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I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

Please comment with corrections, additions and further suggestions.

All the information here is collected from the internet, and it might be out of date or inaccurate, so please use your judgement and adhere to your hospital's protocols. If you do notice any errors or omissions please comment so we can put them right!

To navigate, decide whether you want to start with a PMP or a PAP. You can then select which PMP or PAP you want to look at. You will then be taken to the summary page for that PMP, with links expanded topic collections. If you know what topic you want to look at already, click on the link on the right hand side.

Friday, 23 August 2019

Rashes in Children

Eczema and Seborrhoeic Dermatitis
Are essentially the same thing, and I think don't forgetthebubbles have it covered!

Bites and Infestations 
Lyme disease causes erythema migrans (pathognomic). If rash present treat - otherwise test. You can get a Jarisch-Herxheimer reaction  - normally self limiting. Don't give routine prophylactic antibiotics. Remove a tip with direct forceful pressure. 

Dog Bites
Probably OK for primary closure, and no routine prophylactic antibiotics. 
Human Bites
Prophylactic antibiotics - always. Don't close if over 24hours old. Remember tetanus and BBV prophylaxis.

Scabies
The classic burrows may be difficult to see in children. May look a bit pustular - but always VERY itchy! Treat with permethrin.

Head Lice or Nits
Can you read this without itching?

References
https://www.youtube.com/watch?v=QcpjbKCmqAw&feature=youtu.be
https://www.rcemlearning.co.uk/reference/trek-tragedy-review-on-lyme-disease/
https://www.rcemlearning.co.uk/modules/trek-tragedy-review-on-lyme-disease/exams/lyme-disease-post-test/
https://www.rcemlearning.co.uk/modules/lemons-and-lymes/
https://www.rcemlearning.co.uk/modules/the-forest/
https://first10em.com/dog-bite/
https://rebelem.com/myths-management-dog-bites/
https://www.cochrane.org/CD001738/WOUNDS_antibiotics-for-reducing-the-rate-of-infection-after-bites-by-mammals-such-as-humans
https://cks.nice.org.uk/bites-human-and-animal
https://dontforgetthebubbles.com/mel-thompson-eradicating-scabies-at-dftb17/

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