Tag Archives: thalassaemia

Toolbox Talk

Studenten halten Daumen hoch in der UniToolbox talks are a way of ensuring best practice in your workplace.

Since my post yesterday I have had a number of emails asking what a ‘Toolbox Talk’ is?

Toolbox talks are a way of disseminating information on a topic to a group of people you work with to make sure that everyone gets the same message, that they understand that message and in some instances you get them to sign to say they have read and understand that information. It is a way of ensuring that all staff follow best practice. The talk should be brief and presented during work time.

The recent document on Mongolian blue is a good example. Print the document attach a cover sheet with a toolbox number, attach a sheet with all the staff names and ask them to sign it when they have read it. Nominate a member of staff to coordinate the document and ensure that staff know they can go to that person to ask questions if they need to. The document and the information will take no more than 5 minutes to present in the staff room. Limit the document to two weeks on the notice board and then chase up any staff who have not read it and then when complete file it in a folder that must be accessible at all times.

If you number the documents sequentially you can track who has and who has not read the information.



Mongolian Blue Spots

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Mongolian Blue spots

I have had this raised by a nursery recently which they felt would be helpful to other child care professionals.

Mongolian Blue Spots can occasionally be mistaken for bruises however they are a type of birthmark and are a non cancerous skin marking and they are not associated with any disease.

Mongolian Blue spots are blue or a blue grey flat skin marking that appear at birth or very soon afterwards. They can be single or multiple in number and they can appear any where on the body but are usually on the back on or near to the buttocks.

They can be mistaken for bruises if they appear after birth and can be irregular in shape approximately 2 to 8 cm wide. They are birthmarks not bruises.

A high percentage of children from Asian, East Indian and African descent can develop these but they are quite rare in white European children. More boys than girls are affected.

They tend to fade as the child gets older.

First Aid Treatment

None required as they are not painful, you just need to bring it to the attention of the parents and advise them to see their GP incase they need any further advice. It should be picked up by the healthcare routine newborn examination.

Make sure you log the condition in the child’s notes so that you can discount this during any pre hospital surveys and treatments.

The biggest issue is wrong diagnosis when they can be mistaken as bruises and treated as such.

Make sure all your staff are made aware of this condition especially if you have children from the at risk group.

It is important that if the child has an accident make sure you carry out your Primary and Secondary survey and get a history  for the child.


Make sure you highlight the condition to any ambulance crew who attend the child.


I have attached a handout from Great Ormond Street Hospital which is excellent. I would print this out and make sure all staff are made aware of it as a ‘ToolBox Talk’.

Mongolian blue spot F0170 A4 bw FINAL Jun13



During the paediatric first aid courses I talk about Sickle Cell Anaemia and I mention the increase recently in the number of children suffering from thalassaemia. It has been my intention to raise awareness for childcare professionals about this blood disorder for a while.

Below is a simple explanation and a link to more information about this disorder.

DuThalassAemias are a group of blood disorders that affect the way the body makes HAEMOGLOBIN, a protein found in red blood cells that is responsible for carrying oxygen throughout the body.

The body contains more red blood cells than any other type of cell, and each has a life span of about 4 months. Each day, the body produces new red blood cells to replace those that die or are lost from the body.

With a thalassaemia, the red blood cells are destroyed at a faster rate, leading to anaemia, a condition that can cause fatigue and other complications.

Thalassaemias are inherited conditions — they’re carried in the genes and passed on from parents to children. People who are carriers of a thalassaemia gene show no thalassaemia symptoms and might not know they’re carriers. If both parents are carriers, they can pass the disease to their kids. Thalassaemias are not contagious.

While there are many different types of thalassemias, the main two are:

  1. Alpha thalassaemia: when the body has a problem producing alpha globin
  2. Beta thalassaemia: when the body has a problem producing beta globin

When the gene that controls the production of either of these proteins is missing or mutated, it results in that type of thalassaemia.

Thalassaemias are most common in families from Asia, the Mediterranean basin, and the Middle East.

Sickle-cell disease / thalassaemia can be managed by simple procedures including:

  • high fluid intake
  • healthy diet
  • folic acid supplementation
  • pain medication
  • vaccination and antibiotics for the prevention and treatment of infections
  • a number of other therapeutic measures.


WHO | Sickle-cell disease and other haemoglobin disorders