Promoting child health in Papua New Guinea through paediatric care, research, training, and advocacy. Learn more about our mission and activities. Championing Child Health Across Papua New Guinea Child Health Caring for every stage of childhood Training & Support Building skills, sharing knowledge Advocacy Championing child health for all Who Are We? The Paediatric Society of Papua New Guinea, founded in 1975, is a professional medical society dedicated to advancing child and adolescent health. With a growing membership of over 100 pediatricians, trainees, nurses, and health workers, the Society works closely with the National Department of Health and the University of Papua New Guinea. The Society's key roles include setting national standards for pediatric care, advising on health policies, raising community awareness, supporting medical training, and offering continued professional development and peer support. Articles for Parents Care for Sick Children Children are prone to get sick, especially from infections caused by germs. Infants and young children under 5 years of age are the ones... Vaccines and Immunization Vaccines (also called immunisation) save many thousands of children’s lives each year. Vaccines prevent children becoming ill from... Nutrition Breast Feeding and Good Nutrition Help Your Child Survive, Grow and be Healthy Malnutrition is very common in PNG. Many mothers have... Read More Our Role The roles of the Paediatric Society t o develop and maintain standards of paediatric clinical care and public health, according to the latest evidence. The Society is the custodian of clinical guidelines, and ensures they are kept up to date. Read more...

Training Tools Training The School of Medicine at the University of Papua New Guinea runs post-graduate training in paediatrics and child health. The training consists of a 1-year Diploma of Child Health (DCH), followed by a 3-year Masters of Medicine in Paediatrics. The DCH can be done from any hospital where there is a paediatrician. The training is a mixture of clinical paediatrics and public health, with a focus on the common causes of disease in PNG children, available treatments and holistic care, determinants of health and illness prevention, and evidence-based health care. Trainees do a research project for both their DCH and Masters. Curriculum: UPNG Post graduate curriculum DCH and MMed in Paediatrics From Pregnancy to Adolescence — We’re Here Every Step of the Way

Quality Improvement Quality Improvement This page contains tools for Quality Improvement in Paediatric Care. Assessment Checklist for Quality Improvement Quality Check List for Paediatrics Above is a link to a ‘self-assessment’ checklist, to identify areas where improvements are needed. It is not meant to be too detailed, just key quality indicators that you can run through, to highlight strengths, identify gaps, and make changes. Improving Monitoring and Identification of the Deteriorating Patient Paediatric Monitoring and Response Chart 2023 These charts have thresholds for escalation (Red you must call a doctor – registrar or above – to review the child ASAP; Orange , you should also be alert and escalate to a senior nurse or RMO). These charts require trained nurses who understand how to plot the charts, and RMOs and registrars who can come to review patients and make assessments if observations are in the Red zone. Depending on the frequency of observations, each chart can last 2 days (if 2nd hourly observations), 3 days (if 3rd hourly observations) or 4 days (if 4 hourly observations). The frequency of observations is prescribed by the doctor, depending on the severity of the patient, and this changes as the child improves. PNG Paediatric Quality Improvement Program The components of this program include: A quality improvement team in each hospital Use of a Quality Improvement Checklist for paediatric health services Regular mortality and morbidity audits Training on the care of seriously ill children, through the WHO Hospital Care for Children training Establishment of intensive care areas in the paediatric wards for the care of the most critically ill children Paediatric monitoring and response charts with early warning indicators and escalation processes Infection control and antibiotic stewardship , including hand hygiene Improved systems for managing children with chronic conditions (cerebral palsy or developmental problems, epilepsy, chronic cardiac, respiratory, cancer) Improved laboratory support and diagnostic tests , especially diagnostics to guide antibiotic use Continuing medical education for paediatricians and paediatric nurses Communication about