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Fifteen-minute consultation: A structured approach to a child with primary spontaneous pneumothorax
This article provides a clear, evidence-based and structured approach to assessment and management of PSP in children and young people. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - September 19, 2022 Category: Pediatrics Authors: Buckley, S. J., Adu, J., Whitaker, D., Gupta, A. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Fifteen-minute consultation: ABCDE approach to nutritional assessment in preterm infants
This article provides a brief approach to nutritional assessment for use on the NICU summarised as ABCDE: A—anthropometry, B—biochemistry, C—clinical, D—dietary intakes, E—environment and evaluation. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - September 19, 2022 Category: Pediatrics Authors: Embleton, N. D. Tags: Best practice and Fifteen Minute Consultations Best practice and Fifteen-minute consultations Source Type: research

Highlights from this issue
This article is the Editor’s choice of the month, as it is has a... (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - September 19, 2022 Category: Pediatrics Authors: Gupta, N. Tags: Epistle Highlights from this issue Source Type: research

Olanzapine was an effective additional antiemetic for children and young people undergoing highly emetogenic chemotherapy
Review of: Perkin MR, Bahnson HT, Logan K, et al. Association of early introduction of solids with infant sleep. A secondary analysis of a randomized clinical trial. JAMA Pediatr 2018;172:e180739. Setting: Tertiary hospital in New Delhi, India. Patients: Children aged between 5 and 18 years, weighing over 15 kg, who were scheduled to receive their first cycle of highly emetogenic chemotherapy. Intervention: Olanzapine (0.14 mg/kg orally, once daily, rounded to the nearest 2.5 mg, up to a maximum of 10 mg) during treatment and for 3 days afterwards, in addition to a standard antiemetic regimen (ondansetron, dexamethasone an...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Friend, A. J., Phillips, B. Tags: Key publications in paediatrics: Picket Source Type: research

Nirsevimab reduces medically attended RSV-associated lower respiratory tract infection and hospitalisations in healthy pre-term infants
Review of: Griffin MP, Yuan Y, Takas T, et al. Single-dose nirsevimab for prevention of RSV in preterm infants. N Engl J Med 2020;383:415–25. Study design: Randomised clinical trial. Allocation and blinding: Nirsevimab: placebo, 2:1 ratio. Randomisation was stratified by hemisphere (northern or southern) and by age (≤3 months, >3 months to ≤6 months, or >6 months). Concealment was ensured by using an interactive web response system. Participants, carers and outcome observers were blinded to allocation. Setting: Multisite international clinical trial including 23 countries from both the northern and southe...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Murphy, S. Tags: Key publications in paediatrics: Picket Source Type: research

Treatment with amoxicillin for 3 days for chest-indrawing pneumonia was non-inferior to treatment for 5 days in HIV-uninfected Malawian children
Review of: Perkin MR, Bahnson HT, Logan K, et al. Association of early introduction of solids with infant sleep. A secondary analysis of a randomized clinical trial. JAMA Pediatr 2018;172:e180739. Study design: This is a prospective, double-blinded, randomised, placebo controlled, non-inferiority trial. Allocation: Randomisation was used with 1:1 ratio according to age group and trial phase, in blocks of 2, 4 or 6. Study question Setting: The setting was two hospitals in a malaria-endemic area of Malawi. Patients: Patients studied were 3000 HIV-uninfected children, aged 2–59 months, who presented to the outpatient de...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Ntovolou, A. A., Murphy, S. Tags: Key publications in paediatrics: Picket Source Type: research

Continuous glucose monitoring improves patient satisfaction and frequency of glucose monitoring but does not lead to better glycaemic control in youth with type 1 diabetes
Conclusion: The 6-month isCGM intervention improved testing frequency and diabetes treatment satisfaction for youth with high-risk... (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Farrant, M., Friend, A. J. Tags: Key publications in paediatrics: Picket Source Type: research

Introducing a one-queue model to the paediatric emergency department
Introduction of ‘One Queue’ to our paediatric emergency department (PED)—changing to a single-stream triage destination in PED to improve patient flow, clinician experience and team cohesion. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Greenbury, C., Asim, L., Baynes, H., Mitchell, R. C. Tags: COVID-19 Quality improvement Source Type: research

Implementing less invasive surfactant administration on a neonatal unit
There is increasing evidence reflected in both UK 2019 NICE and European guidelines suggesting that less invasive surfactant administration (LISA) reduces the need for mechanical ventilation and reduces the combined outcome of death or bronchopulmonary dysplasia, and is now the optimal method for surfactant delivery in spontaneously breathing babies. Despite this, uptake in England has been slow compared with Europe. This quality improvement project outlines the process of implementing LISA in a neonatal intensive care unit over a 2-year period, the barriers and challenges which were encountered, and how they were overcome...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Williamson, S. L., McDermott, H., Gowda, H. Tags: Quality improvement Source Type: research

