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Acute Agitation
Acute Agitation  Key Resources

Best practices in managing child and adolescent behavioral health emergencies  (2018)

Best practices in managing child and adolescent behavioral health emergencies

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Acute Agitation  Clinical guidelines

Management of pediatric agitation and aggression: Lessons learned from the national consensus pediatric BETA guidelines  (2019)

Management of pediatric agitation and aggression: Lessons learned from the national consensus pediatric BETA guidelines

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Malas, N.

Malas, N.

Implementing clinical pathways for acute behavioral health issues in pediatric medical settings  (2017)

Implementing clinical pathways for acute behavioral health issues in pediatric medical settings

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Feuer, V. and L. M. Prager

Feuer, V. and L. M. Prager

The Expert Consensus Guideline Series. Treatment of behavioral emergencies  (2001)

The Expert Consensus Guideline Series. Treatment of behavioral emergencies

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Allen, M. H., G. W. Currier, D. H. Hughes, M. Reyes-Harde, J. P. Docherty and E. Expert Consensus Panel for Behavioral

Allen, M. H., G. W. Currier, D. H. Hughes, M. Reyes-Harde, J. P. Docherty and...

Acute Agitation  Systematic reviews

A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department  (2019)

A Retrospective Review of Antipsychotic Medications Administered to Psychiatric Patients in a Tertiary Care Pediatric Emergency Department

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Rudolf, F., K. Hollenbach, K. L. Carstairs and S. D. Carstairs

Rudolf, F., K. Hollenbach, K. L. Carstairs and S. D. Carstairs

Safety and effectiveness of physostigmine: a 10-year retrospective review*  (2018)

Safety and effectiveness of physostigmine: a 10-year retrospective review*

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Arens, A. M., K. Shah, S. Al-Abri, K. R. Olson and T. Kearney

Arens, A. M., K. Shah, S. Al-Abri, K. R. Olson and T. Kearney

Acute Agitation  Key studies

Pediatric patients with behavioral emergencies: Who's coming in and what happens while they're here?  (2019)

Pediatric patients with behavioral emergencies: Who's coming in and what happens while they're here?

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Sanchez, A. R., J. Sterris and E. Z. Shoemaker

Sanchez, A. R., J. Sterris and E. Z. Shoemaker

Executive summary: Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: Common clinical challenges of patients with mental health and/or behavioral emergencies  (2016)

Executive summary: Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: Common clinical challenges of patients with mental health and/or behavioral emergencies

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Chun, T. H., S. E. Mace, E. R. Katz, J. E. Shook, J. M. Callahan, G. P. Conners, E. E. Conway, N. C. Dudley, T. K. Gross, N. E. Lane, C. G. Macias, N. L. Tim...

Chun, T. H., S. E. Mace, E. R. Katz, J. E. Shook, J. M. Callahan, G. P. Conne...

Acute Otitis Media
Acute Otitis Media  Key Resources

Bottom Line Recommendations: Acute Otitis Media (2022)

Bottom Line Recommendations: Acute Otitis Media (2022)

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Dr. Nicole Le Saux

Dr. Nicole Le Saux

Bottom line recommendations for the treatment of acute otitis media. Published online November (2022).

Recommandations de base: Otite moyenne aigue (2022)

Recommandations de base: Otite moyenne aigue (2022)

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Dr. Nicole Le Saux

Dr. Nicole Le Saux

French bottome line recommendations for the treatment of acute otitis media. Published online November, 2022. 

Acute Otitis Media- Emergency Management in Children - Flowchart  (2018)

Acute Otitis Media- Emergency Management in Children - Flowchart

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Children's Health Queensland Hospital and Health Service

Children's Health Queensland Hospital and Health Service

Flowchart of emergency management in children for acute otitis media.

Flow diagram for the management of children with suspected and confirmed acute otitis media  (2016)

Flow diagram for the management of children with suspected and confirmed acute otitis media

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Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and Immunization Committee

Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and ...

Flow chart of criteria for management of children with suspected and confirmed acute otitis media based on symptoms of children over 6 months of age.

Videos in clinical medicine. Diagnosing otitis media--otoscopy and cerumen removal  (2010)

Videos in clinical medicine. Diagnosing otitis media--otoscopy and cerumen removal

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Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL

Shaikh N, Hoberman A, Kaleida PH, Ploof DL, Paradise JL

Video instructing how to diagnose otitis media with otoscopy and cerum removal.

Acute Otitis Media  Clinical guidelines

Clinical Practice Guideline: Acute Otitis Media  (2021)

Clinical Practice Guideline: Acute Otitis Media

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The Royal Children's Hospital Melbourne

The Royal Children's Hospital Melbourne

Guideline on the assessment and management of acute otitis media in children

Clinical Practice Guideline: Otitis media (acute): antimicrobial prescribing  (2021)

Clinical Practice Guideline: Otitis media (acute): antimicrobial prescribing

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National Institute for Health and Care Excellence (NICE) NICE Guideline

National Institute for Health and Care Excellence (NICE) NICE Guideline

Objective: This guideline sets out an antimicrobial prescribing strategy for acute otitis media (ear infection). aims to limit antibiotic use and reduce antimicrobial resistance.

Clinical Practice Guideline: Diagnosis and management of Pediatric Acute Otitis Media (Ear Infection)  (2019)

Clinical Practice Guideline: Diagnosis and management of Pediatric Acute Otitis Media (Ear Infection)

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Intermountain Healthcare

Intermountain Healthcare

Objective: This CPM provides best-practice recommendations for diagnosis and management of acute otitis media (AOM), including guidance for appropriate use of antibiotics.

Clinical Practice Guideline: Guidelines of the French Society of Otorhinolaryngology (SFORL): Nonsteroidal anti-inflammatory drugs (NSAIDs) and pediatric ENT infections. Short version  (2019)

Clinical Practice Guideline: Guidelines of the French Society of Otorhinolaryngology (SFORL): Nonsteroidal anti-inflammatory drugs (NSAIDs) and pediatric ENT infections. Short version

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Truffert, E. et al.

Truffert, E. et al.

Objective: To present the guidelines of the French Society of Otolaryngology-Head and Neck Surgery concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs) in pediatric ENT infections.

Clinical Practice Guideline: Acute otitis media - Emergency management in children  (2018)

Clinical Practice Guideline: Acute otitis media - Emergency management in children

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Children's Health Queensland Hospital and Health Service

Children's Health Queensland Hospital and Health Service

Children's Health Queensland Statewide Paediatric Guideline for emergency management of acute otitis media in children.

Clinical Practice Guideline: Management of otitis media with effusion in children. Socit franc aise dORL et de chirurgie cervico-faciale clinical practice guidelines  (2018)

Clinical Practice Guideline: Management of otitis media with effusion in children. Socit franc aise dORL et de chirurgie cervico-faciale clinical practice guidelines

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Blanc, F. et al.

Blanc, F. et al.

Objective: The Socit franaise dORL et de chirurgie cervico-faciale clinical practice guidelines concern the management of otitis media with effusion (OME) in children under the age of 12 years. They are based on extensive review of MEDLINE and Cochrane Library publications in English or French from 1996 to 2016 concerning the methods of diagnosis and assessment of otitis media with effusion, as well as the efficacy of tympanostomy tubes and medical and surgical treatments of OME.

Clinical Practice Guideline: Management of acute otitis media in children six months of age and older  (2016)

Clinical Practice Guideline: Management of acute otitis media in children six months of age and older

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Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and Immunization Committee

Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and ...

Canadian Paediatric Society position statement on the management of acute otitis media in children aged 6 months and older.

Clinical Practice Guideline: Danish guidelines on management of otitis media in preschool children  (2016)

Clinical Practice Guideline: Danish guidelines on management of otitis media in preschool children

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Heidemann CH, Lous J, Berg J, Christensen JJ, Hkonsen SJ, Jakobsen M, Johansen CJ, Nielsen LH, Hansen MP, Poulsen A, Schousboe LP, Skrubbeltrang C, Vind AB, ...

Heidemann CH, Lous J, Berg J, Christensen JJ, Hkonsen SJ, Jakobsen M, Johanse...

The Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of recurrent AOM and chronic OME in preschool children.

Clinical Practice Guideline: The diagnosis and management of acute otitis media  (2013)

Clinical Practice Guideline: The diagnosis and management of acute otitis media

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Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, Joffe MD, Miller DT, Rosenfeld RM, Sevilla XD, Schwartz RH, Thomas PA, Tunkel DE

Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA,...

Evidence-based clinical practice guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians.

Acute Otitis Media  Summaries of systematic reviews

Cochrane Summary: Systemic corticosteroids for improving symptoms in children with acute middle ear infection  (2018)

Cochrane Summary: Systemic corticosteroids for improving symptoms in children with acute middle ear infection

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Ranakusuma RW, Pitoyo Y, Safitri ED, Thorning S, Beller EM, Sastroasmoro S, Del Mar CB

Ranakusuma RW, Pitoyo Y, Safitri ED, Thorning S, Beller EM, Sastroasmoro S, D...

Objective: To assess the effects of systemic corticosteroids (oral or parenteral), with or without antibiotics, for AOM in children.

Cochrane Summary: Influenza vaccine for preventing acute otitis media (middle ear infection)  (2017)

Cochrane Summary: Influenza vaccine for preventing acute otitis media (middle ear infection)

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Norhayati MN, Ho JJ, Azman MY

Norhayati MN, Ho JJ, Azman MY

Objective: To assess the effectiveness of influenza vaccine in reducing the occurrence of acute otitis media in infants and children.

Cochrane Summary: Pain relievers for children with acute middle ear infection  (2016)

Cochrane Summary: Pain relievers for children with acute middle ear infection

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Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoiseaux RA

Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoise...

Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.

Cochrane Summary: Antibiotics for otitis media with effusion ('glue ear') in children  (2016)

Cochrane Summary: Antibiotics for otitis media with effusion ('glue ear') in children

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Venekamp RP, Burton MJ, van Dongen TM, van der Heijden GJ, van Zon A, Schilder AG

Venekamp RP, Burton MJ, van Dongen TM, van der Heijden GJ, van Zon A, Schilde...