seriously unwell patients – improving handover ISBAR communication tool for seriously ill patients March 2019 Clinical handover using ISBAR Registrars should be present at handover every morning Report on admissions overnight – numbers, diagnoses Say specifically which beds the sickest patients are in (all new admissions and children who have deteriorated), whether in the wards or still in emergency department Report on patients who have deteriorated or been admitted to the PICU area overnight. Start a PICU handover as part of the morning handover, with a status update of the patients in the PICU or high dependency area on your ward in provincial hospitals. For the handover of the sickest patients, and any seriously ill children who present overnight and might still be in the emergency department, hospitals may use a communication tool called ISBAR (introduction / situation / background / assessment / recommendation). Investing in Children’s Health is Investing in the Nation

Child Death Review Meetings Child Death Review Meetings Mortality Review Meetings WHO January 2019 This is a description of how to conduct regular child mortality review meetings. The forms below are used for summarising the cases for discussion, identifying diagnoses, and drawing up a plan for actions and recommendations from the meeting. Below is a lecture describing child death review meetings https://youtu.be/Ec51GpWwhtM Death Register Form 01 The Death registrar form is held in the ward, and the names of children who died are recorded. This is so that at the designated time each week that the audit meeting is going to be held, you will have a list of the cases for discussion. This form is taken to the meeting to ensure that all cases, or the selected cases, are discussed. Child Mortality Reporting Form Final Version 2017 02 The Child Mortality Reporting Form is the main form used at the weekly audit meeting to record information about the case. It is best if the person who is coordinating the meeting fill some of the demographic information in before the meeting, so the meeting can focus on discussing the story, and determining if there are any avoidable factors, and what action needs to be taken. Cause of Death Codes 03 The Cause of death codes is a list of standardised diagnoses. These are common in PNG, and all are included in the PHR. This is in an effort to assign an accurate and standardised cause(s) of death. 04 Action Plan Summary Form 04 The Action plan summary form is a summary each week of the meetings resolutions, which should be reviewed at the next and subsequent meetings to determine if the required action was taken. Over time, by filling out this form and reviewing all outstanding actions, it should be possible to determine if progress is being made.

CME Continuing Medical Education Q&A 2018 2017 2016 2015 Because Every Child Counts

Guidelines Treatment Guidelines PNG Standard Treatment for Common Illnesses in Children The PNG Standard Treatment manual for common illnesses in children has been continuously in print since 1975, and is now in its 10th Edition. It is one of the longest running clinical guidelines in the world. Members of the Paediatric Society revise and update the manual every 5 years, drawing on international and local evidence and experience. PNG Standard Treatment Book for Children 10th Edition 2016 WHO Pocket Book of Hospital Care for Children The Pocket Book of Hospital Care for Children is a clinical guideline used in provincial and district hospital for hospital management of serious illness. The second edition was published in 2013. There is a 4-day training course that teaches staff how to use the guidelines in clinical practice. The Paediatric Society is active in training health workers in many provinces. Training is linked to other measures to improve quality of care. Hospital Care for Children Paediatrics for Doctors in PNG Paediatrics for Doctors in PNG was originally written in the 1980s by Frank Shann and Professor John Biddulph. The book was revised in 2000 by Prof John Vince and Prof Frank Shann. It contains guidance on practical procedures and the treatment of many common conditions. Download Paediatrics for Doctors Child Health for Nurses and HEOs This third edition of the text-book on child health for nursing and HEO schools and reference for nurses looking after children was completed in 2022. Child Health for Nurses and HEOs in Papua New Guinea 3th Edition March 2022 PNG Standard Treatment Manual for Obstetrics and Gynaecology These guidelines have been produced since 1986 by the O&G Society, with input from the Society of Midwives. The latest edition, edited by Professor Glen