The association between hyperlactataemia and poorer outcomes in acutely unwell adults and children is well recognised. Blood lactate testing has become readily available in acute settings and is considered a first-line investigation in international guidelines for the management of sepsis. However, while healthcare professionals do appreciate the value of measuring blood lactate in acute ...

Paracetamol (internationally known as acetaminophen) is the most common medicine encountered in paediatric practice. It is used widely by parents and health professionals and it has analgesic and antipyretic effects. Its short-term safety and efficacy are well established and it is readily available for purchase over the counter. Its mechanism of action is not fully understood but it …

Bleeding per rectum in children is an infrequent presentation associated with a wide range of differential diagnoses, from benign to life-threatening. Irrespective of the underlying aetiology, it is typically a worrisome symptom for caregivers. Published data are limited, particularly for the UK population, from which to provide clear evidence-based guidance for assessment and management of ...

Meningitis is a critical diagnosis not to miss in children presenting with fever. Since the early 20th century, classical clinical signs have been used to aid the diagnosis of meningitis. These classical signs are nuchal rigidity, Kernig’s sign and Brudzinski’s sign. Each of these relies on the principle that stretching the inflamed meningeal membranes causes clinically detectable irritation.

The Bayley Scales of Infant and Toddler Development—Third Edition (Bayley-III) is a gold standard series of behavioural assessments used by clinicians and researchers to assess the developmental functioning of young children. The rigorous psychometric properties of the tool are attributed to the carefully standardised normative sample and quantitative scoring system. It is a common end-point ...

In September 2016, the National Institute for Health and Care Excellence (NICE) published their first guideline on ‘harmful sexual behaviour among children and young people’.1 The aim of this document was to enable the safe and appropriate management of children and young people presenting with harmful sexual behaviour. This includes the identification of such children and young people ...

### Key points A 2-year-old child is brought to the emergency department with a barking cough, subcostal recessions and intermittent stridor. Concerned about the symptoms, their parents are asking for the best possible treatment to improve the symptoms and reduce the need for further treatment or admission. In any child presenting with stridor, it is …

The management of head trauma is an essential component of working in Emergency Medicine, be it a paediatric, adult or mixed emergency department. Between 33% and 50% of the 1.4 million people who attend UK emergency departments (ED) annually with a head injury are children. Patient outcomes in this cohort are strongly associated with rapid identification and treatment of intracranial pathology.

Neonatal infection has been recognised as the third most common cause of neonatal death globally.1 In the UK, a retrospective analysis that spanned over 30 neonatal units from 2005 to 2014 found the incidence of neonatal infection was 6.1 per 1000 live births and 48.8 per 1000 neonatal admissions.2 The incidence of early-onset neonatal sepsis (EONS) in the UK was 0.7 per 1000 live births.2 The ...

How to use capillary refill time David King,1 Robert Morton,1 Cliff Bevan2 1Academic Unit of Child Health, Sheffield Children’s Hospital, Sheffield, UK 2Paediatric Intensive Care Unit, Sheffield Children’s Hospital, Sheffield, UK Correspondence to