Objective: To assess the benefits and harms of oral antibiotics in children up to 18 years with OME.

Acute Otitis Media  Overviews of systematic reviews

Evidence Summary: Are topical antibiotics an alternative to oral antibiotics for children with acute otitis media and ear discharge?  (2016)

Evidence Summary: Are topical antibiotics an alternative to oral antibiotics for children with acute otitis media and ear discharge?

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Venekamp RP, Prasad V, Hay AD

Venekamp RP, Prasad V, Hay AD

Objective: To review the evidence comparing efectiveness of topical antibiotics with oral antibiotics, placebo, or no treatment in children with AOM presenting with ear discharge caused by spontaneous perforation of the eardrum.

Acute Otitis Media  Systematic reviews

Cochrane Review: Pneumococcal conjugate vaccines for preventing acute otitis media in children  (2020)

Cochrane Review: Pneumococcal conjugate vaccines for preventing acute otitis media in children

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de Svaux JLH, Venekamp RP, Lutje V, Hak E, Schilder AGM, Sanders EAM, Damoiseaux RAMJ de

de Svaux JLH, Venekamp RP, Lutje V, Hak E, Schilder AGM, Sanders EAM, Damoise...

Objective: To assess the effect of PCVs in preventing AOM in children up to 12 years of age.

Systematic Review: Clinical practice guidelines for acute otitis media in children: a systematic review and appraisal of European national guidelines  (2020)

Systematic Review: Clinical practice guidelines for acute otitis media in children: a systematic review and appraisal of European national guidelines

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Suzuki, H.G. et al.

Suzuki, H.G. et al.

Objective: To appraise European guidelines for acute otitis media (AOM) in children, including methodological quality, level of evidence (LoE), astrength of recommendations (SoR), and consideration of antibiotic stewardship

Systematic Review: A systematic review and meta-analysis of antimicrobial resistance in paediatric acute otitis media  (2019)

Systematic Review: A systematic review and meta-analysis of antimicrobial resistance in paediatric acute otitis media

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Michael W. Mathera, Michael Drinnana, John D. Perryc, Steven Powellb, Janet A. Wilsonb, Jason Powella

Michael W. Mathera, Michael Drinnana, John D. Perryc, Steven Powellb, Janet A...

Objective: We present a comprehensive review and meta-analysis, of both the microbiology and antimicrobial resistance of AOM organisms to commonly used antimicrobial agents, with the aim of informing responsible antimicrobial stewardship.

Cochrane Review: Probiotics for preventing acute otitis media in children  (2019)

Cochrane Review: Probiotics for preventing acute otitis media in children

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Scott AM, Clark J, Julien B, Islam F, Roos K, Grimwood K, Little P, Del Mar CB

Scott AM, Clark J, Julien B, Islam F, Roos K, Grimwood K, Little P, Del Mar CB

Objective: To assess the effects of probiotics to prevent the occurrence and reduce the severity of acute otitis media in children.

Review: From paper to practice: Strategies for improving antibiotic stewardship in the pediatric ambulatory setting.  (2018)

Review: From paper to practice: Strategies for improving antibiotic stewardship in the pediatric ambulatory setting.

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Bozzella MJ, Harik N, Newland JG, Hamdy RF

Bozzella MJ, Harik N, Newland JG, Hamdy RF

Objective: The intent with this review is to provide an overview of strategies that pediatric providers can take from paper to practice.

Cochrane Systematic Review: Systemic corticosteroids for acute otitis media in children  (2018)

Cochrane Systematic Review: Systemic corticosteroids for acute otitis media in children

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Ranakusuma RW, Pitoyo Y, Safitri ED, Thorning S, Beller EM, Sastroasmoro S, Del Mar CB

Ranakusuma RW, Pitoyo Y, Safitri ED, Thorning S, Beller EM, Sastroasmoro S, D...

Objective: To assess the effects of systemic corticosteroids (oral or parenteral), with or without antibiotics, for AOM in children.

Cochrane Systematic Review: Influenza vaccines for preventing acute otitis media in infants and children  (2017)

Cochrane Systematic Review: Influenza vaccines for preventing acute otitis media in infants and children

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Norhayati MN, Ho JJ, Azman MY

Norhayati MN, Ho JJ, Azman MY

Objective: To assess the effectiveness of influenza vaccine in reducing the occurrence of acute otitis media in infants and children.

Review: Antibiotic therapy for children with acute otitis media  (2017)

Review: Antibiotic therapy for children with acute otitis media

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Sakulchit T, Goldman RD

Sakulchit T, Goldman RD

Objective: Review of AOM and the evidence regarding use of antibiotics or watchful waiting to treat children at different levels of disease severity.

Cochrane Systematic Review: Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children  (2016)

Cochrane Systematic Review: Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children

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Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoiseaux RA

Sjoukes A, Venekamp RP, van de Pol AC, Hay AD, Little P, Schilder AG, Damoise...

Objective: Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM.

Cochrane Systematic Review: Antibiotics for otitis media with effusion in children  (2016)

Cochrane Systematic Review: Antibiotics for otitis media with effusion in children

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Venekamp RP, Burton MJ, van Dongen TM, van der Heijden GJ, van Zon A, Schilder AG

Venekamp RP, Burton MJ, van Dongen TM, van der Heijden GJ, van Zon A, Schilde...

Objective: To assess the benefits and harms of oral antibiotics in children up to 18 years with OME.

Cochrane Systematic Review: Antibiotics for acute otitis media in children  (2015)

Cochrane Systematic Review: Antibiotics for acute otitis media in children

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Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM

Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM

Objective: To assess the effects of antibiotics for children with AOM.

Systematic Review: Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis  (2010)

Systematic Review: Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis

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Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD

Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD

Objective: To systematically review the literature and, where appropriate, meta-analyse studies investigating subsequent antibiotic resistance in individuals prescribed antibiotics in primary care.

Acute Otitis Media  Key studies

Key Study: Invasive bacterial Infections in afebrile infants diagnosed with acute otitis media  (2021)

Key Study: Invasive bacterial Infections in afebrile infants diagnosed with acute otitis media

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Son H McLaren 1, Andrea T Cruz 2, Kenneth Yen, et al. Pediatrics

Son H McLaren 1, Andrea T Cruz 2, Kenneth Yen, et al. Pediatrics

Objective: to determine the prevalence of invasive bacterial infections (IBIs) and adverse events in afebrile infants with acute otitis media (AOM).

Key study: Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?  (2019)

Key study: Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

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Niroshan Balasundaram, Dung Phan, Daniel Mazzoni, Elliot Duong, Amy Sweeny, Chris Del Mar and Gerben Keijzers

Niroshan Balasundaram, Dung Phan, Daniel Mazzoni, Elliot Duong, Amy Sweeny, C...

Objective: To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines.

Key study: Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media  (2019)

Key study: Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media

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Brinker DL Jr, MacGeorge EL, Hackman N

Brinker DL Jr, MacGeorge EL, Hackman N

Objective: To assess the implications and recommendations to improve antibiotic stewardship through watchful waiting as an alternative to immediate antibiotic treatment in children with AOM.

Key Study: Anaesthetic-analgesic ear drops to reduce antibiotic consumption in children with acute otitis media: the CEDAR RCT  (2019)

Key Study: Anaesthetic-analgesic ear drops to reduce antibiotic consumption in children with acute otitis media: the CEDAR RCT

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Hay, A.D. et al.

Hay, A.D. et al.

Objective: The Childrens Ear Pain Study (CEDAR) investigated whether or not providing anaestheticanalgesic ear drops reduced antibiotic consumption in children with AOM. Secondary objectives included pain control and cost-effectiveness.

Key study: Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial  (2018)

Key study: Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial

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van Uum RT, Venekamp RP, Sjoukes A, van de Pol AC, de Wit GA, Schilder AGM, Damoiseaux RAMJ,

van Uum RT, Venekamp RP, Sjoukes A, van de Pol AC, de Wit GA, Schilder AGM, D...

Objective: We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness.

Key study: Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children  (2016)

Key study: Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children

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Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, Martin JM, Kurs-Lasky M, Copelli SJ, Colborn DK, Block SL, Labella JJ, Lynch TG, Coh...

Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, Mart...

Objective: Given methodologic limitations in available publications, we undertook the current trial involving children 6 to 23 months of age to determine whether limiting antimicrobial treatment to 5 days rather than using the standard 10-day regimen would afford equivalent outcomes and whether doing so also for subsequent episodes would lead to a reduction in the overall use of antimicrobial treatment, with a resulting reduction in the development of antimicrobial resistance.

Key study: Use of symptoms and risk factors to predict acute otitis media in infants  (2016)

Key study: Use of symptoms and risk factors to predict acute otitis media in infants

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McCormick DP, Jennings K, Ede LC, Alvarez-Fernandez P, Patel J, Chonmaitree T

McCormick DP, Jennings K, Ede LC, Alvarez-Fernandez P, Patel J, Chonmaitree T

Objective: The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants.

Key study: Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development  (2015)

Key study: Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development

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Chonmaitree T, Alvarez-Fernandez P, Jennings K, Trujillo R, Marom T, Loeffelholz MJ, Miller AL, McCormick DP, Patel JA, Pyles RB

Chonmaitree T, Alvarez-Fernandez P, Jennings K, Trujillo R, Marom T, Loeffelh...

Objective: This study determined the epidemiologic characteristics and etiology of asymptomatic upper respiratory tract infection in the first year of life and the association with acute otitis media complication.

Key study: Treatment of acute otitis media in children under 2 years of age  (2011)

Key study: Treatment of acute otitis media in children under 2 years of age

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Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, Colborn DK, Kurs-Lasky M, Bhatnagar S, Haralam MA, Zoffel LM, Jenkins C, Pope MA, Balent...

Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, Colborn ...