Mola, contains many updates on new treatments, and new diagnostics, including ultrasound. PNG Standard Treatment Manual for Obstetrics and Gynaecology 7th Edition 2018 Oxygen Therapy Guidelines WHO Oxygen therapy for children 2016 Bubble-CPAP guidelines 2017 Child Health Record Book Every new baby in PNG should have a Child Health Record Book (Baby Book) for recording vaccines, weight, any illnesses and how they are treated. This is a very important book, and should be kept in a safe place and brought to the clinic at every visit. The Baby Book also contains information for parents on feeding, what signs of illness to look out for, and family planning. Weight charts are essential for growth monitoring, you can download these below. Baby Book Girls Baby Book Boys Monitoring Growth and Nutrition Weight for age chart Girls 0-5 years Weight for age chart Boys 0-5 years For older children monitoring growth is also important, especially in children with a chronic illness. Below are the WHO body mass index charts for females and males aged 5-19 years. Body mass index charts 5-19 years WHO Mid upper arm circumference (MUAC) is a useful screening test for malnutrition. The chart below shows reference ranges for different ages, so MUAC can be useful from infants to adolescents and adults. This chart was designed by the University of Rochester, adapted from WHO guidelines. Malnutrition – Guidelines and Tools for Management In this section there are tools to guide management of children with severe and moderate malnutrition. The case fatality rate for severe malnutrition in PNG hospitals was 18-20%, but this has now been reduced with a systematic approach. Our target is to eliminate all preventable deaths and have the case fatality rate for severe malnutrition well under 10%. Severe acute malnutrition PNG guidelines 2018 Management of severe malnutrition wall poster F75 and F100 Milk feeding chart Recipes for home-made F75 and F100 Inpatient Weight Chart Severe Malnutrition monthly recording form Nutrition Education Resources Frangipani Friendly Clinic Healthy Plate Poster Pasifika Plates Recipe Book HIV Treatment Guidelines These guidelines highlight the importance of using new combination ART, given the high rates of resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI). All children should be transitioned or commenced on Dolutegravir (DTG) based therapy: Abacavir (ABC), Lamivudine (3TC) and DTG as 1st line treatment – see UPDATE Summary below. For adolescents over 30kg, the preferred 1st line regimen is Tenofovir (TDF) + 3TC + DTG. The new guidelines also highlights the need for regular viral load monitoring and clinical assessment to detect treatment failure. PNG HIV care and treatment guidelines 2019 UPDATE Memo from NDoH on DTG-based therapy for children Nov 2021 UPDATE Summary of ABC 3TC DTG therapy for children and adolescents Nov 2021 Instructional video: How to Administer Lopinavir/Ritonavir Pellets to Children with HIV Nurse Abigael Wanyana from Gertrudes Children’s Hospital in Kenya shows clearly how to give Lopinavir/ritonavir (LPV/r) pellets to children. LPV/r is part of second-line therapy for children and adolescents, and is bitter tasting, so mixing with expressed breast milk makes it palatable. WHO Guideline on Management of Tuberculosis in Children and Adolescents (2024) WHO Management of tuberculosis in children and adolescents Module 5 2024 This comprehensive WHO guideline covers all aspects of TB diagnosis, treatment, prevention and prophylaxis. WHO Treatment Guidelines for Multi-Drug-Resistant Tuberculosis (2019) WHO guidance on MDR Tuberculosis 2019 The MDR regimen depends on the drugs you have available and how unwell the child is. See pages 96-99 of this WHO guideline on MDR, it contains the medication doses and weight bands for children. Look at the charts, and in general choose 1-2 drugs from each class (A, B, C), until you have at 4-5 drugs. For example: A: Levofloxacin B: Cycloserine C: Ethionamide and pyrazinamide and para-amino-salicylic acid (PAS) Avoid injectable aminoglycosides (kanamycin / amikacin) if bedaquiline or delamanid are available, to avoid IM injections and serious side-effects, especially deafness which occurs in 20% of children on long-term aminoglycosides. Child Protection, Maltreatment and Gender-Based Violence Child maltreatment clinical handbook WHO 2022 Child protection resources Sexual and gender-based violence clinical guideline 2021 1-Tok-Kaunselin Helpim Lain Service Provider Directory 2017 Paediatric Cancer Protocols Click here for more details of the PNG paediatric cancer protocols, developed by Dr Gwenda Anga. Evidence-Based Care. Lifelong Impact.

