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Skeletal surveys in intubated patients: does UK clinical practice match national guidelines?
Introduction The investigation of suspected paediatric non-accidental injury in children under 2 years of age includes a skeletal survey, which is also indicated in older children on a case-by-case basis. In 2018, the UK national standards for the ‘radiological investigation of suspected physical abuse in children’ were updated by relevant radiology and radiography bodies and endorsed by the Royal College of Paediatrics and Child Health.1 The standards now mandate a skeletal survey within 72 hours of presentation, ideally within 24 hours. Initial and targeted follow-up images facilitate the crucial timing of an...
Source: Archives of Disease in Childhood - April 18, 2024 Category: Pediatrics Authors: Manning, G. L. P., Sharpe, E., Calder, A., Brierley, J. Tags: PostScript Source Type: research

Low-quality evidence for medication errors reduction strategies in hospital paediatrics
Commentary on: King C, Dudley J, Mee A, Tomlin S, Tse Y, Trivedi A, Hawcutt DB; Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacist Group Joint Standing Committee on Medicines. For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review. Arch Dis Child. 2023 Jul;108(7):583–588. doi: 10.1136/archdischild-2022-324772. Epub 2023 Feb 15. PMID: 36792347. Implications for practice and research Medication errors can occur throughout many complex steps. Children are exposed to a higher risk of harm than adults when it comes to medication err...
Source: Evidence-Based Nursing - March 28, 2024 Category: Nursing Authors: Desforges, J., Roumeliotis, N. Tags: Child health Source Type: research

Abusive head trauma and the eye in infants and children - clinical guideline update by the royal college of ophthalmologists and the royal college of paediatrics and child health: executive summary
Eye, Published online: 05 March 2024; doi:10.1038/s41433-024-02977-7Abusive head trauma and the eye in infants and children - clinical guideline update by the royal college of ophthalmologists and the royal college of paediatrics and child health: executive summary (Source: Eye)
Source: Eye - March 5, 2024 Category: Opthalmology Authors: Patrick Watts Gillian Adams Susmito Biswas Paul Davis Paul Leach I. Christopher Lloyd Jo McPartland Alan Mulvihill Source Type: research

UK paediatric trainee research involvement: A national mixed-methods survey to highlight opportunities and challenges
Child health research is considered essential to paediatric training. However, due to service provision demands and workforce planning, research capacity within paediatric consultant contracts is declining.1 This affects paediatric trainees who perceive lack of leadership in this domain.2 Considering these concerns, in 2021, the Royal College of Paediatrics and Child Health (RCPCH) established the Trainee Research Network (TRN) to support regional research. To broadly evaluate trainee participation in research as a marker of future UK research capacity, we conducted a national survey of trainees’ experiences to help ...
Source: Archives of Disease in Childhood - February 19, 2024 Category: Pediatrics Authors: Ratnaike, T., McDermott, H., McQuaid, F., Plumb, L., Wooding, E. L., Course, C. W., Jackson, C., RCPCH Trainee Research Network Working Group, Cottrell, Course, McDermott, McQuaid, Plumb, Ratnaike, Wooding, Blakey, Vawda, Callaghan, Donald, DSouza, Flinn, Tags: PostScript Source Type: research

How can we best chart childrens growth in the paperless age? The UK experience
This article describes the key issues to consider in planning this transition and the charting options available, ranging from bespoke local systems to commercial packages and a new initiative by the Royal College of Paediatrics and Child Health. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - January 22, 2024 Category: Pediatrics Authors: Wright, C. M., Chapman, S., Cole, T. J. Tags: Review Source Type: research

Short-term and medium-term clinical outcomes of multisystem inflammatory syndrome in children: a prospective observational cohort study
ConclusionsDespite the severity of their acute MIS-C, the majority of children in our cohort fully recovered with none having elevated laboratory markers of inflammation at 6 weeks, few (< 10%) reporting persistent symptoms at 6 weeks, and only one with persistent echocardiographic abnormalities. (Source: Italian Journal of Pediatrics)
Source: Italian Journal of Pediatrics - January 4, 2024 Category: Pediatrics Source Type: research

Message to the new prime minister (whoever this might be)
The country is in serious difficulties. Here I suggest a course of action alternative to that pursued by recent administrations, one that recognises the value of healthy children to the economy. The UK is experiencing a revolving-door set of prime ministers in this 12th year of Conservative rule. New cabinet ministers are no doubt eager to make their mark, aware that the country is in very grave economic difficulty. However, the turbulence in fiscal policy is clear evidence of disagreement in the approach to pursue. Therefore, it seems an appropriate moment to draw their attention to the value of children to the nation&rsq...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Modi, N. Tags: Viewpoint Source Type: research

Towards an integrated clinical network of care for children with sleep disordered breathing
In this edition of Thorax, the new British Thoracic Society (BTS) guideline for diagnosing and monitoring paediatric sleep disordered breathing (SDB)1 is published. The primary aim of the guideline is to promote clinical networking and to equip paediatricians in secondary care, with an interest in sleep, with the skills and knowledge to run a local service. The tertiary referral centre would offer support to the local service with more complex diagnostic testing, clinical discussion and advice underpinned by expert physiologists and specialists within a respiratory and ventilation team with wider access to neurology and ne...
Source: Thorax - September 15, 2023 Category: Respiratory Medicine Authors: Elphick, H. E. Tags: Thorax Editorial Source Type: research

