OPD/A&E Clinicians Meeting.

2016 Minutes
DATE: 27 May 2016

PRESENT: Dr. Pafilio Tangitau

Dr. Matamoana Tupou

SHO Alauna Fuka

Dr. Siosaia Faupula

ABSENT: Dr. Maletino Mafi

Dr. Penisimani Poloniati (rugby leave)

Dr. Kaloafu Nofoakifolau (apologies)

Dr. Viliami Vao

SHO Viliami Funaki

BUSINESS:

Todays meeting was a paediatric education session with Dr. Siaosi Aho, with the following
discussion points:

1. There has been a large number of 3 5 week old infants admitted with aspiration
complications due to using Tongan medicine. Common reason given is that the baby was
taken to the hospital and not given anything, or only given paracetamol. We can have a
lower threshold for admitting these young babies to paeds ward, especially younger than 2
months.

2. Another reason that young infants are given Tongan medicine is due to our lack of
explanation to the family about the natural history of the illness (often due to time pressures).
If we could take a bit of extra time to explain about the condition, why antibiotics are not
needed at this moment, what condition baby is expected to be in over the course of the
illness, why Tongan medication can be harmful, etc then we can decrease these cases.

3. Always explain the danger signs of when to bring baby back (poor feeding, lethargy,
colour change pallor, cyanosis difficult breathing, etc). Emphasize not to wait at home,
but come straight to ED for assessment.

4. Reminder normal saline nebulizer is not helpful. It was nebulized hypertonic saline
that had been shown to have effect.

5. We requested to have copies of the wheezing protocols that the paeds ward uses.

6. Adrenaline can be given as a nebulizer for croup. These patients should usually be
admitted.
7. Avoid using anti-emetics for vomiting in children {metoclopramide (Maxalon) or
promethazine (Phenergan)}. Find the cause of the vomiting, which is a non-specific
symptom in children. Can give a low dose of promethazine if requested by patients for
motion sickness on long boat trips, but make sure they understand not to double-dose, etc.

8. For non-itchy rashes, do not give medication to treat the rash.

9. Urine bag is only for screening, for MCS use a catheter specimen of urine with a
small feeding tube.

10. Use 10% glucose for hypoglycaemia at 2ml/kg bolus dose, then continue with
infusion.

MEETING END.