Research Research Below are summaries of the latest research on child and adolescent health in developing countries: evidence derived from all the randomized trials. The aim is to make this information widely available to paediatricians, child health nurses, midwives, researchers, students and administrators in places where up-to-date health information is hard to find. We hope it will be helpful in reviewing treatment guidelines and clinical and public health approaches, and in teaching about paediatrics and evidence-based medicine. RCTs in child and adolescent health in developing countries 2023-2024 RCTs in child and adolescent health in developing countries 2022-2023 RCTs in child and adolescent health in developing countries 2021-2022 RCTs in child and adolescent health in developing countries 2020-2021 RCTs in child and adolescent health in developing countries 2018-2019 RCTs in child and adolescent health in developing countries 2017-2018 RCTs in child and adolescent health in developing countries 2016-2017 RCTs in child and adolescent health in developing countries 2015-2016 RCTs in child health in developing countries 2014-2015 RCTs in child health in developing countries 2013-2014 RCTs in child health in developing countries 2012-2013 RCTs in child health in developing countries 2011-2012 RCTs in child health in developing countries 2010-2011 RCTs in child health in developing countries 2009-2010 RCTs in child health in developing countries 2008-2009 RCTs in child health in developing countries 2007-2008 RCTs in child health in developing countries 2006-2007 RCTs in child health in developing countries 2005-2006 RCTs in child health in developing countries 2004-2005 RCTs in child health in developing countries 2003-2004 RCTs in child health in developing countries 2002-2003 Healthy Beginnings. Strong Futures.

Hospital Reporting Program Hospital Reporting Program Click here to download and install PHRV12.5 on the desktop Steps to install PHRV12.5 1. Download PHRV12.5.zip 2. Go to the downloads folder and find PHRV12.zip and extract it into the computer (Please use 7ZIP to extract the file to the computer . ) 3. Go inside the PHRV12.5 folder and find PHRV12.5.exe. 4. Double click on PHRV12.5.exe and follow the installation prompts. Paediatric data form PHR 12.5 Neonatal data form PHR 12.5 Maternal and Newborn data form PHR 12.

2022 - Weekly Paediatric Lectures 2022 – Weekly Paediatric Lectures Paediatric training overview and how to learn https://youtu.be/MzbUAiWAopo This teaching session focuses on the many ways we can learn paediatrics and child health, so that trainees can make the most of the learning opportunities, and include them into a learning plan for 2022 and beyond. COVID in 2022 and the other side of the pandemic https://youtu.be/WAP7soFUK6g This session covers where COVID is up to in 2022. We discuss the SARS Co-V-2 variant Omicron and its effect on children. We know a lot about this in the last months from what has happened in South Africa and other heavily affected countries. We need to understand the ways in which COVID in 2022 is different from 2021 and 2020, and what it means for paediatrics (mostly it will be good news!) In addition to vaccines, what other therapies are useful in COVID? Type 1 Diabetes in children https://youtu.be/44Iaw79ktZU In the past type 1 diabetes was rare in children in the Pacific, but it is now increasingly, as it is in all countries around the world. Children with diabetes need careful management of their initial presentation – usually ketoacidosis, and they need careful transition to chronic long-term treatment. There is a lot to think about when we are looking after a child with diabetes, but if we manage all issues then these children can have a very good outcome. In this session we cover all stages of management and describe the complications and pitfalls to avoid. Meningitis and encephalitis in children https://youtu.be/Z3q85tj5zVw This teaching session covers meningitis and encephalitis, and other causes of acute febrile encephalopathy. We cover diagnosis and treatment, including basic measures to prevent secondary brain injury – we will go through all the causes and how to prevent them. To care for such patients, we need to understand the rationale for using certain antibiotics in meningitis, antimalarial therapy in cerebral malaria, and how to monitor children properly to prevent secondary brain injury. We also cover identification and treatment of complications (such as cerebral abscess) and when to suspect other causes (tuberculosis, cryptococcosis, non-infective causes). Pneumonia and bronchiolitis https://youtu.be/UIEIiCBlSdI Pneumonia is the most common cause of child morbidity and mortality, and it is both simple and complicated. Treatment guidelines outline a Standard treatment approach for simple pneumonia, but many cases are complicated, and we need early recognition of such cases. We need to improve risk assessment for children with pneumonia, and this involves early recognition of risk factors. If we recognise these risks