Archives of disease in childhood
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The Manchester Triage System (MTS) determines an inappropriately low level of urgency (undertriage) to a minority of children. The aim of the study was to assess the clinical severity of undertriaged patients in the MTS and to define the determinants of undertriage. ⋯ Undertriage is infrequent, but can have serious clinical consequences. To reduce significant undertriage, the authors recommend a systematic assessment of vital signs in all children.
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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.
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The aim was to describe intravenous paracetamol pharmacokinetics, determine major covariates and suggest a dosing regimen for (pre)term neonates. ⋯ Patient size (predicted by weight) is the major covariate of clearance variance in neonates. Using these estimates, a mean paracetamol serum concentration of 11 mg/l is predicted in neonates of 32-44 weeks' PMA given a standard dose of intravenous paracetamol of 10 mg/kg every 6 h. Safety data for this drug are limited in neonates. Continued surveillance therefore remains essential.