Archives of disease in childhood
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Parent-reported symptoms are frequently used to triage children, but little is known about which symptoms identify children with serious respiratory infections. The authors aimed to identify symptoms and triage findings predictive of serious respiratory infection, and to quantify agreement between parent and nurse assessment. ⋯ Parent-reported symptoms were unreliable discriminators of serious respiratory infection in children with suspected acute infection, and did not correlate well with nurse assessment. Using symptoms to identify higher risk children in this setting is unreliable. Nurse triage assessment of respiratory distress and some vital signs are important predictors.
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Acute severe asthma in children is a common cause of admission to intensive care units (ICU), but there are few reports on long-term outcomes. This study describes outcomes for children with asthma admitted to an ICU. ⋯ Admission to the ICU for asthma is a predictor of hospital readmission. Those with persistent asthma or requiring ventilation are at significant risk of mortality in subsequent years and require close follow-up.
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Bronchiolitis is a significant cause of acute morbidity in the first 12 months of life and some infants with bronchiolitis are admitted to hospital. No studies have yet devised a scoring system to predict admission for routine use in the emergency department. ⋯ The authors have identified important clinical predictors of admission in acute bronchiolitis. This information has been used to develop a simple clinical risk scoring system to aid decision making in the emergency department.