Objective: We undertook this clinical trial to determine the extent to which antimicrobial treatment affects the course of both symptoms and signs of acute otitis media, irrespective of the apparent severity of the disease, among children 6 to 23 months of age in whom the diagnosis of acute otitis media is quite certain.

Key study: A placebo-controlled trial of antimicrobial treatment for acute otitis media  (2011)

Key study: A placebo-controlled trial of antimicrobial treatment for acute otitis media

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Thtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A

Thtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A

Objective: We conducted a randomized, double-blind, placebo-controlled study of the efficacy of antimicrobial therapy in the age group with the highest incidence of acute otitis media. Our aim was to assess the efficacy of antimicrobial treatment for acute otitis media when strict diagnostic criteria are used and the antimicrobial coverage and dosage of the active treatment are adequate.

Aerosol Generating Medical Procedure (AGMP)
Aerosol Generating Medical Procedure (AGMP)  Key Resources

Recommandations de Base: Interventions médicales générant des aérosols (IMGA)

Recommandations de Base: Interventions médicales générant des aérosols (IMGA)

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Dr. Kate Maki

Dr. Kate Maki

Aerosole-generating medical procedures (AGMPs) are procedures that can generate aerosols when an infected person's airway is manipulated. 

Aerosol Generating Medical Procedure (AGMP)  (2021)

Aerosol Generating Medical Procedure (AGMP)

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Dr. Kate Maki

Dr. Kate Maki

Aerosol-generating medical procedures (AGMPs) are procedures that can generate aerosols when an infected person’s airway is manipulated.

Anaphylaxis
Anaphylaxis  Key Resources

VIDEO: Anaphylaxis in Kids

VIDEO: Anaphylaxis in Kids

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Bottom Line Recommendations: Anaphylaxis  (2021)

Bottom Line Recommendations: Anaphylaxis

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Alqurashi W and TREKK Network

Alqurashi W and TREKK Network

Bottom line recommendations for the treatment and management of pediatric anaphylaxis - version 1.2. Published online: December 2018.

Recommandations de Base: Anaphylaxie  (2021)

Recommandations de Base: Anaphylaxie

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Alqurashi W and TREKK Network

Alqurashi W and TREKK Network

Bottom line recommendations for the treatment and management of pediatric anaphylaxis - en francais. Published online: October 2018.

Video: Understanding and Managing your Child's Anaphylaxis  (2021)

Video: Understanding and Managing your Child's Anaphylaxis

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ECHO Research and ARCHE

ECHO Research and ARCHE

Anaphylaxis is a severe allergic reaction that involves two or more parts of the body and happens quickly. Watch this video to learn how to recognize anaphylaxis and what can help mange your child's anaphylaxis.

Feuille D’ordonnances Pré-Rédigées pour L’Anaphylaxie  (2020)

Feuille D’ordonnances Pré-Rédigées pour L’Anaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

PedsPac de TREKK sur l'Anaphylaxie

This French order set is for management of pediatric anaphylaxis in the ED and is adaptable to your hospitals form policy. Published online: March 2020, Version 1.2.

Anaphylaxis Order Set  (2020)

Anaphylaxis Order Set

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TREKK Anaphylaxis PedsPac

TREKK Anaphylaxis PedsPac

This order set is for management of pediatric anaphylaxis in the ED. This document is adaptable to your hospitals form policy. Published online: March 2020, Version 1.2.

Anaphylaxis References and Development Team  (2018)

Anaphylaxis References and Development Team

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TREKK Anaphylaxis PedsPac

TREKK Anaphylaxis PedsPac

This document outlines the references used and team involved in the development of the anaphylaxis PedsPac. Published online: October 2018.

Anaphylaxis Algorithm  (2018)

Anaphylaxis Algorithm

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TREKK Anaphylaxis PedsPac

TREKK Anaphylaxis PedsPac

This point of care algorithm is to guide initial management of pediatric anaphylaxis in the Emergency Department. Published online: December 2018, Version 1.1.

Anaphylaxis Pocket Card  (2018)

Anaphylaxis Pocket Card

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TREKK Anaphylaxis PedsPac

TREKK Anaphylaxis PedsPac

This pocket card contains tips to manage pediatric patients with anaphylaxis. Updated online: April 2019, Version 1.2.

Carte de Poche pour LAnaphylaxie  (2018)

Carte de Poche pour LAnaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

PedsPac de TREKK sur l'Anaphylaxie

This pocket card contains tips to manage pediatric patients with anaphylaxis. Published online: April 2019, Version 1.2.

Algorithme pour LAnaphylaxie  (2018)

Algorithme pour LAnaphylaxie

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PedsPac de TREKK sur l'Anaphylaxie

PedsPac de TREKK sur l'Anaphylaxie

This point of care algorithm is to guide initial management of pediatric anaphylaxis in the Emergency Department. Published online: April 2019, Version 1.1.

Caring for a child with food allergy: A guide on what you need to know

Caring for a child with food allergy: A guide on what you need to know

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This visual guide is for caregivers like grandparents, babysitters, and coaches, and provides easy-to-understand information that's essential for managing food allergy and anaphylaxis.  

Prendre soin d’un enfant avec des allergies alimentaires : ce que vous devez savoir

Prendre soin d’un enfant avec des allergies alimentaires : ce que vous devez savoir

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Ce guide visuel s'adressant aux personnes qui s'occupent d'enfants, comme les grands-parents, les gardiennes et les entraineurs, fournit des renseignements essentiels pour gerer les allergies aliementaires et l'anaphylaxie qui sont faciles a comprendre. 

Video (French): Le plan d’action Canadien pour l’anaphylaxie chez les enfants

Video (French): Le plan d’action Canadien pour l’anaphylaxie chez les enfants

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Infographic: How to Manage your Child's Anaphylaxis Reaction

Infographic: How to Manage your Child's Anaphylaxis Reaction

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ECHO Research and ARCHE

ECHO Research and ARCHE

An anaphylactic reaction, or anaphylaxis, is a severe allergic reaction. Symptoms can start very quickly and it could be life-threatening. 
 
Anaphylaxis is caused by an allergen that triggers an immune response in the body. This is your body’s way of trying to protect itself. Common allergens include food, some insects (like bees or wasps), and medications.

Canadian Anaphylaxis Action Plan for Kids

Canadian Anaphylaxis Action Plan for Kids

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Anaphylaxis  Clinical guidelines

Clinical Practice Guideline: Time to revisit the definition and clinical criteria for anaphylaxis?  (2019)

Clinical Practice Guideline: Time to revisit the definition and clinical criteria for anaphylaxis?

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Turner PJ, Worm M, Ansotegui IJ, et al.

Turner PJ, Worm M, Ansotegui IJ, et al.

The objective of this was to overview and discuss current definitions of anaphylaxis.

Clinical Practice Guideline: CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria.  (2019)

Clinical Practice Guideline: CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria.

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Fein MN, Fischer DA, OKeefe AW, Sussman GL

Fein MN, Fischer DA, OKeefe AW, Sussman GL

The objective of this was to overview the effects of new and old h1 antihistamines.

Clinical Practice Guideline: Anaphylaxis in Schools & Other Settings, 3rd Edition Revised  (2016)

Clinical Practice Guideline: Anaphylaxis in Schools & Other Settings, 3rd Edition Revised

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Canadian Society of Allergy and Clinical Immunology

Canadian Society of Allergy and Clinical Immunology

This manual has been developed for primarily non-medical people. It consists of an updated Consensus Statement and an Appendices section from the Canadian Society of Allergy and Clinical Immunology. The Consensus Statement provides recommendations for the management of anaphylaxis in the community, which are based on the most current research. The Appendices section provides resources that will help individuals at risk of anaphylaxis, educators, caregivers, and parents understand the basics of anaphylaxis.

Position Statement: CSACI position statement - epinephrine auto-injectors and children < 15 kg  (2015)

Position Statement: CSACI position statement - epinephrine auto-injectors and children < 15 kg

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Halbrich M, Mack DP, Carr S, Watson W, Kim H

Halbrich M, Mack DP, Carr S, Watson W, Kim H

This position statement addresses a number of questions regarding epinephrine administration/prescribing suggestions for the infant under 15kg who is at risk for anaphylaxis, including: What are possible consequences of administering a larger than recommended dose of epinephrine? Are there other ways to prescribe the recommended dose of epinephrine? What are the consequences of not administering epinephrine? What does the Canadian Society for Allergy and Clinical Immunology suggest for the infant less than 15kg?

Clinical Practice Guideline: Anaphylaxis--a practice parameter update 2015  (2015)

Clinical Practice Guideline: Anaphylaxis--a practice parameter update 2015

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Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J, Ellis A, Golden DB, Greenberger P, Kemp S, Khan D, Ledford D, Lieberman J, Metc...

Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J,...

The objective of this parameter is to update these previous versions and ultimately to improve the care of patients by providing the practicing physician with an evidence-based approach to the diagnosis and management of anaphylactic events.

Clinical Practice Guideline: 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines  (2015)

Clinical Practice Guideline: 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines

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Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, Lockey RF, El-Gamal YM, Brown SG, Park HS, Sheikh A

Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, Lockey RF...

The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis provide a unique global perspective on this increasingly common, potentially life-threatening disease. Recommendations made in the original WAO Anaphylaxis Guidelines remain clinically valid and relevant, and are a widely accessed and frequently cited resource. In this 2015 update of the evidence supporting recommendations in the Guidelines, new information based on anaphylaxis publications from January 2014 through mid- 2015 is summarized.

Clinical Practice Guideline: Emergency department diagnosis and treatment of anaphylaxis: a practice parameter  (2014)

Clinical Practice Guideline: Emergency department diagnosis and treatment of anaphylaxis: a practice parameter

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Campbell RL, Li JT, Nicklas RA, Sadosty AT, Members of the Joint Task Force Practice Parameter Workgroup

Campbell RL, Li JT, Nicklas RA, Sadosty AT, Members of the Joint Task Force P...