early, we can put in place measures to achieve a better outcome. These risks include hypoxaemia, WHO emergency signs, malnutrition, chronic comorbidity, neonates, special x-ray changes, and sometimes other laboratory tests. We need to identify complicated cases of pneumonia, especially empyema, and lung abscess, and cases that will not be treated with standard antibiotic therapy, including tuberculosis or Staph pneumonia. There are ways to do this, and we discuss in this teaching session. Antibiotics and antibiotic resistance https://youtu.be/LCL5wJEFeEo Antibiotics treat bacterial infections, but in the last 25 years bacteria causing common infections are becoming resistant to many antibiotics, in Papua New Guinea and in all countries. We need to understand the mechanisms of antibiotic resistance, the different types of resistance in different bacteria, and the options of treatment. Standard Treatment is still effective first line treatment for most common infections, but we need ways to identify clinically and with simple tests the patients most at risk of antibiotic resistance. We can put in place steps to limit antibiotic resistance in our hospitals and paediatric wards, this is called antibiotic stewardship, and we discuss the ways to do this. Epilepsy in children https://youtu.be/rhiUQQFbpCI Epilepsy is common in children, as high as 1-4% in some communities. We need to know how to diagnose epilepsy, an understanding of the types of childhood epilepsy, the anti-epileptic medications, why to choose certain drugs, their complications, what to do if one drug is not working, and the overall goals of care for children with epilepsy. Most children and adolescents with epilepsy can have a good outcome if they and their families are cared for in a holistic way. Fluid and electrolyte management https://youtu.be/6i37wZV1SVo In this session we cover the essentials of fluid and electrolyte management in children, including the type and volume of fluid to use, the dangers of low sodium containing intravenous fluids formerly commonly used in paediatrics, the risks of hyponatraemia and hypernatraemia and how to treat, the importance of clinical monitoring of oedema and dehydration, and how to calculate fluid replacement in a child with severe dehydration, including the deficit, maintenance, and ongoing losses. Neurological examination of children https://youtu.be/QN5vHMKXzMw In this session we go through the neurological examination of children and describe a practical approach to making clinical diagnoses – by first asking “where is the lesion”, to locate the neurological abnormality, and afterwards ask “what is the lesion”. With history and neurological and general examination, many clinical diagnoses can be made. Vaccines and vaccine preventable diseases https://youtu.be/SSBU5XcrHqo This session covers the basic information paediatric trainees need to know about vaccines and the diseases they prevent, the history of the expanded programme of immunisation (EPI), the different types of vaccines, and the recent changes to the vaccine schedule. This will help you become familiar with the current EPI schedule, and vaccine terminology, for example what live attenuated, inactivated, recombinant, conjugate, and adjuvant mean. We also cover the science of why measles outbreaks occur, and the reasons for recent polio and pertussis outbreaks in PNG. Failure to thrive https://youtu.be/II2C6KV2BPs Failure to thrive is a common paediatric presentation. It is not just malnutrition but encompasses the developmental impact of poor nutrition. Failure to thrive is often a combination of inadequate energy (calorie) or protein intake, inadequate absorption of nutrients in the gut, increased energy utilisation, underlying infectious or genetic condition, psychosocial and environmental factors. It is important to understand each component to manage these children properly. We will discuss the assessment of a child with failure to thrive, the stages of management of severe malnutrition according to WHO and Standard Treatment guidelines, and how to identify and manage refeeding syndrome, which can cause patients to deteriorate after recommencing feeds. Neonatology I: care of the very low birth weight baby https://youtu.be/LV-tib4RQJg In this teaching session we cover definitions of low birth weight and prematurity, gestational age assessment, multi-system complications of prematurity, respiratory complications and care for the developing lungs, nutrition and growth monitoring, gastrointestinal complications, retinopathy, anaemia, hospital discharge criteria and follow-up of very low birth weight babies. Neonatology II – infections https://youtu.be/rzlfrFFdyNc In this session we cover all common neonatal infections: bacterial, viral, including intrauterine, and post-natally acquired infections in newborns. Paediatric mortality and morbidity audit meetings https://youtu.be/ROiuFhpnPpQ Auditing of child deaths allows the identification areas that can be addressed to improve quality of care. About 50% of child deaths have at least