240 results found
Soar J, Donnino MW, Maconochie I, et al., 2018, 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary, RESUSCITATION, Vol: 133, Pages: 194-206, ISSN: 0300-9572
de Caen A, Maconochie I, 2018, EtCO2 measurement during pediatric cardiac arrest: Does the Emperor have no clothes?, Resuscitation, Vol: 133, Pages: A1-A2, ISSN: 0300-9572
Ahmad F, Prabhu R, Liao J, et al., 2018, Biomechanical properties and microstructure of neonatal porcine ventricles, Journal of the Mechanical Behavior of Biomedical Materials, Vol: 88, Pages: 18-28, ISSN: 1751-6161
Neonatal heart disorders represent a major clinical challenge, with congenital heart disease alone affecting 36,000 new-borns annually within the European Union. Surgical intervention to restore normal function includes the implantation of synthetic and biological materials; however, a lack of experimental data describing the mechanical behaviour of neonatal cardiac tissue is likely to contribute to the relatively poor short- and long-term outcome of these implants. This study focused on characterising the mechanical behaviour of neonatal cardiac tissue using a porcine model, to enhance the understanding of how this differs to the equivalent mature tissue. The biomechanical properties of neonatal porcine cardiac tissue were characterised by uniaxial tensile, biaxial tensile, and simple shear loading modes, using samples collected from the anterior and posterior walls of the right and left ventricles. Histological images were prepared using Masson’s trichrome staining, to enable assessment of the microstructure and correlation with tissue behaviour. The mechanical tests demonstrated that the neonatal cardiac tissue is non–linear, anisotropic, viscoelastic and heterogeneous. Our data provide a baseline describing the biomechanical behaviour of immature porcine cardiac tissue. Comparison with published data also indicated that the neonatal porcine cardiac tissue exhibits one-half the stiffness of mature porcine tissue in uniaxial extension testing, one-third in biaxial extension testing, and one-fourth stiffness in simple shear testing; hence, it provides an indication as to the relative change in characteristics associated with tissue maturation. These data may prove valuable to researchers investigating neonatal cardiac mechanics.
Lillitos PJ, Lyttle MD, Roland D, et al., 2018, Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion, Emergency Medicine Journal, Vol: 35, Pages: 685-690, ISSN: 1472-0205
Background Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist.Objectives To establish standardised significant illness endpoints for use in determining the performance accuracy of PEWS and safety systems in emergency departments (ED), using a consensus of expert opinion in the UK and Ireland.Design Between July 2017 and February 2018, three online Delphi rounds established a consensus on ‘significant’ clinical conditions, derived from a list of common childhood illness/injury ED presentations. Conditions warranting acute hospital admission in the opinion of the respondent were defined as ‘significant’, using a 5-point Likert scale. The consensus was a priori ≥80% (positive or negative). 258 clinical conditions were tested.Participants and settings Eligible participants were consultants in acute or EM paediatrics, or adult EM, accessed via 53 PERUKI (Paediatric Emergency Research in the UK and Ireland)’s research collaborative sites, and 27 GAPRUKI (General and Adolescent Paediatric Research in the UK and Ireland)’s sites, 17 of which overlap with PERUKI.Main outcome measures To create a list of conditions regarded as ‘significant’with ≥80% expert consensus.Results 43 (68%) of 63 PERUKI and GAPRUKI sites responded; 295 experts were invited to participate. Participants in rounds 1, 2 and 3 were 223 (76%), 177 (60%) and 148 (50%), respectively; 154 conditions reached positive consensus as ‘significant’; 1 condition reached a negative consensus (uncomplicated Henoch-Schönlein purpura); and 37 conditions achieved non-consensus.Conclusions A list of significant childhood conditions has been created using UK and Irish expert consensus, for research purposes, for the first time. Th
Vassallo J, Nutbeam T, Rickard AC, et al., 2018, Paediatric traumatic cardiac arrest: the development of an algorithm to guide recognition, management and decisions to terminate resuscitation, EMERGENCY MEDICINE JOURNAL, Vol: 35, Pages: 669-674, ISSN: 1472-0205
Booth A, Moylan A, Hodgson J, et al., 2018, Resuscitation registers: How many active registers are there and how many collect data on paediatric cardiac arrests?, RESUSCITATION, Vol: 129, Pages: 70-75, ISSN: 0300-9572
Rickard AC, Vassallo J, Nutbeam T, et al., 2018, Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management, EMERGENCY MEDICINE JOURNAL, Vol: 35, Pages: 434-439, ISSN: 1472-0205
Kleinman ME, Perkins GD, Bhanji F, et al., 2018, ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement, RESUSCITATION, Vol: 127, Pages: 132-146, ISSN: 0300-9572
