The limits of parental responsibility regarding medical treatment decisions.

Parental responsibility (PR) was a concept introduced by the Children Act (CA) 1989 which aimed to replace the outdated notion of parental rights and duties which regarded children as parental possessions. Section 3(1) CA 1989 defines PR as 'all the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child'. In exercising PR, individuals may make medical treatment decisions on children's behalf.

Knee pain: an unusual late complication of meningococcal septicaemia.

Meningococcal disease remains an important cause of mortality and morbidity in the paediatric population. Survivors of invasive meningococcal disease remain at risk from the long-term sequelae of microvascular disease. Chronic orthopaedic sequelae have been reported infrequently in the orthopaedic and radiology literature and there are no reports in the Emergency Medicine literature.

Femoral venous thrombosis in a 5-week old with diabetic ketoacidosis and a femoral venous catheter.

Children with diabetic ketoacidosis (DKA) may require central venous catheters (CVC) for fluid resuscitation. CVC-related thrombus has been reported in a variety of conditions but only rarely in association with DKA and never in a child under one. The case of a five week old child with DKA and a CVC-related thrombus is presented.

Neonatal diabetes mellitus: A rare but important diagnosis in the critically ill infant.

Diabetes mellitus is a heterogeneous disorder that may occur at any age. Neonatal diabetes mellitus, defined as hyperglycaemia presenting within the first 6 weeks of life in term infants, is a rare disorder that may result in permanent or transient diabetes mellitus. Although reported in paediatric diabetes literature, there are no reports of this condition in emergency medicine journals and these children may present to emergency departments with a picture mimicking sepsis.

Acute compartment syndrome secondary to diabetic muscle infarction: case report and literature review.

Acute compartment syndrome has a multitude of aetiologies. Unfortunately, the diagnosis is often delayed, resulting in permanent functional loss. Although spontaneous muscle infarction is an uncommon, yet well-recognized complication of diabetes mellitus, subsequent development of compartment syndrome appears to be rare, with only five case reports identified in the literature.

History of possible foreign body ingestion in children: don't forget the rarities.

Foreign body ingestion in children is a common presenting complaint to the emergency department. Although the majority of ingested foreign bodies pass through the gastrointestinal tract unaided, some children will require either non-surgical or surgical intervention. Retained oesophageal foreign bodies may cause a multitude of problems, including mucosal ulceration, inflammation or infection, and more seriously paraoesophageal or retropharyngeal abscess formation, mediastinitis, empyema, oesophageal perforation and aorta-oesophageal fistula formation.