one modifiable or preventable factor: in the community, in primary health care, or in hospitals. Audit is an important process, but it must be non-blameful, open to and supportive of all staff, and educational. This teaching session goes through how to run M&M meetings, and the importance of follow-up after such meetings by a quality improvement team to put changes in place. All hospitals should do regular audit, and paediatric trainees need to learn how to conduct these meetings. Cardiac disease in children I https://youtu.be/Iw7pDHKo_BE In this first of two sessions on paediatric cardiology, we will discuss the causes of heart failure at different ages, especially focus on acyanotic congenital heart disease, and the most common left to right shunts (ASD, VSD, PDA). We will go through how to assess cardiac function clinically, and how to integrate the history (age of presentation, severity, symptoms, associated features), the examination finding, the chest x-ray and ECG to make the diagnosis 90% of cases. We will cover the basics of echocardiography, but very often we can make a working diagnosis on clinical grounds and with proper interpretation of x-ray and ECG. Cardiac disease in children II – cyanotic CHD and pulmonary hypertension https://youtu.be/Hm5TyQ8GmwI In this session we will discuss cyanotic congenital heart disease (CHD), its different presentations in the newborn period, infancy, and older childhood. We will discuss how to manage the cyanosed neonate, who might have CHD, but also might have other conditions, such as persistent pulmonary hypertension of the newborn (PPHN), sepsis, or congenital lung disease. We will also discuss acquired pulmonary hypertension that arises due to chronic lung disease, severe pneumonia, high altitude, and nutritional issues, especially a problem in the highlands. In this session you will learn the ECG and x-ray changes of common forms of cyanotic CHD and pulmonary hypertension, so the diagnoses can be made using clinical features and basic investigations. Renal disease in children https://www.youtube.com/watch?v=utB37NOvkbA We cover nephrotic syndrome, post Streptococcal glomerulonephritis and congenital renal diseases that can lead to chronic renal failure. We also cover acute renal failure and its management, nephrotoxic drugs and management of complications, particularly hypertension. Adolescent health Part 1: https://youtu.be/styx0_YSIyA Part 2: https://youtu.be/REIx6UKoAhg This teaching session in 2 parts, by Dr Mary Paiva covers the main issues in adolescent health. Adolescent health is increasingly important in PNG, and paediatricians need a good understanding of the neurobiology, the neurodevelopmental transition and vulnerabilities of adolescence, the factors that influence health seeking behaviours of adolescents, and their health concerns, including sexual health, mental health, substance use, nutrition, and particular issues for adolescents with chronic diseases. Dr Paiva discusses the roles of health services for adolescents in hospitals and in the community, in prevention, education and treatment. Anaemia in children Video links (in 2 parts): https://youtu.be/Ra_eq54-7TY https://youtu.be/h8mQbv1bH1Q In 2021 anaemia was reported in at least 7% of all paediatric hospital admissions, the case fatality rate was 12%, and anaemia was a comorbidity in at least 17% of all child deaths. Anaemia increases the risks of infection, poor growth and development. In this session we will cover the common causes of anaemia in children, especially iron deficiency and nutritional anaemia. We will discuss how to assess the child with pallor, how to distinguish based on clinical features and an analysis of the FBC the different causes of anaemia. We will cover iron physiology, anaemia of malaria, anaemia due to haemolysis and anaemia due to bone marrow failure, and Thalassaemia. We will also discuss nutritional treatment of anaemia, safe use of iron, and indications for blood transfusion. Soil transmitted helminths in children Video link https://youtu.be/OyGiBaejNjQ WHO identifies soil-transmitted helminths as among the neglected tropical diseases (NTD). Many children in PNG are affected by these infestations, including from Ascaris, Human hookworm, Cutaneous larva migrans (dog hookworm), Whipworm, and Strongyloides. This session will discuss sources, lifecycles, clinical features, and treatment of these infections, which cause a lot of morbidity and nutritional problems in children. Trainees need a good understanding of the basics of helminth infections, as they are often truly neglected in our management of patients. Liver disease in children Video link: https://youtu.be/geKKZWi3VgA Liver disease is more common than may think, being caused by a variety of conditions directly affecting the liver, and systemic infections where liver dysfunction is a part of it. Liver disease can be a part of virus, bacterial and parasitic infections, cancer, and drug side effects. Paediatricians need to have a good understanding of liver anatomy and physiology, the different