The recommendations made in this document about the management of anaphylaxis apply to anaphylaxis that occurs in an ED setting. Some of these recommendations might be different if anaphylaxis occurs in an office setting.

Clinical Practice Guideline: Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology  (2014)

Clinical Practice Guideline: Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology

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Muraro A, Roberts G, Worm M, Bil MB, Brockow K, Fernndez Rivas M, Santos AF, Zolkipli ZQ, Bellou A, Beyer K, Bindslev-Jensen C, Cardona V, Clark AT, Demoly P...

Muraro A, Roberts G, Worm M, Bil MB, Brockow K, Fernndez Rivas M, Santos AF, ...

Anaphylaxis is a clinical emergency, and all healthcare professionals should be familiar with its recognition and acute and ongoing management. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Anaphylaxis. They aim to provide evidence-based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis.

Clinical Practice Guideline: World Allergy Organization guidelines for the assessment and management of anaphylaxis  (2011)

Clinical Practice Guideline: World Allergy Organization guidelines for the assessment and management of anaphylaxis

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Simons FE, Ardusso LR, Bil MB, El-Gamal YM, Ledford DK, Ring J, Sanchez-Borges M, Senna GE, Sheikh A, Thong BY, World Allergy Organization

Simons FE, Ardusso LR, Bil MB, El-Gamal YM, Ledford DK, Ring J, Sanchez-Borge...

The illustrated World Allergy Organization (WAO) Anaphylaxis Guidelines were created in response to absence of global guidelines for anaphylaxis. They incorporate contributions from more than 100 allergy/immunology specialists on 6 continents. Recommendations are based on the best evidence available, supported by references published to the end of December 2010. The Guidelines review patient risk factors for severe or fatal anaphylaxis, co-factors that amplify anaphylaxis, and anaphylaxis in vulnerable patients, including pregnant women, infants, the elderly, and those with cardiovascular disease. They focus on the supreme importance of making a prompt clinical diagnosis and on the basic initial treatment that is urgently needed and should be possible even in a low resource environment.

Anaphylaxis  Summaries of systematic reviews

Cochrane Summary: Glucocorticoids for the treatment of anaphylaxis  (2012)

Cochrane Summary: Glucocorticoids for the treatment of anaphylaxis

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Choo K, Simons FR, Sheikh A

Choo K, Simons FR, Sheikh A

To overview literature of emergency treatment of anaphylaxis

Anaphylaxis  Systematic reviews

Review:Cardiac safety of second-generation H1 -antihistamines when updosed in chronic spontaneous urticaria  (2019)

Review:Cardiac safety of second-generation H1 -antihistamines when updosed in chronic spontaneous urticaria

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Cataldi M, Maurer M, Taglialatela M, Church MK.

Cataldi M, Maurer M, Taglialatela M, Church MK.

To overview literature cardiac health and second wave antihistamines

Review: Guiding Principles for the Recognition, Diagnosis, and Management of Infants With Anaphylaxis: An Expert Panel Consensus  (2019)

Review: Guiding Principles for the Recognition, Diagnosis, and Management of Infants With Anaphylaxis: An Expert Panel Consensus

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Greenhawt, M., Gupta, R. S., Meadows, J. A., Pistiner, M., Spergel, J. M., Camargo, C. A., Jr, Simons, F., Lieberman, P. L

Greenhawt, M., Gupta, R. S., Meadows, J. A., Pistiner, M., Spergel, J. M., Ca...

To overview the current recommendations for yes

Review: Evaluation of Prehospital Management in a Canadian Emergency Department Anaphylaxis Cohort.  (2019)

Review: Evaluation of Prehospital Management in a Canadian Emergency Department Anaphylaxis Cohort.

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Gabrielli S, Clarke A, Morris J, et al.

Gabrielli S, Clarke A, Morris J, et al.

To assess prehospital management of anaphylaxis by measuring the effect of epinephrine use compared with antihistamines and corticosteroids on negative outcomes of anaphylaxis (intensive care unit/hospital ward admission, multiple doses of epinephrine in the emergency department [ED], and intravenous fluids given in the ED).

Review: Duration of Observation for Detecting a Biphasic Reaction in Anaphylaxis: A Meta-Analysis.  (2019)

Review: Duration of Observation for Detecting a Biphasic Reaction in Anaphylaxis: A Meta-Analysis.

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Kim TH, Yoon SH, Hong H, Kang HR, Cho SH, Lee SY.

Kim TH, Yoon SH, Hong H, Kang HR, Cho SH, Lee SY.

to determine a practical observation time for detecting a biphasic reaction after resolution of the initial anaphylactic reaction.

Review: Factors increasing the risk for a severe reaction in anaphylaxis: An analysis of data from The European Anaphylaxis Registry.  (2018)

Review: Factors increasing the risk for a severe reaction in anaphylaxis: An analysis of data from The European Anaphylaxis Registry.

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Worm M, Francuzik W, Renaudin JM, et al.

Worm M, Francuzik W, Renaudin JM, et al.

To identify and prioritize factors associated with an increased risk of developing severe anaphylaxis.

Review: Epinephrine auto-injector needle lengths Can both subcutaneous and periosteal / intraosseous injection be avoided ?  (2018)

Review: Epinephrine auto-injector needle lengths Can both subcutaneous and periosteal / intraosseous injection be avoided ?

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Dreborg S, Kim L, Tsai G, Kim H.

Dreborg S, Kim L, Tsai G, Kim H.

To discuss suitable EAI needle lengths based on ultrasound measurements related to weight.

Review: Do Corticosteroids Prevent Biphasic Anaphylaxis?  (2017)

Review: Do Corticosteroids Prevent Biphasic Anaphylaxis?

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Alqurashi W, Ellis AK

Alqurashi W, Ellis AK

This review analyzes the use of corticosteroids for reducing anaphylaxis severity and preventing biphasic anaphylaxis.

Review: Quality indicators for the acute and long-term management of anaphylaxis: a systematic review.  (2017)

Review: Quality indicators for the acute and long-term management of anaphylaxis: a systematic review.

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Dhami S, Sheikh A, Muraro A, et al.

Dhami S, Sheikh A, Muraro A, et al.

To identify quality indicators to support the acute and long-term management of anaphylaxis.

Review: Safety profile of H1-antihistamines in pediatrics: an analysis based on data from VigiBase.  (2017)

Review: Safety profile of H1-antihistamines in pediatrics: an analysis based on data from VigiBase.

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Motola D, Donati M, Biagi C, et al.

Motola D, Donati M, Biagi C, et al.

comparative analysis of the safety profiles of H1antihistamines using data from the WHO database

Comprehensive Review: Pitfalls in the use of epinephrine for anaphylaxis: patient and provider opportunities for improvement  (2016)

Comprehensive Review: Pitfalls in the use of epinephrine for anaphylaxis: patient and provider opportunities for improvement

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Cohen MB, Saunders SS, Wise SK, Nassif S, Platt MP

Cohen MB, Saunders SS, Wise SK, Nassif S, Platt MP

The purpose of this study was to identify the scope of epinephrine pitfalls and opportunities for improvement in the management of allergy emergencies.

Systematic Review: Time of Onset and Predictors of Biphasic Anaphylactic Reactions: A Systematic Review and Meta-analysis  (2015)

Systematic Review: Time of Onset and Predictors of Biphasic Anaphylactic Reactions: A Systematic Review and Meta-analysis

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Lee S, Bellolio MF, Hess EP, Erwin P, Murad MH, Campbell RL

Lee S, Bellolio MF, Hess EP, Erwin P, Murad MH, Campbell RL

The aim of this study was to evaluate the time of onset and predictors of biphasic anaphylactic reactions.

Review: Anaphylaxis: Unique aspects of clinical diagnosis and management in infants (birth to age 2 years)  (2015)

Review: Anaphylaxis: Unique aspects of clinical diagnosis and management in infants (birth to age 2 years)

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Simons FE, Sampson HA

Simons FE, Sampson HA

In this rostrum we aim to increase awareness of anaphylaxis in infancy in order to improve clinical diagnosis, management, and prevention of recurrences.

Review: Risk multipliers for severe food anaphylaxis  (2015)

Review: Risk multipliers for severe food anaphylaxis

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Smith PK, Hourihane JO, Lieberman P

Smith PK, Hourihane JO, Lieberman P

This paper reviews the factors that contribute to the risk of severe anaphylactic events and provides a framework for the ongoing management of patients at risk of severe food allergy.

Systematic Review: H2-antihistamines for the treatment of anaphylaxis with and without shock: a systematic review  (2014)

Systematic Review: H2-antihistamines for the treatment of anaphylaxis with and without shock: a systematic review

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Nurmatov UB, Rhatigan E, Simons FE, Sheikh A

Nurmatov UB, Rhatigan E, Simons FE, Sheikh A

The objective of this systematic review was to assess the benefits and harms of H2-antihistamines in the treatment of anaphylaxis.

Cochrane Systematic Review: Glucocorticoids for the treatment of anaphylaxis  (2012)

Cochrane Systematic Review: Glucocorticoids for the treatment of anaphylaxis

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Choo KJ, Simons FE, Sheikh A

Choo KJ, Simons FE, Sheikh A

We sought to assess the benefits and harms of glucocorticoid treatment during episodes of anaphylaxis.

Cochrane Systematic Review: Adrenaline auto-injectors for the treatment of anaphylaxis with and without cardiovascular collapse in the community  (2012)

Cochrane Systematic Review: Adrenaline auto-injectors for the treatment of anaphylaxis with and without cardiovascular collapse in the community

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Sheikh A, Simons FE, Barbour V, Worth A

Sheikh A, Simons FE, Barbour V, Worth A

The objective of this systematic review was to assess the effectiveness of adrenaline (epinephrine) auto-injectors in relieving respiratory, cardiovascular, and other symptoms during episodes of anaphylaxis that occur in the community.