Kleinman ME, Perkins GD, Bhanji F, et al., 2018, ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care A Consensus Statement, CIRCULATION, Vol: 137, Pages: E802-E819, ISSN: 0009-7322
Perkins GD, Olasveengen TM, Maconochie I, et al., 2018, European Resuscitation Council Guidelines for Resuscitation: 2017 update, RESUSCITATION, Vol: 123, Pages: 43-50, ISSN: 0300-9572
Chong S-L, Ong GY-K, Chin WYW, et al., 2018, A retrospective review of vital signs and clinical outcomes of febrile infants younger than 3 months old presenting to the emergency department., PLoS ONE, Vol: 13, ISSN: 1932-6203
OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED. We documented the primary outcome of SI for each infant, as well as the clinical findings, vital signs, and Severity Index Score (SIS). We assessed the performance of the Paediatric Canadian Triage and Acuity Scale (PaedCTAS), Advanced Pediatric Life Support (APLS) guidelines and Fleming normal reference values, using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operating characteristics curve (AUC). RESULTS: 1057 infants were analyzed, with 326 (30.6%) infants diagnosed with SI. High temperature, tachycardia, and low SIS score were significantly associated with SI. Item analysis showed that the SIS performance was driven by the presence of mottling (p = 0.003) and high temperature (p<0.001). The APLS guideline had the highest sensitivity (66.0%, 95% CI 60.5-71.1%), NPV (73.3%, 95% CI 69.7-76.5%) and AUC (0.538), while the PaedCTAS (2 standard deviation from normal) had the highest specificity (98.5%, 95% CI 97.3-99.3%) and PPV (55.2%, 95% CI 32.7-71.0%). CONCLUSIONS: Current guidelines on infantile heart rates have a variable performance. In our study, the APLS heart rate guidelines performed with the highest sensitivity, but no individual guideline predicted for SIs satisfactorily.
Maconochie I, de Caen A, 2018, When should ADULT CPR be delivered to children?, RESUSCITATION, Vol: 122, Pages: A4-A5, ISSN: 0300-9572
Appelbaum N, Clarke J, Maconochie I, et al., 2017, A model for habitus-adjusted paediatric weight estimation by age and data concerning the validation of this method on a large dataset of English children., Data in Brief, Vol: 16, Pages: 771-774, ISSN: 2352-3409
It is often not possible to weigh children upon arrival at an emergency room before commencing the provision of emergency care. Because drugs for children are prescribed on the basis of age and body weight, estimations of weight are necessitated. Age-based equations have been one of the most commonly used weight estimation strategies historically. Due to the variability of weight for age in children, and variations in body habitus, these methods are inaccurate by design (Young and Korotzer, 2016) .
Olasveengen TM, de Caen AR, Mancini ME, et al., 2017, 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary, CIRCULATION, Vol: 136, Pages: E424-E440, ISSN: 0009-7322
Olasveengen TM, de Caen AR, Mancini ME, et al., 2017, 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary, RESUSCITATION, Vol: 121, Pages: 201-214, ISSN: 0300-9572
Perkins GD, Neumar R, Monsieurs KG, et al., 2017, The International Liaison Committee on Resuscitation-Review of the last 25 years and vision for the future, RESUSCITATION, Vol: 121, Pages: 104-116, ISSN: 0300-9572
Appelbaum N, Clarke J, Maconochie I, et al., 2017, Paediatric weight estimation by age in the digital era: optimising a necessary evil., Resuscitation, Vol: 122, Pages: 29-35, ISSN: 0300-9572
BACKGROUND: Age-based weight estimation methods are regularly used in paediatric emergency medicine despite their well-established inaccuracy. AIM: Determine the potential improvement in accuracy achievable by the use of a new mobile application, based on CDC/WHO weight-for-age centile data, which incorporates a gender assignment, a body habitus assessment, and which is capable of an age-in-months based calculation. METHODS: A theoretical, simulated validation study, comparing the performance of the widely used APLS/EPALS formulae against two contemporary habitus-adjusted methods, and the Helix Weight Estimation Tool. 1,070,743 children from the 2015/2016 UK National Child Measurement Program dataset, aged between 4 and 5 and 11 and 12 years, had age-based weight estimates made by all five methods. RESULTS: Primary outcomes were the percentage of weight estimations within 10%, 20%, and those greater than 20% discrepant from actual weight for each method. Our theoretical, gender-dependent, habitus-adjusted method performed better than all other methods across all error thresholds. The overall number of estimations within 10% was 70.4%, and within 20% was 95.45%. The mean percentage error was -1% compared to actual weight. CONCLUSION: The use of a digital tool incorporating a subjective assessment of body habitus, gender assignment, and the ability to estimate weight based on age-in-months might be able optimise the process of paediatric weight estimation by age, making this practice as safe and accurate as possible for the occasions when weight estimation by age is chosen over length-based methods.
