Paeds ENT

Paediatric ENT

Newcastle - STSFT 22-23

Core conditions

Tonsillitis

Otitis media

Glue ear

Allergic rhinitis

Tonsillitis

​Link to NICE CKS guidelines for sore throat on the next page

Applies to both adults and children, but there is some paeds specific stuff

CKS is only available in the UK | NICE

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FeverPAIN

The FeverPAIN score can help you decide whether to give antibiotics

Fever- over 38, in last 24 hours

P- Purulence - exudate on the tonsils on examination

A- Attend rapidly - within 3 days of symptom onset

I- Severely inflamed tonsils

N- No cough or coryza

FeverPAIN

If the score is 3 or more in a child, prescribe antibiotics

Some text here about the topic of discussion

Multiple Choice

You see a 3 year-old girl. On assessment, her temperature is 37.8, but mum reports her temperature was 38.5 at home today, before paracetamol. On examination, her tonsils are mildly swollen, but there is exudate present. She has been coughing. She has been pyrexial and off her food for 2 days. What is her FeverPAIN score?

• 1

• 2

• 3

• 4

Multiple Choice

She has no allergies. What is the most appropriate antibiotic to treat her with?

• Phenoxymethylpenicillin

• Amoxicillin

• Clarithomycin

• Erythromycin

Otitis media

Inflammation of the middle ear

Common in children, particularly following an URTI

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To give antibiotics or not?

Limited evidence that they help

Usually, symptoms start to resolve within 3 days

Sometimes, delayed scripts are issued, in case symptoms don't improve

See the guidelines on the next slides for more info if required :)

Recommendations | Otitis media (acute): antimicrobial prescribing | Guidance | NICE

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Glue ear

Also known as otitis media with effusion

Trisomy 21 = increased risk

Multiple Choice

Glue ear can present with hearing loss. Do you think this would be conductive, or sensorineural?

• Conductive

• Sensorineural

Dull, loss of light reflex

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Otoscopy - glue ear

How do we manage glue ear?

Most self-resolves in 3 months

If it doesn't self resolve, the child might require grommets

Useful link

Otitis Media with Effusion - Grommets - Myringotomy - TeachMeSurgery

Allergic rhinitis

This is hayfever

More likely if personal or family history of atopy

Managed by avoiding allergens, oral antihistamines, and intranasal corticosteroids

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