Intended for healthcare professionals


A paediatric emergency

BMJ 2004; 328 doi: (Published 10 June 2004) Cite this as: BMJ 2004;328:1419
  1. Frances da Cunha, general practitioner
  1. Lonsdale Medical Centre, London

    It was an ordinary evening surgery when a mother brought in her 2 week old baby, saying that he was “not himself, not feeding, sleepy… perhaps, I'm being fussy… fine until this morning,” alternating between platitudes and anxiety. One glance was sufficient to realise that the baby required immediate attention. I had a sudden, automatic change to a clinical “hospitaloid” approach; no patient centred consultation, but an urgent demand to ascertain facts and assess the sick baby.

    He was feverish, breathing satisfactory, awake, with no localising signs, no grunting, no rash or meningism, but probably septicaemic. As I explain to …

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