Monsieurs KG, Nolan JP, Bossaert LL, et al., 2017, Executive Summary. Section 1 of the European Resuscitation Council Guidelines for Resuscitation 2015 (vol 19, pg 54, 2015), NOTFALL & RETTUNGSMEDIZIN, Vol: 20, Pages: 538-539, ISSN: 1434-6222
Maconochie IK, 2017, Highlights from this issue, Emergency Medicine Journal, Vol: 34, ISSN: 1472-0205
Bressan S, Lyphout C, Yordanov Y, et al., 2017, Management of pediatric head injury: a survey of EuSEM pediatric emergency section, EUROPEAN JOURNAL OF EMERGENCY MEDICINE, Vol: 24, Pages: 308-309, ISSN: 0969-9546
Lopez-Herce J, Rodriguez Nunez A, Maconochie I, et al., 2017, Current international recommendations for pediatric cardiopulmonary resuscitation: the European guidelines, EMERGENCIAS, Vol: 29, Pages: 266-281, ISSN: 1137-6821
Deakin CD, England S, Diffey D, et al., 2017, Can ambulance telephone triage using NHS Pathways accurately identify paediatric cardiac arrest?, RESUSCITATION, Vol: 116, Pages: 109-112, ISSN: 0300-9572
Robinson C, Wolters A, Steventon A, et al., 2017, Predictors of emergency department attendance following NHS 111 calls for children and young people: analysis of linked data., Clin Med (Lond), Vol: 17, Pages: s13-s13
Lillitos PJ, Maconochiet IK, 2017, Paediatric early warning systems (PEWS and Trigger systems) for the hospitalised child: time to focus on the evidence, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 102, Pages: 479-480, ISSN: 0003-9888
Cleugh FM, Maconochie IK, 2017, Management of the multiply injured child, PAEDIATRICS & CHILD HEALTH, Vol: 27, Pages: 209-214, ISSN: 1205-7088
Donoghue K, Rose H, Boniface S, et al., 2017, Alcohol Consumption, Early-Onset Drinking, and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England, JOURNAL OF ADOLESCENT HEALTH, Vol: 60, Pages: 438-446, ISSN: 1054-139X
Maconochie I, 2016, Highlights from this issue, Emergency medicine journal : EMJ, Vol: 33
Nijman R, Jorgensen R, Maconochie I, 2016, MANAGEMENT OF CHILDREN WITH FEVER FULFILLING CRITERIA FOR PAEDIATRIC SEPSIS: PROSPECTIVE STUDY IN PAEDIATRIC EMERGENCY CARE, EUROPEAN JOURNAL OF PEDIATRICS, Vol: 175, Pages: 1494-1494, ISSN: 0340-6199
Sandell JM, Maconochie IK, 2016, Paediatric early warning systems (PEWS) in the ED, EMERGENCY MEDICINE JOURNAL, Vol: 33, Pages: 754-755, ISSN: 1472-0205
Nijman R, Jorgensen R, Oostenbrink R, et al., 2016, THE ROLE OFANTIPYRETICS IN LOWERING HEART RATE AND RESPIRATORY RATE IN FEBRILE CHILDREN AT RISK OF SERIOUS BACTERIAL INFECTIONS IN THE EMERGENCY DEPARTMENT, EUROPEAN JOURNAL OF PEDIATRICS, Vol: 175, Pages: 1431-1432, ISSN: 0340-6199
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