functions of the liver, the production and excretion of bile, and the significance of different tests of liver function. In this teaching session we discuss the differences between physiological and pathological jaundice in newborns, thresholds for phototherapy, the various forms of congenital liver disease such as biliary atresia and neonatal hepatitis. We also cover liver disease in older children, where we need to distinguish acute from chronic liver disease and recognise the effect of drugs on liver function. We can diagnose most liver diseases with a good history, clinical examination, and an understanding of the basic LFTs. Although there is often no specific treatment that can be given to children with liver disease, many types of liver disease resolve with time, and there are important ways to support such patients to give their liver the best chance of recovery. Paediatric x-rays Video link: https://youtu.be/xBNqltqj8P4 In this teaching session we will go through a series of x-rays to show common problems in seriously ill children and learn how to relate the changes you see on x-rays to the clinical picture and pathophysiology. So many diagnoses can be made by linking these things together (clinical, x-ray, pathophysiology). In the DCH and MMed exams you will need to be interpreting x-rays, so watch the session if you can. Management of critical illnesses in children I Video link: https://youtu.be/WGJ7G7tV5Aw In this session we will go through some common scenarios in the management of common severe illness in children, including severe acute respiratory distress, upper airway obstruction in infants, and sudden cardiac arrest in a previously well adolescent. We can use clinical signs and basic test to differentiate the causes of these clinical syndromes: for example, differentiating when severe respiratory distress is due to pneumonia or airways disease, and then considering the different causes of airways disease at different ages. This type of deductive reasoning allows for specific treatment that addresses the underlying pathophysiology, at the end we discuss a framework for thinking about children with critical illness on ward rounds. Common critical illness in children II Video link: https://youtu.be/4bZt2AkEIKc In this second teaching session on the management of critical illness in children we discuss a few case scenarios and how to approach them, including unusual causes of respiratory distress, the causes and management of shock in a child with Hirschsprung disease, and basic neuroprotection for children with meningitis or encephalitis. Differentiating causes of acute illness, understanding the pathophysiology, providing supportive care and monitoring, and giving time are all important for critically ill patients to recover. How to write a minor thesis Video link: https://youtu.be/KXavdZfRCrg In this teaching session, we cover the next step of how to write a thesis. Includes developing a spreadsheet, ensuring it is analysable, and how to construct and write a thesis. There are many things you can do to make the process easier, and that help you learn about doing research. HIV in children and adolescents YouTube recording did not work In this session we discuss all things related to HIV management. The diagnosis, types of anti-retroviral drugs, mechanisms of drug resistance, and the new recommendations for ART dolutegravir-based therapy. We also discuss chronic care for children and adolescents with HIV, which involves a lot more than ART, including consideration of nutrition, gastrointestinal, lung, cardiovascular, renal and bone health, development, and neurological issues. Care of children and adolescents with HIV also requires improving mental health, self-esteem, and school participation. Paediatric cancer YouTube video link is at: https://youtu.be/5ZxQQr-QsOg These 2 sessions on common cancers affecting children in PNG give an overview, covering acute leukaemia, lymphoma, retinoblastoma, chest tumours, and abdominal tumours. We discussed the diagnosis using important clinical signs, basic laboratory investigations, imaging cancer using ultrasound and CT, and cover treatments of the commonest cancers and their complications, and the management of common cancer emergencies. Acute kidney failure and encephalopathy case discussion Video link: https://youtu.be/dVusXDFI05c This session highlights the many cases of acute renal failure and encephalopathy in children in Indonesia. Dr Nina Putri, paediatrician from Jakarta presents a typical case, and other specialists from Indonesia also provide input. We discuss the likely causes, which include diethylene glycol contamination of cough and cold medicines, or a post-COVID complication that severely affects the kidneys. We discuss similar outbreaks in other countries from contaminated medicines including recently in Gambia, and previously in India, Bangladesh, Nigeria, South Africa, treatment options for acute renal failure, public health measures, and the reasons why some remedies have been contaminated in the manufacturing process.

