Paediatrics

www.starship.org.nz

It is always good to have well-resourced tools to assist in our day to day management of common problems in general practice and the area of paediatrics is no exception.

Starship Hospital has made its paediatric guidelines available online for some time and it is a good opportunity to check out this good local website.

Generally paediatric problems are more succinct, perhaps needing to be dealt with a little less circumspectly than in adult medicine - and in paediatrics there is also rarely any significant comorbidity to confound our diagnostic and therapeutic armamentarium.

The paediatric staff at Auckland's Starship Hospital have always had a good reputation in primary care; they have tended to be quite proactive in hosting CME events over the last five to 10 years and these events have by and large been rewarded with high attendances from all over the upper North Island.

The guidelines link on the Starship website is under the "health professionals" section and includes an extremely comprehensive list of some 80 common topics in acute and semi-acute New Zealand paediatric medicine, together with some paediatric orthopaedics and paediatric surgery.

While this is certainly no textbook of paediatrics, the individual topics are nevertheless carefully and specifically selected and each topic has been dealt with comprehensively (yet at the same time succinctly) and referenced.

Most have been prepared over the last three to four years by Starship paediatric staff, presumably based on lecture notes to students and house officers and appear generally to be regularly updated.

The average topic includes three to six pages of text in a PDF format.

While all 80 items could be aggregated together into a booklet or manual, presumably the articles will be added to and perhaps amended occasionally, so I felt these "lecture notes" are more appropriately sourced directly from the website.

Some of the topics which stood out for me were abdominal pain, recurrent in childhood (6 pages), adolescent consultation (3), anorexia (6), failure to thrive (3), gastrostomy (3), headaches in childhood (9), ITP (4), iron deficiency (3), Kawasaki disease (4), paediatric wound closure (3), nephrotic syndrome (3), paediatric neuro imaging (2), oesophageal atresia and tracheo-oesophageal fistula (3), paracetamol poisoning (5), pulled elbow (1), paediatric sedation (12), splenectomy (2), paediatric tachycardias (6), paediatric urinary infections (6) and urticaria (3).

It is noted on the site that the UTI guidelines are current (updated at the end of 2007).

Kids' health

www.kidshealth.org.nz

At KidsHealth, the Paediatric Society of New Zealand and the Starship Foundation have combined to provide online information resources for certain aspects of child and youthcare for New Zealand parents.

The guides are selective and focused on perceived problem areas rather than pretending to be some sort of "family health" cookbook.

The site includes important information such as keeping children well, medical conditions and helping families through health complexities such as disability, education and accessing welfare help.

For example, one of the great topics (from a list of around 100) in KidsHealth is a very comprehensive guide on dental care titled "Looking after your child's teeth - the first year; the pre-school years and at primary school".

Each section is quite detailed and would certainly also be a great resource for GPs challenged in their detailed dental knowledge base.

Some other sample topics were: what to do with the crying baby; foreskin care; mobile phones and text bullying; grief (reactions by age groups, what to do after a child has died, coping with the death of a parent); how to support your child in pain; how to tell if your child is sick; support when your child has a disability; and the New Zealand health system - finding your way through it.

The KidsHealth site is divided into "Conditions, tests and treatments A to Z" and "Keeping your child well".

It is a very good resource for parents with both sick and healthy children, and could only perhaps be improved with some Asian language options.

Staff and volunteers at Starship Hospital and the Starship Foundation are to be congratulated.