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· FBC with differential.
· Blood cultures.
· Bedside diagnosis of methaemoglobinaemia: place a drop of blood on a piece of filter paper. After 30s exposure to air, normal blood turns red, while blood taken from a patient with methaemoglobinaemia remains chocolate brown.
· Lumbar puncture as indicated.
· Urinary culture.
In the older child a single measurement is needed. In the neonate, assess the change in PaO2 in response to FiO2 100% for 5–10min.
In the neonate the lung fields should be assessed for signs of increased vascularity, pulmonary congestion, or oligaemia. Characteristic radiographic findings are:
· Egg on a string: transposition of the great arteries.
· Boot-shaped heart: tetralogy of Fallot, pulmonary atresia, ventriculoseptal defect.
· Snowman sign: supracardiac total anomalous pulmonary venous drainage.
· Wall-to-wall heart: Ebstein’s anomaly.
Characteristic findings include:
· Superior left axis: tricuspid atresia; endocardial cushion defect; primum atrial septal defect.
· Left axis deviation: pulmonary atresia ± atrial atresia.
· Marked right atrial hypertrophy: Ebstein’s anomaly.
Assessment for specific cardiac lesions.
Standard cardiorespiratory monitoring.
Therapies for specific cardiac, respiratory, and poisoning conditions are discussed elsewhere
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