For these reasons, guidelines will never be a substitute for the need for clinical knowledge and understanding. Our child with non-specific symptoms guideline needs to have another layer – specific diagnoses, what they look like and when to consider them.
We need guidelines to be simple in order to be practical and complex because nothing is simple. We need them to be based on real-world clinical practice and to be honest about the uncertainties inherent to that.
The short answer to the child with non-specific symptoms? Anything is possible, including Kawasaki disease. Early recognition of Kawasaki disease is important as the treatment will reduce complications. So, you better think. In fact, because type 1 thinking will do very nicely most of the time, but not all of the time, you better think.
Edward Snelson is a consultant in paediatric emergency medicine at Sheffield Children’s Hospital. He writes gppaedstips.blogsot.co.uk and is the author of The Essential Clinical Handbook of Common Paediatric Cases. This post was originally published on his site and is used with his permission.
Disclaimer: Over and under-thinking are both perfectly acceptable in the right circumstances.