Should I prescribe antibiotics for a child with otitis media and discharge from eardrum rupture? — Paediatrics for Primary Care (and anyone else)

The answer to that question is much more complicated than most guidelines will lead you to believe.The headline statement recommending the use of antibiotics in this scenario has buried the evidence in multiple layers of interpretation. To get to the truth, we have to look at the lierature ferred to in the decision to make… via…

The Practicalities of Croup Management in the Community — Paediatrics for Primary Care (and anyone else)

This post is in response to a very specific question from a local GP. The question wasn’t about recognising croup or even about the best evidence based treatment. Recognising croup is fairly straightforward. There is pretty much consensus on the best management of croup. The question was about the practicalities.The evidence for the ideal management… via…

Decision Fatigue and What to Do About It – When to Use Antibiotics for URTI, AOM and Tonsillitis in Children — Paediatrics for Primary Care (and anyone else)

Recently I was speaking to a GP colleague about the ways to protect oneself from decision fatigue. Decision fatigue is a serious issue for anyone in a high volume, high turnover medical job. He had some great insights into the problem and the solutions.What are the effects of decision fatigue? In the short term, your… via…

Nightmares in children

Standing outside a house that has seen too many years you wonder how you got here. Soil baked dry by a hundred summer suns tickles over your toes as you look down. No shoes! Why don’t you have any shoes on? The brown dirt crumbles between your toes as you take a single step forward,… via…

Rashes algorithm

General practice can be challenging for medical students and young students because they have not been ‘exposed’ to many rashes. Even GPs who have many years experience can occassionally be stumped. Here is a great algorithm/flowchart available from Patient.co.uk which can help us discern the likely causes – Link