NICE guideline review: neonatal infection: antibiotics for prevention and treatment (NG195)
Background Neonatal infection has been recognised as the third most common cause of neonatal death globally.1 In the UK, a retrospective analysis that spanned over 30 neonatal units from 2005 to 2014 found the incidence of neonatal infection was 6.1 per 1000 live births and 48.8 per 1000 neonatal admissions.2 The incidence of early-onset neonatal sepsis (EONS) in the UK was 0.7 per 1000 live births.2 The National Institute for Health and Care Excellence (NICE) published the first guideline (CG149) intended for management of early-onset sepsis in 2012; this has been updated (NG195) in 2021.3 The guideline refers to the use ...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Paul, S. P., Khattak, H., Kini, P. K., Heaton, P. A., Goel, N. Tags: Guideline review Source Type: research

Guideline review: RCPCH perplexing presentations, fabricated or induced illness in children guidance 2021
Introduction In the 40 years since Professor Roy Meadow first described ‘Munchausen Syndrome by Proxy’, there have been a number of significant developments, including terminology, definition, prevalence and management. The Royal College of Paediatrics and Child Health (RCPCH) guidance on Perplexing Presentations (PP)/Fabricated or Induced Illness (FII) in Children outlines procedures in order to safeguard children who present with perplexing presentations and fabricated or induced illness. It offers practical advice on how to recognise it, how to manage risk and how to manage these presentations. Information a...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Wear, K. R., Li, S. Tags: Guideline review Source Type: research

How to interpret the paediatric 12-lead ECG
ECG interpretation is a core skill for any healthcare practitioner that looks after children. The article aims to educate the reader in basic interpretation of paediatric ECG in a succinct, interactive, organised manner in a way that it can be easily referenced and applied in everyday clinical practice. We include clinical examples as well as age and sex-related reference ranges for QT intervals, P-wave duration, Q-wave amplitude, QRS complex duration, R-wave and S-wave amplitude, R/S ratio and PR intervals. (Source: Archives of Disease in Childhood - Education and Practice)
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Mikrou, P., Shivaram, P., Kanaris, C. Tags: Interpretations Source Type: research

Adolescent with abdominal pain poorly responsive to analgesia
Case presentation A 14-year-old boy, with autism spectrum disorder, presented with a 1-day history of colicky abdominal pain, non-bilious vomiting, anorexia and loose normal-coloured stool. Two days previously, he had a poorly reheated takeaway chicken. On examination, body mass index (BMI) was >99th centile. He had inconsistent epigastric, periumbilical and umbilical tenderness, and guarding, with normal bowel sounds. Observations were within normal limits, but his pain was poorly responsive to paracetamol, ibuprofen, hyoscine butylbromide, codeine and morphine. Investigations are in table 1. On day 3, his temperature ...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Chanchlani, N., Jarvis, P., Hart, J. W., McMillan, C. H., Moudiotis, C. R. Tags: Epilogue Source Type: research

BCG lymphadenitis: a potential complication of immune reconstitution following haematopoietic stem cell transplant
Case report An MHC class II deficient 2-year-old boy presented with fever and an enlarging left neck mass 100 days post allogeneic haematopoietic stem cell transplant (HSCT). Fever persisted despite treatment with broad-spectrum β-lactam antibiotics. His BCG vaccination site at presentation was quiescent. Ultrasound showed enlarged cervical lymph nodes. An incisional biopsy of the large nodal mass yielded acid-fast bacilli, identified as Mycobacterium bovis by genome sequencing. Treatment with rifampicin, isoniazid and pyridoxine was started. The mass suppurated (figure 1), before healing concurrently with T-lymphocyt...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Tsilifis, C., Schim van der Loeff, I., Williams, E., Owens, S., Powell, S., Gennery, A., Slatter, M. Tags: Epilogue Source Type: research

Unilateral leg swelling in a newborn
­ A female neonate was born with asymmetric lower limbs, the right leg appearing enlarged, with thickened, reddish-purple skin and ectasic superficial reticulum (figure 1A,B). Limb pulses were present and symmetrical. The girl’s family history and prenatal scans were unremarkable. Laboratory findings were within the normal range, except for a mild thrombocytopenia (90 000/μL), which spontaneously resolved during the next few days. A leg X-ray and the Doppler analysis ruled out the presence of calcifications and venous varices, respectively. Ultrasound showed significant skin thickening, with marked dermal hype...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2022 Category: Pediatrics Authors: Cortellazzo Wiel, L., Berti, I., Starc, M., Murru, F. M., Barbi, E., Risso, F. M. Tags: Epilogue Source Type: research