60 breaths/minutedifficulty with breastfeeding or inadequate oral fluid intake (50–75% of usual volume, taking account of risk factors and using clinical judgement)clinical dehydration.
Slide9Risk factors:bronchopulmonary dysplasiahaemodynamically significant congenital heart diseaseage in young infants (under 3 months)premature birth, particularly under 32 weeksneuromuscular disordersimmunodeficiency.
Slide10Carer:social circumstancesthe skill and confidence of the carer in looking after a child with bronchiolitis at homeconfidence in being able to spot red flag symptoms (see recommendation 1.6.1)distance to healthcare in case of deterioration
Slide11My thoughts:You can’t assess these kids other than f2fYou need a paediatric saturation probe
Slide12If staying home…Bronchiolitis is a 2-3 week illness – get worse for the first 3-5 daysCoughing is okBed sharing a noWhen to come back:Feeding – less than 50%CyanosisApnoeaWorsening DIBWorried
Slide13Questions and Answers
Slide14My child has a rash….Justin DanielsConsultant Paediatrician NMUHJuly 2021
Slide15‘Data’How common is this - very How often is this life threatening – very rarely How much time – lotsHow many prescriptions - lots
Slide16How to classify?Scary rashesBaby rashesEczema rashesInfections worth knowingEverything else
Slide17Scary rashes (1)Febrile, tachycardia, tumbler test positive
Slide18Scary rashes (2)Looks really unwell, tachycardia
Slide19Scary rashes (3)Background eczemaRapid onset
Slide20Baby rashes (1)
Slide21Baby rashes (2)
Slide22Baby rashes (3)
Slide23Baby rashes (4)
Slide24Baby rashes (5)
Slide25EczemaSeverityTypeLichenified, excoriated, erythrodermic, infectedPost inflammatory changesDiscoid
Slide26eeaediatric
Eczema Will guide your steroid choice – Mild, Moderate or Potent steroid
Severiw3ety of inflammation
Slide27Paediatric
EczemaQuality of eczema – excoriated, erythrodermic
,
lichenified
,
hyperpigmented
,
hypopigmented
Slide28Paediatric
EczemaType of eczema - Discoid
Slide29Paediatric
EczemaBacterial, fungal, viral (herpeticum
)
Infected Eczema
Slide30EczemaSteroids Steroids
SteroidsMatch potency to level of inflammationEarly Effective treatment prevents life long problemsLonger duration of treatment for chronic changesOintments not creamsSpace layers of creams by >30minsEducation and Personalised management plans essential - BASCIAssess quality of life
Consider immunosuppression
Slide31Infections worth knowing (1)…
Slide32Infections worth knowing (2)…
Slide33Everything Else (1)
Slide34Everything Else (2)
Slide35Everything Else (3)
Slide36Everything Else (4)
Slide37Everything Else (5)
Slide38Everything Else (6)
Slide39Everything Else (7)
Slide40Everything Else (8)
Slide41Everything Else (9)
Slide42Everything Else (10)
Slide43Resources www.Dftskindeep.com https://eczema.org/https://www.bsaci.org/https://dermnetnz.org/
Slide44Questions and Answers
Slide45Thank you for joining
Please email any feedback to nclccg.nclth@nhs.net
Next C&YP webinar
Date: 14
th
and 29
th
September
Time: 13:00 – 14:00
Details
to follow