To bark like a dog

Have you ever heard a child bark like a dog? Most likely everyone has seen a child imitate a dog during playtime when they pretend to walk around on all fours and keep yapping. But, have you ever thought you heard a dog when in fact it was a child coughing? I have. At 2:00 …

Neonatal examination

The neonatal examination is one of those medical examinations that will have you stumped if you don't do it routinely. As a medical student I would hate having to practice it, primarily because I didn't have that much experience with neonates. Working in a NICU, I now do a neonatal examination at least 20 times …

All night tears

Getting ready to be a paediatric intern? Then get ready to be woken up between midnight and 3 a.m. by an admission of excessive crying. More often than not by the time the baby comes to the hospital, the vibration of the car/trishaw ride has soothed the baby into pretty much a sedative coma. Annoying? …

The fitting child

This is one of the commonest emergencies in paediatrics. A fitting child. Post-ictal. Or during the ictal phase. They come in all stages of a fit. Whilst attending to the patient, one of the most useful things would be to ensure that the parent remains calm. This is a very hard task, but it will …

Blood transfusions – the basics

As an intern you deal with so many blood transfusions, you become a borderline vampire. In surgery it's the never ending trauma, in obgyn its' all the post-partum haemorrhage whilst in paediatrics it's all the thalassaemia patients. (In medicine it's basically everyone!) If you are super unlucky, you'll end up in a hospital that requests …

Sugar lows in neonates – the basics

Neonatal hypoglycaemia is a very common reason for you to get woken up as an intern in the postnatal ward. The WHO guideline defines hypoglycaemia as <45 mg/dl but this value has been found to vary quite a bit amongst different guidelines around the world. If you're working in Sri Lanka though I would advise …

Neonatal resuscitation – the basics

As an intern in the postnatal ward (which should happen for a period of your paediatric appointment), one of your responsibilities will be routinely attending emergencies. Be it obstructed labour, meconium stained liquor, reduced fetal movements or even to document an IUD, the indications are endless. As an intern, I had to go alone for …

Neonatal jaundice – the basics

As a paediatric intern on the postnatal ward jaundice is going to be a common occurrence. Most of the time the serum bilirubin will come back well below, but very rarely the baby will need either single or double phototherapy. So below I'm going to write about what should be done when a baby seems …

Fluid calculations in neonates – the basics

Due to the large surface area that new born babies have, they are quick to be victims of dehydration. It is vital the healthcare practitioners are on the look out for signs of dehydration in babies (dry skin, reduced urine output and lethargy especially) and also correct any feeding difficulties/prescribe adequate maintenance fluid. In the …

Life in the NICU

So as it goes, I didn't choose the NICU life. The NICU life chose me. How did I get here? In Sri Lanka, you can only choose 2 out of the main 4 medical subjects to do your internship in and each lasts 6 months. After doing paediatrics and surgery during my internship, I was …