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Clinical Practice Guidelines

  • Positional plagiocephaly
    www.rch.org.au/clinicalguide/guideline_index/Positional_plagiocephaly/
    use 4-6 months corrected age), and ongoing growth until the anterior fontanelle closes Self-correction … of cervical rotation  Palpate Size of anterior fontanelle The anterior fontanelle can vary in size from small … to large 1% have a closed fontanelle at 3 months of age, 38% at 12 months of age, 96% at 24 months of age …
  • Recognition of the seriously unwell neonate and young infant
    www.rch.org.au/clinicalguide/guideline_index/Recognition_of_the_seriously_unwell_neonate_and_young_infant/
    tachycardia  Central CRT ≥3 seconds  Dry mucous membranes, reduced skin turgor, sunken fontanelle   Reduced … urine output / Hypotension Neurological Bulging fontanelle  Neck stiffness  Tone Focal neurological … fontanelle Infective – Viral Bronchiolitis Tachypnoea, increased work of breathing Primary HSV – in first 1 …
  • Radiology - Acute indications
    www.rch.org.au/clinicalguide/guideline_index/Radiology_Guidelines_Acute_indications/
    : Large head  Rapidly enlarging head with open fontanelle. Neurological concerns in neonates/ infants … Clinical usefulness will vary depending on size of fontanelle and indications and should be discussed …
  • Lumbar puncture
    www.rch.org.au/clinicalguide/guideline_index/Lumbar_puncture/
    Note: a bulging fontanelle in the absence of other signs of raised ICP is  not  a contraindication ….3-A106. 10.1136/archdischild-2012-301885.250 Beri S et al 2011. Bulging fontanelle in febrile infants …
  • Vomiting
    www.rch.org.au/clinicalguide/guideline_index/Vomiting/
    may suggest intracranial pathology bulging fontanelle may be a sign of raised intracranial pressure …
  • Dehydration
    www.rch.org.au/clinicalguide/guideline_index/Dehydration/
    & fontanelle Not sunken Sunken Deeply sunken Mucous membranes Moist Dry Dry Skin turgor Instant recoil Mildly …
  • Acute meningococcal disease
    www.rch.org.au/clinicalguide/guideline_index/Acute_meningococcal_disease/
    stiffness , headache , photophobia , bulging fontanelle Non-blanching rash: petechiae/purpura Note …
  • Gastrooesophageal reflux disease in infants
    www.rch.org.au/clinicalguide/guideline_index/Gastrooesophageal_reflux_disease_in_infants/
    Hepatosplenomegaly Bulging fontanelle and/or increasing head circumference Management Investigations Investigations …
  • Febrile child
    www.rch.org.au/clinicalguide/guideline_index/Febrile_child/
    Reduced skin turgor Reduced urine output Neurological Bulging fontanelle Excessive irritability Neck …
  • Vitamin D deficiency
    www.rch.org.au/clinicalguide/guideline_index/Vitamin_D_deficiency/
    (eg genu varum/valgus - if weight bearing) widening of wrists/ankles delayed anterior fontanelle …

The Royal Children’s Hospital (RCH) acknowledges the traditional owners of the land on which the RCH is situated, the Wurundjeri people of the Kulin Nation, and we pay our respects to their Elders past and present.

The Royal Children’s Hospital (RCH) acknowledges the traditional owners of the land on which the RCH is situated, the Wurundjeri people of the Kulin Nation, and we pay our respects to their Elders past and present.

The Royal Children’s Hospital (RCH) acknowledges the traditional owners of the land on which the RCH is situated, the Wurundjeri people of the Kulin Nation, and we pay our respects to their Elders past and present.