Mind the gap: addressing mental health competency on the acute paediatric ward
Problem In acute paediatrics, there is lack of parity between the care of patients with physical and mental health problems, and as paediatricians, we must equip ourselves to redress the balance. This is reflected nationally in National Confidential Enquiry into Patient Outcome and Death and Care Quality Commission data.1 2 We recognise the Royal College of Paediatrics and Child Health’s position statement on the role of the paediatrician in supporting children and young people’s (CYP) mental health3 and the dramatic rise in mental health presentations during the COVID-19 pandemic.4–6 Aims To improve qual...
Source: Archives of Disease in Childhood - Education and Practice - July 19, 2023 Category: Pediatrics Authors: Todd, E., Adamson, R., Leith, E., Davies, A. Tags: Equipment QI Reports Equipped: quality improvement Source Type: research

For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review
Conclusions There are limited data on interventions to improve medication safety in paediatric ward rounds, with all published data being small scale, either quality improvement or audits, and locally derived/delivered. Good-quality interventional or robust quality improvement studies are required to improve medication safety on ward rounds. PROSPERO registration number CRD42022340201. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - June 19, 2023 Category: Pediatrics Authors: King, C., Dudley, J., Mee, A., Tomlin, S., Tse, Y., Trivedi, A., Hawcutt, D. B., on behalf of the Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacist Group Joint Standing Committee on Medicines Tags: ADC Drug Therapy Source Type: research

Patient and public involvement in paediatric medical education
This article aims to identify how organisations can facilitate the involvement of paediatric patients and their parents/carers. While involving children in research can present challenges, we describe examples where organisations have successfully involved young people in clinical research and selection of research topics. Involving paediatric patients and their parents/carers in medical education helps develop a patient centred approach to practice for medical students. Participation of paediatric patients in objective structured clinical examination (OSCE) examinations is employed by many medical schools, however allowin...
Source: Archives of Disease in Childhood - Education and Practice - May 18, 2023 Category: Pediatrics Authors: Donnelly, S., Ferris, K., Kennedy, N., Bourke, T., O'Donoghue, D. Tags: Learning and teaching Source Type: research

Can the governments new integrated care systems deliver for children in England?
Children’s healthcare is suffering from many of the same problems besetting services for adults, although in some instances more acutely. Earlier this year, the respected Nuffield Trust1 warned that children were facing lengthening waiting times for both planned hospital and mental healthcare at a time when the burden of mental ill health is growing rapidly. The Royal College of Paediatrics and Child Health (RCPCH) has repeatedly signalled its concern about worsening health inequalities among children.2 In theory, the government’s new integrated care systems (ICS) for the National Health Service (NHS) in Englan...
Source: Archives of Disease in Childhood - April 19, 2023 Category: Pediatrics Authors: Ruane, S. Tags: Viewpoint Source Type: research

P31 Oral propranolol liquid: a snapshot survey of concentrations in use
Conclusions The recommendation to use 1 mg/mL when treating haemangioma is not followed in just under 50% of centres. Over 40% of centres reported having more than one concentration of propranolol in use. There is a desire to adopt a single standardised concentration for all indications, although there are a number of potential barriers. Further work is needed to establish the best approach for standardisation. References Propranolol. Joint Formulary Committee. British National Formulary for Children (Online). London: BMJ Group and Pharmaceutical Press. Available from: http://www.medicinescomplete.com [Accessed June 2022]...
Source: Archives of Disease in Childhood - April 19, 2023 Category: Pediatrics Authors: Wignell, A., Duncan, J., Gill, A., Cooper, H., Gooding, N., Tomlin, S. Tags: Abstract from the Neonatal and Paediatric Pharmacists Conference 2022 Source Type: research

P11 Adaptation and implementation of standardised concentrations and guardrails technology in paediatric intensive care
Conclusions and Lessons Learned In conclusion ‘one size does not fit all’ and using a dataset without adapting it to context poses safety risks. Adaptation of datasets by individuals tailored to local practice and patient cohort is key for successful and safe implementation. This is aligned with the evidence translation literature, which recognises that adoption of changes is complex and context dependent.4 Key learning points include engagement of key stakeholders is essential to ensure good communication and buy-in. Tailoring of datasets to meet patient needs is vital; considering PDSA cycles and the test, l...
Source: Archives of Disease in Childhood - April 19, 2023 Category: Pediatrics Authors: Gandhi, H., Rogers, N., Tugwell, S., Eftychiou, L., Briar, C., Zizkova, E., Makhecha, S. Tags: Abstract from the Neonatal and Paediatric Pharmacists Conference 2022 Source Type: research

Giving a voice to the voiceless: end of life second opinions
As modern medicine can achieve greater than ever prolongation of life, the difficult issue of whether it is right as opposed to possible to continue with intensive treatment has become ever more important, not least in light of recent high-profile cases where professionals and parents have been unable to agree. The Royal College of Paediatrics and Child Health (RCPCH) has published an ethical framework setting out in rigorous, scholarly and humane documents the principles by which life-sustaining treatment may be withheld or withdrawn from a child,1 2 and important principles for giving a second opinion have also been publ...
Source: Archives of Disease in Childhood - March 17, 2023 Category: Pediatrics Authors: Bush, A. Tags: Viewpoint Source Type: research