Avoiding Errors in Paediatrics

Contributors, viii Foreword, ix Abbreviations, xi Introduction, xiii Part 1 Section 1: Errors and their causes A few words about error, 1 Learning from system failures - the vincristine case, 1 Person-centred paediatric errors and their causes, 8 The patient consultation, 10 Failure to identify a sick child, 12 Inability to perform practical procedures competently, 13 Failure to check test results or act on abnormal findings, 15 Prescribing errors, 16 Failures in resuscitation, 17 Sources of error in child protection cases, 19 References and further reading, 22 Section 2: Medico-legal aspects Error in a legal context, 25 Negligence, 25 Medical negligence, 26 Issues around consent, 29 Confidentiality, 34 References and further reading, 37 Part 2 Clinical cases Introduction, 39 Case 1 A boy with a limp, 40 Case 2 A fitting infant, 43 Case 3 A persistent fever, 45 Case 4 A biking injury, 48 Case 5 A teenager with abdominal pain, 51 Case 6 A young girl with a vaginal discharge, 54 Case 7 An iatrogenic problem, 57 Case 8 An infant with a large head, 59 Case 9 An infant with bloody diarrhoea, 62 Case 10 An infant with persistent jaundice, 64 Case 11 A child with leukaemia and tummy ache, 66 Case 12 A boy with fever and rigors, 68 Case 13 A stiff hand, 70 Case 14 A serious feeding problem, 72 Case 15 Fits, faints and funny turns, 74 Case 16 A hospital acquired infection, 76 Case 17 Recurrent wheeze, 79 Case 18 A jaundiced neonate, 82 Case 19 A febrile boy with a limp, 85 Case 20 A febrile neonate, 87 Case 21 A neonate with abnormal movements, 89 Case 22 A teenager with scrotal pain, 91 Case 23 A boy with nonspecific symptoms, 93 Case 24 A delayed walker, 96 Case 25 A diabetic girl with a headache, 98 Case 26 A boy with sickle cell disease and a fever, 101 Case 27 Negative test results, 104 Case 28 A bad case of 'flu, 107 Case 29 A difficult transfer, 110 Case 30 Treatment for tonsillitis, 112 Case 31 Increasing respiratory distress, 114 Case 32 A feverish girl with poor feeding, 116 Case 33 An infant with a swollen face, 118 Case 34 Starting a new treatment, 121 Case 35 The importance of interpretation, 124 Case 36 A febrile boy with a scald, 126 Part 3 Investigating and dealing with errors 1 Introduction, 129 2 How hospitals try to prevent errors and their recurrence, 129 3 The role of hospital staff, 134 4 External investigators, 136 5 Hospital investigations, 138 6 Legal advice - where to get it and how to pay, 143 7 External inquiries, 146 8 The role of the doctor, 165 9 Emotional repercussions, 167 10 Conclusion, 169 References and further reading, 169 Index, 171