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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Multicenter Study Comparative Study Controlled Clinical Trial
A community intervention trial to evaluate emergency care practitioners in the management of children.
To evaluate the impact of emergency care practitioners (ECPs) on the patient care pathway for children presenting with minor conditions in unscheduled care settings. ⋯ ECPs are not as effective as usual health providers in discharging children after assessment of urgent healthcare problems. This has implications for the workload of other paediatric providers such as the emergency department. ECPs may be better targeted to settings and patients groups in which there is more evidence of their effectiveness in patient care pathways.