All posts by dbhcurrentawareness

Health behaviour in school age children: data analysis – 3 reports from PHE

health behaviour

The series of 3 reports from Public Health England focus on:

These reports examine the data and explore what protective factors may exist in a young person’s life which may be linked to their mental health outcomes, ranging from personal attributes, family, school, peer and wider community context.

Public Health England has also produced a summary of data from the most recent HBSC survey.

Time to Appendectomy and Risk of Complicated Appendicitis and Adverse Outcomes in Children

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JAMA Pediatrics, June 19th:

Question  In children diagnosed with appendicitis, does delay in appendectomy within 24 hours of hospital presentation increase the risk of complicated appendicitis or adverse events?

Findings  In this retrospective cohort study of 2429 patients from 23 children’s hospitals, delay of appendectomy within 24 hours of presentation was not associated with increased risk of complicated disease or postoperative complications.

Meaning  These results support the premise that appendectomy can be performed as an urgent rather than emergency procedure.

Link to full article here

Cochrane review: Management for intussusception in children

intussusception cochrane.PNG

Intussusception is a common abdominal emergency in children with significant morbidity. Prompt diagnosis and management reduces associated risks and the need for surgical intervention. Despite widespread agreement on the use of contrast enema as opposed to surgery for initial management in most cases, debate persists on the appropriate contrast medium, imaging modality, pharmacological adjuvant, and protocol for delayed repeat enema, and on the best approach for surgical management for intussusception in children.

Link to full review here

Cochrane Systematic Review: Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in children (excluding neonates)

intubation pic

Evidence suggests that indirect laryngoscopy, or videolaryngoscopy, leads to prolonged intubation time with an increased rate of intubation failure when compared with direct laryngoscopy (very low-quality evidence due to imprecision, inconsistency, and study limitations). Review authors had difficulty reaching conclusions on adverse haemodynamic responses and other adverse effects of intubation, as only a few children were reported to have these outcomes. Use of indirect laryngoscopy, or videolaryngoscopy, might lead to improved vocal cord view, but marked heterogeneity between studies made it difficult for review authors to reach conclusions on this outcome.

Link to review here

RCPCH – Stroke in Childhood: Clinical guideline for diagnosis, management and rehabilitation (2017)

Stroke 2017 guidelines

The first clinical guideline on stroke in childhood was published by the Royal College of Physicians (RCP) in 2004. These guidelines may no longer reflect the best and most up-to-date clinical practice, and as such required urgent updating to ensure utilisation of current evidence.

This 2017 iteration of the clinical guideline delivers an update and scope extension, and provides guidance on the identification, diagnosis, management and rehabilitation of children and young people (aged 29 days to 18 years at time of presentation) with arterial ischaemic stroke (AIS) and haemorrhagic stroke (HS).

Link to guidance here