2426 Chapter 2426
We have repeatedly mentioned before in the obstetrics department that the key factor in determining whether a child can deliver normally is the child's head. For this reason, the doctor's hands during normal delivery should especially protect the baby's brain and standard delivery gestures.
When the doctor checks the fontanel, in addition to seeing whether the closing time of the fontanel is normal or not, like a child with a fever today, he can feel the anterior fontanel to see if it is bulging or tense. Some words may represent the presence of intracranial hypertension in children. If the fontanel is too large accompanied by a large head circumference, it is suspected that it is not congenital hydrocephalus. If the fontanel is too small or prematurely closed, it is necessary to check whether the child's brain is underdeveloped. All of the above reasons represent central nervous system lesions, which may cause equinus.
When Xie was checking the fontanel, Wei came over with a soft ruler to help measure the child's head circumference.
Duan checked the medical records of the temperature and blood pressure records taken by the nurse before the child.
A series of neurosurgical examinations down. The child's state of consciousness is acceptable, and there is no abnormal state such as lethargy. The posterior fontanel is closed, which is normal. The head circumference is 42cm, which is within the normal range. There was no swelling or depression of the anterior bregma, and no abnormality of intracranial pressure. Pupil 3mm, normal. The child's spine is not deformed or abnormally curved. The weight is 8kg, and the body length is 60cm, which shows that the child has good nutrition and is a normal development. Only the left foot is deformed. You need to take another film of the bone to see if there is any bone deformity.
It's just that equinus usually doesn't cause fever in children. Doctors need to continue to check around the child's fever. Xie and Duan put on a stethoscope 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 that your child had a fever?" Classmate Wei asked, nodding on his notebook.
The child's mother replied: "It should have been yesterday. We tried to rub alcohol on him, trying to reduce his fever, and brought him to the hospital if he couldn't."
The common people know that seeing a doctor is troublesome. Some parents see that if their child’s condition is not serious, they will think at home to find a way to reduce their child’s fever.
"When did his foot look like this, do you know?"
After receiving the question from the doctor, the child's mother seemed to have discovered that her son's left foot was abnormal, and said in surprise: "When I took him for a physical examination, the doctor didn't say anything about his foot."
It shows that the child's equinus was discovered now. It is not surprising that the symptoms of many children's congenital diseases are not obvious, and they cannot be noticed until the later symptoms become more and more prominent.
"Did he vomit, did he have diarrhea?" Student Wei asked again.
The mother shook her head.
"Do you have a cough?"
"It seems to be there." The child's mother said, "He is still crying, crying hoarsely, and we think he seems to have a throat discomfort."
The child cries hoarsely, the throat is uncomfortable, and the vocal cords have problems with the glottis? Is it acute laryngitis in children? Several young doctors were taken aback.
The onset and progress of pediatrics are acute and rapid, and laryngitis in children is most vividly reflected in this aspect. Because children's laryngeal cavity is small, laryngitis is prone to swelling. Children's throat emission is worse than that of adults, and airway secretions cannot be discharged spontaneously, which further aggravates the blockage and eventually causes laryngeal obstruction and suffocation. It is one of the most common emergency diseases in pediatrics.