CME 2021 2021 The following are lecture notes on paediatric topics in the DCH and MMed 2021 1 Covid-19 update 2 Pneumonia and bronchiolitis 3 Fever in children 4 Anaemia in children 5 Failure to thrive 6 Vaccines 7 Common paediatric problems I 8 Meningitis and encephalitis in children 9 Oxygen therapy for the Pandemic 10 Fluid and electrolyte management in paediatrics 11 Neonatology – Preterm and low birth weight infants 12 Neonatal infections 13 Endocrine problems in children 14 Paediatric Cancer 15 Intensive management of common paediatric problems 16 Intensive management of common paediatric problems II 17 Paediatric Hospital Reporting Program 18 Common paediatric problems II 19 Soil transmitted helminths in children 20 Cardiac disease in children 21 Cardiac disease in children 22 Common paediatric medical and surgical problems 23 Epilepsy in children 24 Common paediatric medical and surgical problems 25 COVID Delta variant and multisystem inflammatory illness 26 Common kidney diseases in children 27 HIV in children and adolescents 28 Basic research methods how to design a research project 29 CPAP 30 Jaundice and liver disease in children 31 Dengue in children 32 Diagnosis of tuberculosis in children 33 Treatment of COVID infections in children and adolescents

Hospital Care for Children Hospital Care for Children Hospital Care for Children: Education Modules Below are modules for the WHO Hospital Care for Children course which teaches health workers how to use the guidelines in everyday clinical practice. The course teaches the 10 Stages of Management of all sick children: Triage, Emergency treatment, History and examination, Laboratory investigations, Main diagnosis and other diagnoses, Treatment, Supportive care, Monitoring, Discharge planning, and Follow-up. The course can be done as a 4½ day workshop, or a module each week for 10 weeks. It can be done in groups as a workshop or individually for self-learning as part of Continuing Medical Education for nurses and doctors. Practice using the guidelines in the wards is an essential part of learning. The course material were last updated in February 2023. Hospital Care for Children course timetable 2022 Overview and introduction Chapter 3. Early Essential Newborn Care (2023) Chapter 3. Low birth weight Chapter 3. Neonatal sepsis (2023) Chapter 3. Birth asphyxia and resuscitation (2023) Chapter 4. Cough and difficult breathing II complex case Chapter 4. Cough and difficult breathing I Chapter 4. Chronic cough and fever (2023) Chapter 4. Oxygen therapy for children (2023) Chapter 5. Diarrhoea and severe dehydration (2023) Chapter 5. Diarrhoea and dehydration II Chapter 6. Fever in an infant Chapter 6. Fever, convulsions and coma Chapter 6. Fever and joint pains Chapter 7. Malnutrition (2023) Chapter 8. Children with HIV (2023) Chapter 9. Trauma Chapter 9. Burns Chronic illnesses in children (2023) Prevention of infections (2022)

Paediatric Teaching Resources Paediatric Teaching Resources Below are the links to some good teaching videos about clinical history taking and examination for different systems, and some procedures. They are all freely available from the Internet, and the sources are acknowledged. Thanks to Dr Paulus Ripa and others for finding these. Gastrointestinal assessment https://www.youtube.com/watch?v=932E4B9UApg&t=103s https://www.youtube.com/watch?v=oJ1CsJJHZCQ https://www.youtube.com/watch?v=H0e8XkYe7uQ&t=47s Respiratory assessment https://www.youtube.com/watch?v=gcS7RS8pXqs https://www.youtube.com/watch?v=gcS7RS8pXqs&t=11s https://www.youtube.com/watch?v=rKgbIEPYqQ8&t=44s Cardiovascular assessment https://www.youtube.com/watch?v=Mu0C_of6Aw0 https://www.youtube.com/watch?v=hTClmf8egGM&t=343s https://www.youtube.com/watch?v=y-n6MWmT1YA Neurological assessment https://www.youtube.com/watch?v=_XTY8YYhkGU https://www.youtube.com/watch?v=HDDVqEa_MpY How to perform a lumbar puncture This is an excellent video from Dr Osama Naga on how to safely perform an LP and how to interpret the CSF findings. https://youtu.be/Md4Bp4HD5xE Developmental assessment https://www.youtube.com/watch?v=RfemPAlDzN4 https://www.youtube.com/watch?v=ThNsIohZzAY&t=208s https://www.youtube.com/watch?v=nxvAaQm659M Airway videos by Sydney intensive care ambulance officers (input the same password to watch each video: “AiRblogVideos”) https://sydneyhems.com/airway-registry/cmac-videos/