title: [Challenges in acute paediatric medicine].
abstract: A big drop in the number of severe infections has resulted in less experience in recognising a seriously ill child. The challenge is finding a safe and effective balance between high-quality expertise and quickly accessible care, while avoiding over-diagnosis. There are a number of tools available to aid recognition of a seriously ill child and to avoid delay in diagnostic procedures and treatment: the use of a validated paediatric triage system, validated decision rules and guidelines, listening carefully to the parents ('my child's illness is different this time'), the clinical intuition of the experienced paediatrician and the provision of good 'safety net' advice to parents concerning the alarm signals and when they should contact a care provider. Experienced paediatricians should be at the forefront in the evaluation of the acutely ill child in order to teach their younger colleagues the importance of various alarm signals and the role played by clinical intuition.
authors.affiliation: Erasmus MC - Sophia Kinderziekenhuis, Rotterdam.
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Moll
mesh_terms: D000208:Acute Disease; D002648:Child; D002983:Clinical Competence; D016638:Critical Illness; D003937:Diagnosis, Differential; D006801:Humans; D009426:Netherlands; D010290:Parents / Q000193:education / Q000523:psychology; D010372:Pediatrics / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D014218:Triage