Cochrane Systematic Review: H1-antihistamines for the treatment of anaphylaxis with and without shock  (2007)

Cochrane Systematic Review: H1-antihistamines for the treatment of anaphylaxis with and without shock

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Sheikh A, ten Broek VM, Brown SG, Simons FE

Sheikh A, ten Broek VM, Brown SG, Simons FE

The objective of this systematic review was to assess the benefits and harm of H1-antihistamines in the treatment of anaphylaxis.

Anaphylaxis  Key studies

Key Study: Biphasic Reactions in Emergency Department Anaphylaxis Patients: A Prospective Cohort Study  (2020)

Key Study: Biphasic Reactions in Emergency Department Anaphylaxis Patients: A Prospective Cohort Study

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Liu X, Lee S, Lohse CM, Hardy CT, Campbell RL.

Liu X, Lee S, Lohse CM, Hardy CT, Campbell RL.

To evaluate biphasic reaction rates and associated risk factors.

Key Study: Simulation of Health and Economic Benefits of Extended Observation of Resolved Anaphylaxis  (2019)

Key Study: Simulation of Health and Economic Benefits of Extended Observation of Resolved Anaphylaxis

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Shaker M, Wallace D, Golden DBK, Oppenheimer J, Greenhawt M

Shaker M, Wallace D, Golden DBK, Oppenheimer J, Greenhawt M

What is the cost-effectiveness of 1 hour vs 6 to 24 hours of medical observation for biphasic anaphylaxis?

Key Study: An economic evaluation of immediate vs non-immediate activation of emergency medical services after epinephrine use for peanut-induced anaphylaxis  (2019)

Key Study: An economic evaluation of immediate vs non-immediate activation of emergency medical services after epinephrine use for peanut-induced anaphylaxis

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Shaker M, Kanaoka T, Feenan L, Greenhawt M.

Shaker M, Kanaoka T, Feenan L, Greenhawt M.

To evaluate the cost-effectiveness of this strategy, vs a watchful waiting approach before activating emergency medical services (EMS).

Key Study: Epinephrine Use for Anaphylaxis - A Multi-Incident Analysis  (2017)

Key Study: Epinephrine Use for Anaphylaxis - A Multi-Incident Analysis

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Institute for Safe Medication Practices Canada

Institute for Safe Medication Practices Canada

This multi-incident analysis was conducted to identify factors contributing to errors when epinephrine was used for the treatment of anaphylaxis and to suggest strategies to prevent or minimize potential harm when epinephrine is used for this indication.

Key Study: The Risk of Recurrent Anaphylaxis  (2017)

Key Study: The Risk of Recurrent Anaphylaxis

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O'Keefe A, Clarke A, St Pierre Y, Mill J, Asai Y, Eisman H, La Vieille S, Alizadehfar R, Joseph L, Morris J, Gravel J, Ben-Shoshan M

O'Keefe A, Clarke A, St Pierre Y, Mill J, Asai Y, Eisman H, La Vieille S, Ali...

factors contributing to errors when epinephrine was

Key Study: Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children  (2016)

Key Study: Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children

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Brown JC, Tuuri RE, Akhter S, Guerra LD, Goodman IS, Myers SR, Nozicka C, Manzi S, Long K, Turner T, Conners GP, Thompson RW, Park E

Brown JC, Tuuri RE, Akhter S, Guerra LD, Goodman IS, Myers SR, Nozicka C, Man...

used for the treatment of anaphylaxis and to suggest

Key Study: Embedded Needles Caused by Epinephrine Autoinjector Use in Children  (2016)

Key Study: Embedded Needles Caused by Epinephrine Autoinjector Use in Children

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Dreborg S, Wen X, Kim L, Tsai G, Nevis I, Potts R, Chiu J, Dominic A, Kim H

Dreborg S, Wen X, Kim L, Tsai G, Nevis I, Potts R, Chiu J, Dominic A, Kim H

strategies to prevent or minimize potential harm

Key Study: Increasing visits for anaphylaxis and the benefits of early epinephrine administration: A 4-year study at a pediatric emergency department in Montreal, Canada  (2016)

Key Study: Increasing visits for anaphylaxis and the benefits of early epinephrine administration: A 4-year study at a pediatric emergency department in Montreal, Canada

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Hochstadter E, Clarke A, De Schryver S, LaVieille S, Alizadehfar R, Joseph L, Eisman H, Ben-Shoshan M

Hochstadter E, Clarke A, De Schryver S, LaVieille S, Alizadehfar R, Joseph L,...

when epinephrine is used for this indication.

Key Study: Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis  (2015)

Key Study: Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis

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Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G

Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G

The objective of this study was to investigate the incidence and clinical predictors of biphasic reactions in children presenting to the emergency department (ED) with anaphylaxis.

Key Study: Early treatment of food-induced anaphylaxis with epinephrine is associated with a lower risk of hospitalization  (2015)

Key Study: Early treatment of food-induced anaphylaxis with epinephrine is associated with a lower risk of hospitalization

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Fleming JT, Clark S, Camargo CA Jr, Rudders SA

Fleming JT, Clark S, Camargo CA Jr, Rudders SA

The objective of this study was to identify factors associated with early epinephrine treatment for FIA and to specifically examine the association between early epinephrine treatment and hospitalization.

Key Study: Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial  (2015)

Key Study: Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial

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Umasunthar T, Procktor A, Hodes M, Smith JG, Gore C, Cox HE, Marrs T, Hanna H, Phillips K, Pinto C, Turner PJ, Warner JO, Boyle RJ

Umasunthar T, Procktor A, Hodes M, Smith JG, Gore C, Cox HE, Marrs T, Hanna H...

Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices.

Asthma
Asthma  Key Resources

Asthma Order Set  (2020)

Asthma Order Set

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TREKK Asthma PedsPac

TREKK Asthma PedsPac

This order set is for management of pediatric severe asthma in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients greater than or equal to 12 months of age. Published online: February 2020, Version 1.1.

Feuille D’ordonnances Pré-Rédigées pour d'Asthme  (2020)

Feuille D’ordonnances Pré-Rédigées pour d'Asthme

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PedsPac de TREKK sur d'Asthme

PedsPac de TREKK sur d'Asthme

This order set is for management of pediatric severe asthma in the ED and is adaptable to your hospitals form policy. This document is intended for use on patients > 12 months of age. Published online: Feb 2020, Version 1.1.

UNDER REVIEW: Bottom Line Recommendations: Asthma  (2020)

UNDER REVIEW: Bottom Line Recommendations: Asthma

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Johnson D and TREKK Network

Johnson D and TREKK Network

Bottom line recommendations for the treatment and management of asthma. Updated January 2020, Version 1.5.

Asthma Algorithm  (2018)

Asthma Algorithm

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TREKK Asthma PedsPac

TREKK Asthma PedsPac

This point of care algorithm is to guide initial management of pediatric severe asthma in the Emergency Department. This algorithm is intended for use on patients greater than or equal to 12 months of age. Published online: March 2020, Version 1.2.

Asthma Pocket Card  (2018)

Asthma Pocket Card

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TREKK Asthma PedsPac

TREKK Asthma PedsPac

This pocket card contains tips to manage pediatric patients with severe asthma. This pocket card is intended for use on patients greater or equal to 12 months of age. Published online: March 2020, Version 1.3.

Asthma References and Development Team  (2018)

Asthma References and Development Team

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TREKK Asthma PedsPac

TREKK Asthma PedsPac

This document outlines the references used and team involved in the development of the asthma PedsPac. Published online: December 2018, Version 1.0.

Carte de Poche d'Asthme  (2018)

Carte de Poche d'Asthme

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PedsPac de TREKK sur d'Asthme

PedsPac de TREKK sur d'Asthme

This pocket card contains tips to manage pediatric patients with severe asthma. This pocket card is intended for use on patients > 12 months of age. Published online: April 2019, Version 1.0.

Algorithme Pediatrique pour d'Asthme  (2018)

Algorithme Pediatrique pour d'Asthme

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PedsPac de TREKK sur d'Asthme

PedsPac de TREKK sur d'Asthme

This point of care algorithm is to guide initial management of pediatric severe asthma in the Emergency Department. This algorithm is intended for use on patients greater than or equal to 12 months of age. Published online: March 2020, Version 1.1.

UNDER REVIEW: Recommandations de Base: Asthme  (2017)

UNDER REVIEW: Recommandations de Base: Asthme

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Johnson D and TREKK Network

Johnson D and TREKK Network

Recommandations de base pour l'évaluation et la prise en charge de l'asthme.

Asthma  Clinical guidelines

Clinical Practice Guideline: Paediatric Emergency Department Asthma Clinical Pathway (2014)

Clinical Practice Guideline: Paediatric Emergency Department Asthma Clinical Pathway (2014)

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Expert Content Working Group of the Ontario Lung Association,

Expert Content Working Group of the Ontario Lung Association,

The P-EDACP is for patients aged 1 to 17 years presenting with wheeze and/or cough who have a history of asthma and/or prior history of wheezing. Additional tools include medication guidelines and pre-printed physicians orders (PPO) for each of the four severity levels, a patient education checklist, and discharge instructions with integrated prescription.

Clinical Practice Guideline: Guide Clinique Asthme (2014)

Clinical Practice Guideline: Guide Clinique Asthme (2014)

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Trottier, ED, Gauvin, F, Pettersen, G, Marquis, C, Ducharme, F, Lucas, N, Bédard, P, Morneau, S,

Trottier, ED, Gauvin, F, Pettersen, G, Marquis, C, Ducharme, F, Lucas, N, Béd...

This French language webpage created by the Centre Hospitalier Universitaire Sainte-Justine, provides guidelines, pathways and order sheets for treating acute asthma in emergency departments.

Clinical Practice Guideline: Asthme: Algorithme status asthmaticus (2014)

Clinical Practice Guideline: Asthme: Algorithme status asthmaticus (2014)

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Trottier, ED, Gauvin, F, Pettersen, G, Marquis, C, Ducharme, F, Lucas, N, Bédard, P, Morneau, S,

Trottier, ED, Gauvin, F, Pettersen, G, Marquis, C, Ducharme, F, Lucas, N, Béd...

