CROUP

MLP-case study

Author: Dr Alexander Stapleton
Type: MLP-case study
Date: 2022
ABSTRACT

Background: This literature review was devised to clarify the rationale between the use of
Dexamethasone and Prednisolone for the treatment of paediatric Croup in the community setting.
Methods: A computerised literature search of local and international Guidelines, PubMed and CENTRAL
(Cochrane Central Register of Controlled Trials) was carried out. Fifteen sources were included.
Indications and use of dexamethasone and prednisolone varied across the cited literature. An evidence
based practice viewpoint and appraisal of the literature was undertaken and the results collated.
Results: Analysis of the literature shows a clinical benefit of Dexamethasone in comparison to
Prednisolone when it comes to re-presentation, with a reduction in patient readmission and
re-presentation when using Dexamethasone compared to Prednisolone. Clinical benefit outside of this
parameter has not been proven. There was also a demonstrable effect on caregiver stress levels when
Dexamethasone was given compared to Prednisolone given ease of use. Some benefit with improved
tolerance with Dexamethasone compared to Prednisolone. There is also a potential cost benefit
involved in treating Croup with single dose Dexamethasone but this would need further exploration in
the New Zealand context.

Cannabinoid Hyperemesis Syndrome

MLP-research

Author: Dr Sandy Crofts

October 2021

Abstract:

Cannabinoid Hyperemesis Syndrome (CHS) is a syndrome of intractable vomiting with severe abdominal pain that is associated with chronic marijuana use. Classically, symptoms are relieved by hot showers and are often unresponsive to traditional acute interventions such as antiemetics.

Patients commonly undergo multiple investigations without diagnosis.  Complete resolution of symptoms occurs with abstinence from cannabis.

The following Medical Literature Project gives an overview of Cannabinoid Hyperemesis Syndrome and review of current management.

Point of care ultrasound for the diagnosis of paediatric distal radius buckle fractures

MLP-research

Author: Dr Alice Mason

March 2022

Abstract:

Paediatric forearm fractures are a common presentation seen in Urgent Care, often occurring from a fall onto an outstretched hand. Currently, best practice is for an x-ray when there is suspicion of a fracture.However, this comes with exposure to ionising radiation and can be associated with prolonged waiting times, pain, and further cost. This review aims to investigate whether point of care ultrasound (POCUS) could be used as an alternative or preferred option for suspected distal radius fractures in children.

Is Adenosine safe for conversion of SVT in Urgent Care settings?

MLP-research

Author: Dr Imran Zia

December 2021

Abstract:

A literature review was carried out to assess the safety of Adenosine in Urgent Care (UC) setting for the termination of Paroxysmal Supraventricular tachycardia (PSVT). Thorough literature evaluation advocates the use of adenosine for the acute termination of PSVT in Urgent care settings, especially in rural and remote practices. It has the potential to improve patient management and satisfaction along with a reduction in cost, ED load, and associated hospitalization.

A Case Review of Paediatric Lateral Condylar Fractures

MLP-research

Author: Dr Zeeshaan Khan
Type: MLP-research
December 2022
Abstract:
Paediatric lateral condylar fractures (PLCF) are the most common fractures in children under the age of 7. This article will provide an overview of paediatric lateral condylar fractures with an emphasis on the importance of obtaining adequate radiographs and providing an accurate classification to guide management. It is essential for Urgent Care clinicians to be competent in the reading of paediatric elbow radiographs and possess a sound knowledge of the different classification systems of PLCF in order to provide the correct treatment and knowing when to refer for operative and non-operative treatment.