Children present to general practitioners with a wide range
of problems, but most of the time they are not particularly
unwell. Children with a more serious illness often
compensate very well initially, so there is a risk that their
illness will be overlooked or underestimated.
To outline the early recognition and management of
children who are seriously ill.
The initial assessment of an unwell child includes the
paediatric assessment triangle: appearance, breathing and
circulation to skin; primary survey that focuses on basic life
support, patient assessment and immediate management;
secondary survey with a detailed history of the event and
physical examination; and ongoing assessment. Medical
practitioners and their clinic staff must be prepared to
undertake initial emergency management of a seriously
ill child, and they must have the equipment and supplies
available to carry out that management effectively.
Seriously unwell children present particular challenges to the medical practitioner. The anatomy and physiology of children is different to that of adults, and this can result in differences in the presentation and severity of a range of conditions (Table 1). Children have a great ability for physiological compensation and some of the early signs of illness may not be obvious. The emphasis should be on detecting and treating the seriously ill child at an early stage to prevent deterioration.
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