This French language pathway created by the Centre Hospitalier Universitaire Sainte-Justine, provides guidance on treating pediatric patients with severe status asthmaticus.

Asthma  Summaries of systematic reviews

Cochrane Summary: Holding chambers (spacers) versus nebulisers for delivery of beta-agonist relievers in the treatment of an asthma attack (2013)

Cochrane Summary: Holding chambers (spacers) versus nebulisers for delivery of beta-agonist relievers in the treatment of an asthma attack (2013)

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Cates, CJ, Welsh, EJ, Rowe, BH,

Cates, CJ, Welsh, EJ, Rowe, BH,

Review question: When someone is having an asthma attack is it as safe and effective to use a spacer instead of a nebuliser? Background: During an asthma attack, the airways (tubes in the lungs) narrow making breathing difficult. The initial response to an asthma attack is to treat with a drug that can open up the airways and make breathing easier. These drugs are called bronchodilators and in this review we are looking specifically at a class of bronchodilators called beta-agonists (for example salbutamol). These drugs can be taken straight from an inhaler, but during an asthma attack they are easier to take using either a spacer or a nebuliser. A spacer is a hollow chamber. A puff of drug from an inhaler is added to the chamber and then the person breathes in and out normally (also described as tidal breathing), from a mouthpiece on the chamber. A nebuliser is a machine with a mask that goes over the person's mouth and nose and through which a constant stream of drug and air (or oxygen) is breathed in and out normally. What evidence did we find? We found 39 clinical trials involving 1897 children and 729 adults. Thirty-three of the trials were conducted in an emergency room (or emergency department) and community settings (such as a GP's surgery), and six trials were on inpatients (people in hospital) with acute asthma (207 children and 28 adults). Overall we judged the quality of the evidence to be moderate. What do the studies tell us? Taking beta-agonists through either a spacer or a nebuliser in the emergency department did not make a difference to the number of adults being admitted to hospital, whilst in children we can be fairly confident that nebulisers are not better than spacers at preventing admissions. In children, the length of stay in the emergency department was significantly shorter when the spacer was used instead of a nebuliser. The average stay in the emergency department for children given nebulised treatment was 103 minutes. Children given treatment via spacers spent an average of 33 minutes less. In adults, the length of stay in the emergency department was similar for the two delivery methods. However the adult studies were conducted slightly differently which may have made it more difficult to show a difference in the length of stay in the emergency department. Because all the adult studies used a so-called "double-dummy" design, the adults received a spacer AND a nebuliser (either beta-agonist in a spacer and a dummy nebuliser or vice versa) which meant both groups of people were in the emergency department for as long as it took to take both treatments. Lung function tests were also similar for the two delivery methods in both adults and children. Pulse rate was lower in children taking beta-agonists through a spacer (mean difference 5% baseline), and there was a lower risk of developing tremor. Conclusion: Metered-dose inhalers with a spacer can perform at least as well as wet nebulisation in delivering beta-agonists in children with acute asthma, but we are less certain about the results in adults.

Cochrane Summary: Combined inhaled anticholinergics and beta2-agonists for initial treatment of acute asthma in children (2013)

Cochrane Summary: Combined inhaled anticholinergics and beta2-agonists for initial treatment of acute asthma in children (2013)

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Griffiths, B, Ducharme, FM,

Griffiths, B, Ducharme, FM,

Background: In an asthma attack, the airways (small tubes in the lungs) narrow because of inflammation (swelling), muscle spasms and mucus secretions. Other symptoms include wheezing, coughing and chest tightness. This makes breathing difficult. Reliever inhalers typically contain short-acting beta2-agonists (SABAs) that relax the muscles in the airways, opening the airways so that breathing is easier. Anticholinergic drugs work by opening the airways and decreasing mucus secretions. Review question: We looked at randomised controlled trials to find out whether giving inhaled anticholinergics plus SABAs (instead of SABAs on their own) in the emergency department provides benefits or harms in children having an asthma attack. Key results: We found that children with a moderate or severe asthma attack who were given both drugs in the emergency department were less likely to be admitted to the hospital than those who only had SABAs. In the group receiving only SABAs, on average 23 out of 100 children with acute asthma were admitted to hospital compared with an average of 17 (95% CI 15 to 20) out of 100 children treated with SABAs plus anticholinergics. Taking both drugs was also better at improving lung function. Taking both drugs did not seem to reduce the possibility of another asthma attack. Fewer children treated with anticholinergics reported nausea and tremor, but no significant group difference was observed for vomiting. Quality of the evidence and further research: Most of the studies were in preschool- and school-aged children; three studies also included a small proportion of infants under 18 months of age, although there was no evidence that inclusion of these infants with wheezy episodes affected the results. Nine trials (45%) were at a low risk of bias and we regarded the evidence for hospitalisation as high quality. Physicians can administer the dose of anticholinergic and SABA in several different ways; as a single dose, or as a certain number of doses or more flexibly. Most of the trials gave the children two or three doses and we think that more research is needed to improve characterization of children that benefit from, and the most effective number and frequency of doses of, anticholinergic treatment.

Cochrane Summary: Inhaled corticosteroids for acute asthma following emergency department discharge (2012)

Cochrane Summary: Inhaled corticosteroids for acute asthma following emergency department discharge (2012)

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Edmonds, ML, Milan, SJ, Brenner, BE, Camargo, CA, Rowe, BH,

Edmonds, ML, Milan, SJ, Brenner, BE, Camargo, CA, Rowe, BH,

Acuteasthma is a common cause of visits toemergencydepartments (ED) and the majority of patients are treated and discharged home. Some people will have arelapseofacuteasthma within two weeks of being discharged after apparently successful treatment. Beta2-agonist drugs are used to open the muscles in the airways and corticosteroids drugs are used to reduce inflammation of the swollen airways.Corticosteroidscan be inhaled (ICS) or swallowed as a tablet (so-calledoralcorticosteroids). ICS may reduceadverse effectsand get to the airways more directly thanoralcorticosteroids. Thisreviewof trials found that there was insufficient evidence that inhaling corticosteroids as well as taking the drugs orally is better thanoraluse alone, afteremergencydepartment treatment for an asthma attack. There is also insufficient evidence that taking ICS alone is as good as taking them orally, although there is some evidence to support using ICS alone for mild asthma attacks afteremergencydepartment discharge. Moreresearchis needed.

Cochrane Summary: Role of ketamine for management of acute severe asthma in children (2012)

Cochrane Summary: Role of ketamine for management of acute severe asthma in children (2012)

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Jat, KR, Chawla, D,

Jat, KR, Chawla, D,

Children frequently visit theemergencydepartment foracuteexacerbation of asthma. Some of these children fail to respond tostandard treatment(corticosteroids and bronchodilators) with increasedmorbidity. Ketamine has bronchodilatory properties and may be useful foracuteexacerbation of asthma. We evaluated theefficacyof ketamine for management of severeacuteasthma in children who had not responded to standardtherapy. We found, through systematic search, only onestudywhere investigators assessed the usefulness of ketamine for management of severeacuteasthma in children. While this singlestudysuggested that there is a lack of evidence for usefulness of ketamine inacuteexacerbation of asthma in children, more trials are needed regarding the use of ketamine inacuteasthma before more specific recommendations can be made.

Cochrane Summary: What are the effects of educational interventions delivered to children and/or their families, who have experienced an emergency department visit with their asthma within the previous 12 months? (2010)

Cochrane Summary: What are the effects of educational interventions delivered to children and/or their families, who have experienced an emergency department visit with their asthma within the previous 12 months? (2010)

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Boyd, M, Lasserson, TJ, McKean, MC, Gibson, PG, Ducharme, FM, Haby, M,

Boyd, M, Lasserson, TJ, McKean, MC, Gibson, PG, Ducharme, FM, Haby, M,

Asthma care for children in our society is common and costly. There is now evidence that educationalinterventionfor children who have attended theemergencydepartment for asthma lowers theriskof the need for futureemergencydepartment visits and hospital admissions. Thisreviewlooked at studies which compared usual care for asthma to more intensive educational programmes and the results showed astatistically significantreduction in the treatment groups needing subsequentemergencydepartment visits or hospital admissions. We were not able to determine the most effective type, duration or intensity ofeducationthat should be offered to children to offer the best asthma outcomes.

Cochrane Summary: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department (2009)

Cochrane Summary: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department (2009)

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Rowe, BH, Bretzlaff, J, Bourdon, C, Bota, G, Blitz, S, Camargo, CA,

Rowe, BH, Bretzlaff, J, Bourdon, C, Bota, G, Blitz, S, Camargo, CA,

In an asthma attack, the airways (passages to the lungs) narrow from muscle spasms and swelling (inflammation). Bronchodilator drugs (reliever inhalers) can be used to relax the muscles and open the airways, and corticosteroid drugs to reduce the inflammation. Magnesium sulfate is a drug that can also affect muscles, and may reduce inflammation as well. It can be given through a drip in the veins (intravenously). Thereviewof trials found thatintravenousmagnesium sulfate in addition to bronchodilators seems to be safe and beneficial for people with severe asthma attacks, or those for whom bronchodilators are not working.

Cochrane Summary: Early emergency department treatment of acute asthma with systemic corticosteroids (2008)

Cochrane Summary: Early emergency department treatment of acute asthma with systemic corticosteroids (2008)

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Rowe, BH, Spooner, C, Ducharme, F, Bretzlaff, J, Bota, G,

Rowe, BH, Spooner, C, Ducharme, F, Bretzlaff, J, Bota, G,

In an asthma attack, the airways (passages to the lungs) narrow from muscle spasms and swelling (inflammation). Bronchodilators (reliever inhalers to open up the lungs and airways) can be used for the spasms, and corticosteroids for the swelling.Corticosteroidscan be inhaled, or taken by mouth (orally) or through a drip into the veins (intravenously). Thereviewof trials found thatsystemic(oralorintravenous) corticosteroids reduce the need for people with asthma attacks to stay in hospital, with fewadverse effects.

