Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. Unfortunately, the number of acute wheeze exacerbations coming through the doors is still rising, but are we equipped to manage these children?  In the UK, national guidance advises giving oral prednisolone early when treating paediatric asthma attacks. If the child doesn’t have a diagnosis of asthma but does have severe symptoms, steroids are still advised. However, they should be used with caution if the child ends up having multiple courses of oral steroids for frequent e ..read more

What is Infective Endocarditis? Infective Endocarditis (IE) is an infection of the endocardial surface of the heart, usually one or more heart valves or an intracardiac device. IE can be “acute” with rapid and extensive heart valve damage (high virulence) or “subacute” and progress over weeks (low virulence).  Infective endocarditis is rare, with an incidence of 3-10/100,000. However, with a reported 15-30% in-hospital mortality, it remains an important condition for physicians to know about and recognise. There are new(ish) predisposing factors, including valve prostheses and intracardi ..read more

Bronchiolitis is a common respiratory infection affecting children under two years old. It accounts for almost a fifth of all infant hospital admissions in the UK. Approximately 80% of cases are caused by respiratory syncytial virus (RSV). Infants with various cardio/respiratory conditions, immunodeficiencies and prematurity are at higher risk of severe bronchiolitis, which can result in an intensive care admission. RSV infection itself causes a lower respiratory tract infection (LRTI) and increases the risk of a secondary bacterial LRTI. It is also strongly associated with the development of ..read more

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital).  This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. In this month’s issue of Pediatrics, Brewster and colleagues investigated how well Google Translate ..read more

With millions of journal articles published yearly, it is impossible to keep up.  Every month we ask some of our friends from PERUKI (Paediatric Emergency Research in the UK and Ireland) to point out something that has caught their eye. This time the PICSTAR team, in association with DFTB, are taking over….. PCISTAR is the trainee-led collaborative network for Paediatric Critical Care Society (PCCS). So these articles have a critical care twist! Happy Reading If you or your team are interested in an individual or joint review, please contact Dr. Vicki Currie at @DrVickiCurrie1 ..read more

Why is this study needed? Cervical spine injuries are a rare but serious finding following blunt trauma, affecting around 1-2% of presentations.  In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR). However, there is a lack of large-scale paediatric studies, and so no validated, accurate prediction rule currently exists. What is the problem? Without an accurate predicti ..read more

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. The junior staff member remains silent throughout the debrief and does not attend their shift the following day. How do you manage this situation? Introduction: Civility Matters Healthcare environments, particularly emergency departm ..read more

Welcome to your first day with the neonates! Upon arriving for your initial shift, you set down your bag, and shortly after, you’re asked to evaluate Baby A. Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. However, their nurse expresses concern, noting that they seem a bit “off.” Upon examination and reviewing their observations, everything appears okay. Nonetheless, you were extra cautious, requested a blood gas, conducted a thorough examination, and found that eve ..read more

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital).  This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. In this month’s list of the journal club, we would like to draw your attention to some studies that ..read more

With millions of journal articles published yearly, it is impossible to keep up. Our team has scoured the literature, so you don’t have to—or it might spark an interest in reading the full article. Happy Reading If you or your team are interested in an individual or joint review, please contact Dr. Vicki Currie at @DrVickiCurrie1 or vickijanecurrie@gmail.com. Article 1: Fever after Immunisations in Infants- What should we do?  Casey K, Reilly ER, Biggs K, Caskey M, Auten JD, Sullivan K, Morrison T, Long A, Rudinsky SL. Serious bacterial infection risk in recently immunized febrile infa ..read more