We have repeatedly mentioned in the obstetrics department that the key factor that determines whether a child can be delivered naturally is the child's head. For this reason, the doctor's hands must protect the baby's brain during natural delivery and use standardized delivery gestures.
When the doctor checks the fontanel, in addition to checking whether the fontanel closing time is normal or not, like the child with fever today, he will touch the front fontanel to see if there is any bulge or tightness. If there is any bulge, it may mean that the child has intracranial hypertension.
existence. If the fontanelle is too large and the head circumference is too large, you should suspect congenital hydrocephalus. If the fontanel is too small or closes prematurely, you need to check whether the child's brain is underdeveloped. The above reasons represent the central nervous system.
All lesions may cause clubfoot.
While classmate Xie was checking the fontanel, classmate Wei brought a soft ruler over to help measure the child's head circumference.
Classmate Duan checked the medical records of the temperature and blood pressure recorded by the nurse before taking the child.
After a series of neurosurgery examinations, the child's state of consciousness was acceptable, and he showed no abnormality such as drowsiness. The posterior fontanelle was closed, which is normal. The head circumference was 42cm, within the normal range. There was no bulging or depression in the anterior fontanelle, and no intracranial pressure.
Abnormality. The pupil is 3mm, which is normal. There is no deformity or abnormal curvature of the child's spine. The weight is 81kg and the body length is 60cm, which shows that the child is well nourished and is developing normally. Only the left foot is deformed. The bones need to be photographed again.
Take a X-ray to see if there are any bone deformities.
However, clubfoot generally does not cause fever in children. The doctor needs to continue to examine the child's fever. Xie and Duan put on stethoscopes to listen to the child's heart and lungs.
Student Wei picked up a ballpoint pen and notes, asked the family members and recorded the child's medical history.
"When did you find out your child had a fever?" Student Wei asked, tapping his pen on his notebook.
The child's mother replied: "It must have been yesterday. We tried our best to rub alcohol on him to reduce his fever. If it couldn't be reduced, we took him to the hospital for treatment."
People know that seeing a doctor is troublesome. If some parents see that their child's condition is not serious, they will try to find ways to reduce their child's fever at home. If it can be resolved, it is just a minor problem and there is no need to go to the hospital.
"When did his foot look like this? Do you know?"
After receiving the doctor's question, the child's mother seemed to have just discovered the abnormality in her son's left foot and said in surprise: "When I took him for a physical examination before, the doctor never said there was anything wrong with his foot."
This shows that this child's clubfoot was discovered now. It is not surprising that many children have no obvious symptoms of congenital diseases, and they are not noticed until later symptoms become more and more prominent.
"Did he vomit or have diarrhea?" Student Wei asked again.
The child's mother shook her head.
"Do you have a cough?"
"It seems," the child's mother said. "He was also crying, and his voice was hoarse from crying. We felt that his throat was uncomfortable."
The child cried hoarsely, had an uncomfortable throat, and had problems with the glottis of his vocal cords? Is it acute laryngitis in children? Several young doctors were shocked.
The onset and progression of pediatric laryngitis are acute and rapid, and laryngitis in children is clearly reflected in this aspect. Because children's laryngeal cavities are small, laryngitis is prone to swelling. Children's laryngopharyngeal emission is worse than that of adults, and airway secretions cannot be discharged on their own, further aggravating the obstruction.
, eventually forming laryngeal obstruction and suffocation. It is one of the most common emergency diseases in pediatrics that requires vigilance.