Asthma  Systematic reviews

Cochrane Systematic Review: Intravenous and nebulized magnesium sulfate for treating acute asthma in adults and children: a systematic review and meta-analysis

Cochrane Systematic Review: Intravenous and nebulized magnesium sulfate for treating acute asthma in adults and children: a systematic review and meta-analysis

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Shan, Z, Rong, Y, Yang, W, Wang, D, Yao, P, Xie, J, Liu, L,

Shan, Z, Rong, Y, Yang, W, Wang, D, Yao, P, Xie, J, Liu, L,

This systematic review and meta-analysis was conducted to estimate the effects of intravenous and nebulized magnesium sulfate on treating adults and children with acute asthma.

Cochrane Systematic Review: Dexamethasone for acute asthma exacerbations in children: a meta-analysis (2014)

Cochrane Systematic Review: Dexamethasone for acute asthma exacerbations in children: a meta-analysis (2014)

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Keeney, GE, Gray, MP, Morrison, AK, Levas, MN, Kessler, EA, Hill, GD, Gorelick, MH, Jackson, JL,

Keeney, GE, Gray, MP, Morrison, AK, Levas, MN, Kessler, EA, Hill, GD, Gorelic...

This systematic review and meta-analysis aimed to determine whether intramuscular or oral dexamethasone is equivalent or superior to a 5-day course of oral prednisone or prednisolone. The primary outcome of interest was return visits or hospital readmissions.

Cochrane Systematic Review: Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma (2013)

Cochrane Systematic Review: Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma (2013)

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Cates, CJ, Welsh, EJ, Rowe, BH,

Cates, CJ, Welsh, EJ, Rowe, BH,

Objectives: To assess the effects of holding chambers (spacers) compared to nebulisers for the delivery of beta(2)-agonists for acute asthma. This review includes a total of 1897 children and 729 adults in 39 trials. Thirty-three trials were conducted in the emergency room and equivalent community settings, and six trials were on inpatients with acute asthma (207 children and 28 adults).

Cochrane Systematic Review: Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children (2013)

Cochrane Systematic Review: Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children (2013)

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Griffiths, B, Ducharme, FM,

Griffiths, B, Ducharme, FM,

Objectives: To determine whether the addition of inhaled anticholinergics to SABAs provides clinical improvement and affects the incidence of adverse effects in children with acute asthma exacerbations.

Cochrane Systematic Review: Inhaled steroids for acute asthma following emergency department discharge (2012)

Cochrane Systematic Review: Inhaled steroids for acute asthma following emergency department discharge (2012)

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Edmonds, ML, Milan, SJ, Brenner, BE, Camargo, CA Jr, Rowe, BH,

Edmonds, ML, Milan, SJ, Brenner, BE, Camargo, CA Jr, Rowe, BH,

Objectives: To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids.

Cochrane Systematic Review: Ketamine for management of acute exacerbations of asthma in children (2012)

Cochrane Systematic Review: Ketamine for management of acute exacerbations of asthma in children (2012)

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Jat, KR, Chawla, D,

Jat, KR, Chawla, D,

Objectives: To evaluate the efficacy of ketamine compared to placebo, no intervention or standard care for management of severe acute asthma in children who had not responded to standard therapy.

Cochrane Systematic Review: Interventions for educating children who are at risk of asthma-related emergency department attendance (2009)

Cochrane Systematic Review: Interventions for educating children who are at risk of asthma-related emergency department attendance (2009)

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Boyd, M, Lasserson, TJ, McKean, MC, Gibson, PG, Ducharme, FM, Haby, M,

Boyd, M, Lasserson, TJ, McKean, MC, Gibson, PG, Ducharme, FM, Haby, M,

Objectives: To conduct a systematic review of the literature and update the previous review as to whether asthma education leads to improved health outcomes in children who have attended the emergency room for asthma.

Cochrane Systematic Review: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department (2000)

Cochrane Systematic Review: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department (2000)

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Rowe, BH, Bretzlaff, JA, Bourdon, C, Bota, GW, Camargo, CA Jr,

Rowe, BH, Bretzlaff, JA, Bourdon, C, Bota, GW, Camargo, CA Jr,

Objectives: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department. Seven trials were included (5 adult, 2 pediatric).

Cochrane Systematic Review: Early emergency department treatment of acute asthma with systemic corticosteroids (2000)

Cochrane Systematic Review: Early emergency department treatment of acute asthma with systemic corticosteroids (2000)

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Rowe, BH, Spooner, C, Ducharme, FM, Bretzlaff, JA, Bota, GW,

Rowe, BH, Spooner, C, Ducharme, FM, Bretzlaff, JA, Bota, GW,

Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).

Asthma  Key studies

Key Study: The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers (2008)

Key Study: The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers (2008)

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Ducharme, FM, Chalut, D, Plotnick, L, Savdie, C, Kudirka, D, Zhang, X, Meng, L, McGillivray, D,

Ducharme, FM, Chalut, D, Plotnick, L, Savdie, C, Kudirka, D, Zhang, X, Meng, ...

To determine the performance characteristics of the Preschool Respiratory Assessment Measure (PRAM) in preschool and school-aged children with acute asthma.

Key Study: The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity (2000)

Key Study: The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity (2000)

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Chalut DS, Ducharme FM, Davis GM

Chalut DS, Ducharme FM, Davis GM

To elaborate and validate a Preschool Respiratory Assessment Measure (PRAM) that would accurately reflect the severity of airway obstruction and the response to treatment in young patients with asthma.

Bacterial Meningitis
Bacterial Meningitis  Key Resources

CSF interpretation  (2018)

CSF interpretation

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The Royal Children's Hospital Melbourne

The Royal Children's Hospital Melbourne

Guideline to help with the interpretation of CSF results for the purpose of diagnosing or excluding meningitis.

Lumbar puncture  (2018)

Lumbar puncture

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The Royal Children's Hospital Melbourne

The Royal Children's Hospital Melbourne

Guideline for performing lumbar puncture.

Meningitis - encephalitis  (2018)

Meningitis - encephalitis

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The Royal Children's Hospital Melbourne

The Royal Children's Hospital Melbourne

Guideline for the assessment and management of meningitis-encephalitis.

Management of Bacterial Meningitis in Children and Young People  (2017)

Management of Bacterial Meningitis in Children and Young People

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Meningitis Research Foundation

Meningitis Research Foundation

Flowchart of management of bacterial meningitis in children and young people, incorporating NICE Bacterial Meningitis and Meningococcal Septicaemia Guideline CG102.

Early Recognition of Meningitis and Septicaemia  (2016)

Early Recognition of Meningitis and Septicaemia

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Royal College of Nursing, Meningitis Research Foundation

Royal College of Nursing, Meningitis Research Foundation

Guidance for front line nurses on the early recognition of meningitis and sepsis (what to look for).

Bacterial Meningitis  Clinical guidelines

Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management  (2015)

Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management

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National Institute for Health and Care Excellence

National Institute for Health and Care Excellence

Guideline covering recognising, diagnosing and managing bacterial meningitis and meningococcal septicaemia in babies, children and young people under 16.

Guidelines for the management of suspected and confirmed bacterial meningitis in Canadian children older than one month of age  (2014)

Guidelines for the management of suspected and confirmed bacterial meningitis in Canadian children older than one month of age

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Le Saux N; Canadian Paediatric Society, Infectious Diseases and ImmunizationCommittee

Le Saux N; Canadian Paediatric Society, Infectious Diseases and ImmunizationC...

Statement reviewing the current epidemiology of bacterial meningitis in children beyond the neonatal period and provide guidelines for the empirical management of suspected bacterial meningitis in Canadian children.

Practice guidelines for the management of bacterial meningitis  (2004)

Practice guidelines for the management of bacterial meningitis

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Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ

Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ

Practice guidelines to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis.

Bacterial Meningitis  Summaries of systematic reviews

Cochrane Summary: Fluids for people with acute bacterial meningitis  (2016)

Cochrane Summary: Fluids for people with acute bacterial meningitis

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Maconochie IK, Bhaumik S

Maconochie IK, Bhaumik S

Objective: To evaluate treatment of acute bacterial meningitis with differing volumes of initial fluid administration (up to 72 hours after first presentation) and the effects on death and neurological sequelae.

Cochrane Summary: Corticosteroids for bacterial meningitis  (2015)

Cochrane Summary: Corticosteroids for bacterial meningitis

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Brouwer MC, McIntyre P, Prasad K, Van de Beek D

Brouwer MC, McIntyre P, Prasad K, Van de Beek D

Objective: To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with acute bacterial meningitis.

Summary: Can a Clinical Prediction Rule Reliably Predict Pediatric Bacterial Meningitis?  (2015)

Summary: Can a Clinical Prediction Rule Reliably Predict Pediatric Bacterial Meningitis?

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Ostermayer DG, Koyfman A

Ostermayer DG, Koyfman A

Objective: To determine if a clinical prediction rule can reliably determine which children should be hospitalized and treated with intravenous antibiotics for bacterial meningitis.

Summary: In children with bacterial meningitis, does the addition of dexamethasone to an antibiotic treatment regimen result in a better clinical outcome than the antibiotic regimen alone?: Part A: Evidence-based answer and summary  (2006)

Summary: In children with bacterial meningitis, does the addition of dexamethasone to an antibiotic treatment regimen result in a better clinical outcome than the antibiotic regimen alone?: Part A: Evidence-based answer and summary

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Fox JL

Fox JL

Objective: To determine the efficacy of adjuvant dexamethasone therapy in paediatric bacterial meningitis.

Bacterial Meningitis  Systematic reviews

Review: Emergency Medicine Myths: Computed Tomography of the Head Prior to Lumbar Puncture in Adults with Suspected Bacterial Meningitis - Due Diligence or Antiquated Practice?  (2017)

Review: Emergency Medicine Myths: Computed Tomography of the Head Prior to Lumbar Puncture in Adults with Suspected Bacterial Meningitis - Due Diligence or Antiquated Practice?

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April MD, Long B, Koyfman A

April MD, Long B, Koyfman A

Objective: To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis.

Review: Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department  (2016)

Review: Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department

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Dorsett M, Liang SY

Dorsett M, Liang SY

Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.

Cochrane Systematic Review: Fluid therapy for acute bacterial meningitis  (2016)

Cochrane Systematic Review: Fluid therapy for acute bacterial meningitis

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Maconochie IK, Bhaumik S

Maconochie IK, Bhaumik S

Objective: To evaluate treatment of acute bacterial meningitis with differing volumes of initial fluid administration (up to 72 hours after first presentation) and the effects on death and neurological sequelae.

Cochrane Systematic Review: Corticosteroids for acute bacterial meningitis  (2015)

Cochrane Systematic Review: Corticosteroids for acute bacterial meningitis

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Brouwer MC, McIntyre P, Prasad K, Van de Beek D

Brouwer MC, McIntyre P, Prasad K, Van de Beek D

Objective: To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with acute bacterial meningitis.

Review: Early lumbar puncture in adult bacterial meningitis--rationale for revised guidelines  (2013)

Review: Early lumbar puncture in adult bacterial meningitis--rationale for revised guidelines

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Glimker M, Johansson B, Bell M, Ericsson M, Blckberg J, Brink M, Lindquist L, Sjlin J

Glimker M, Johansson B, Bell M, Ericsson M, Blckberg J, Brink M, Lindquist L,...

Objective: Revised Swedish guidelines regarding early lumbar puncture (LP) are presented, and the background documentation and reasons for omitting impaired consciousness, new onset seizures, and immunocompromised state as contraindications to LP are discussed.

Systematic Review: Does this child have bacterial meningitis? A systematic review of clinical prediction rules for children with suspected bacterial meningitis  (2013)

Systematic Review: Does this child have bacterial meningitis? A systematic review of clinical prediction rules for children with suspected bacterial meningitis

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Kulik DM, Uleryk EM, Maguire JL

Kulik DM, Uleryk EM, Maguire JL

Objective: Our aim was to systematically identify and review the quality and performance of published clinical prediction rules (CPRs) for children with suspected bacterial meningitis.

Systematic Review: Meta-analysis of bacterial meningitis score validation studies  (2012)

Systematic Review: Meta-analysis of bacterial meningitis score validation studies

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Nigrovic LE, Malley R, Kuppermann N

Nigrovic LE, Malley R, Kuppermann N

Objective: The study objective of the present work was to calculate the performance of the Bacterial Meningitis Score by performing a meta-analysis of all published validation studies.

Systematic Review: Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis  (2011)

Systematic Review: Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis

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Sakushima K, Hayashino Y, Kawaguchi T, Jackson JL, Fukuhara S

Sakushima K, Hayashino Y, Kawaguchi T, Jackson JL, Fukuhara S

Objective: Our study's purpose was to assess the utility of CSF lactate in differentiating bacterial meningitis from aseptic meningitis.

Systematic Review: Clinical features suggestive of meningitis in children: a systematic review of prospective data  (2010)

Systematic Review: Clinical features suggestive of meningitis in children: a systematic review of prospective data

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Curtis S, Stobart K, Vandermeer B, Simel DL, Klassen T

Curtis S, Stobart K, Vandermeer B, Simel DL, Klassen T

Objective: To seek evidence supporting accuracy of clinical features of pediatric bacterial meningitis.

Review: Lumbar puncture and brain herniation in acute bacterial meningitis: a review  (2007)

Review: Lumbar puncture and brain herniation in acute bacterial meningitis: a review

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Joffe AR

Joffe AR

Objective: There has been controversy regarding the risk of cerebral herniation caused by a lumbar puncture (LP) in acute bacterial meningitis (ABM). This review discusses in detail the issues involved in this controversy.

Bacterial Meningitis  Key studies

Key study: Cranial CT, Lumbar Puncture, and Clinical Deterioration in Bacterial Meningitis: A Nationwide Cohort Study  (2018)

Key study: Cranial CT, Lumbar Puncture, and Clinical Deterioration in Bacterial Meningitis: A Nationwide Cohort Study

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Costerus JM, Brouwer MC, Sprengers MES, Roosendaal SD, van der Ende A, van de Beek D

Costerus JM, Brouwer MC, Sprengers MES, Roosendaal SD, van der Ende A, van de...

Objective: In 2006, we started a prospective cohort study to identify and characterize host genetic traits and bacterial genetic factors controlling occurrence and outcome of bacterial meningitis (MeninGene). Here, we report data from this study, focusing on complications of LP in adults with community-acquired bacterial meningitis and the role of cranial CT prior to LP.

Key study: Lumbar Puncture Performed Promptly or After Neuroimaging in Acute Bacterial Meningitis in Adults: A Prospective National Cohort Study Evaluating Different Guidelines  (2018)

Key study: Lumbar Puncture Performed Promptly or After Neuroimaging in Acute Bacterial Meningitis in Adults: A Prospective National Cohort Study Evaluating Different Guidelines

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Glimker M, Sjlin J, kesson S, Naucler P

Glimker M, Sjlin J, kesson S, Naucler P

Objective: The aim was to evaluate the effect on outcome of adherence to European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), and Swedish guidelines regarding neuroimaging before LP.

Key study: Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines  (2017)

Key study: Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines

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Salazar L, Hasbun R

Salazar L, Hasbun R

Objective: The main objectives of this study were to identify the adherence of clinicians to IDSA guidelines regarding cranial imaging in patients with CAM, to evaluate the clinical and prognostic differences between those patients with and without an indication for cranial imaging, and to assess the clinical impact in management in those with abnormal intracranial findings with or without altered mental status as their sole indication for imaging.

Key study: Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture  (2015)

Key study: Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture

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Glimker M, Johansson B, Grindborg , Bottai M, Lindquist L, Sjlin J

Glimker M, Johansson B, Grindborg , Bottai M, Lindquist L, Sjlin J

Objective: Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision.

Key study: Prevalence and predictors of bacterial meningitis in young infants with Fever without a source  (2015)

Key study: Prevalence and predictors of bacterial meningitis in young infants with Fever without a source

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Martinez E, Mintegi S, Vilar B, Martinez MJ, Lopez A, Catediano E, Gomez B

Martinez E, Mintegi S, Vilar B, Martinez MJ, Lopez A, Catediano E, Gomez B

Objective: Our objectives were to analyze the prevalence and microbiology of bacterial meningitis in this group and its prevalence in relation to clinical and laboratory risk factors.

Key study: Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study  (2015)

Key study: Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study

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Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, Bettinger JA, Investigators of the Canadian Immunization Monitoring Program ACTive (I...

Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, Betti...

Objective: The objectives of this study were to describe the outcomes following invasive meningococcal disease (IMD) in a prospective cohort of children and adults, and to identify specific risk factors for death and development of neurological and nonneurological complications.

Key study: Distinguishing between bacterial and aseptic meningitis in children: European comparison of two clinical decision rules  (2010)

Key study: Distinguishing between bacterial and aseptic meningitis in children: European comparison of two clinical decision rules

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Dubos F, Korczowski B, Aygun DA, Martinot A, Prat C, Galetto-Lacour A, Casado-Flores J, Taskin E, Leclerc F, Rodrigo C, Gervaix A, Gendrel D, Brart G, Chalum...

Dubos F, Korczowski B, Aygun DA, Martinot A, Prat C, Galetto-Lacour A, Casado...

Objective: To compare the performance of two of these CDRs for children: the Bacterial Meningitis Score (BMS) and the Meningitest.

Key study: Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis  (2007)

Key study: Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis

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Nigrovic LE, Kuppermann N, Macias CG, Cannavino CR, Moro-Sutherland DM, Schemmer RD, Schwab SH, Agrawal D, Mansour KM, Bennett JE, Katsogridakis YL, Mohseni ...

Nigrovic LE, Kuppermann N, Macias CG, Cannavino CR, Moro-Sutherland DM, Schem...

Objective: To validate the Bacterial Meningitis Score in the era of widespread pneumococcal conjugate vaccination.

Key study: Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment  (2001)

Key study: Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment

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Kanegaye JT, Soliemanzadeh P, Bradley JS

Kanegaye JT, Soliemanzadeh P, Bradley JS

Objective: We conducted a retrospective review of children with bacterial meningitis to describe the rate at which parenteral antibiotic pretreatment sterilizes CSF cultures.

Key study: Cerebrospinal fluid findings in aseptic versus bacterial meningitis  (2000)

Key study: Cerebrospinal fluid findings in aseptic versus bacterial meningitis

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Negrini B, Kelleher KJ, Wald ER

Negrini B, Kelleher KJ, Wald ER

Objective: To assess 1) the characteristics of the CSF differential in aseptic versus bacterial meningitis, 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus bacterial meningitis.

Key study: A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children  (1990)

Key study: A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children

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Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Bernath O, Cheseaux JJ, Wedgwood J

Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Berna...

Objective: To compare ceftriaxone with cefuroxime for the treatment of meningitis, we conducted a study in which 106 children with acute bacterial meningitis were randomly assigned to receive either ceftriaxone (100 mg per kilogram of body weight per day, administered intravenously once daily; n = 53) or cefuroxime (240 mg per kilogram per day, administered intravenously in four equal doses; n = 53).

Bronchiolitis
Bronchiolitis  Key Resources

Bottom Line Recommendations: Bronchiolitis  (2020)

Bottom Line Recommendations: Bronchiolitis

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Plint, A & TREKK Network

Plint, A & TREKK Network

Bottom line recommendations for the treatment and management of bronchiolitis. Posted online: January 14, 2021, Version 3.0.

Recommandations de Base: La Bronchiolite  (2020)

Recommandations de Base: La Bronchiolite

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Plint, A & TREKK Network

Plint, A & TREKK Network

Bottom line recommendations for the treatment and management of bronchiolitis - en francais.  Published online: January 14, 2021, Version 3.0.

Bronchiolitis  Clinical guidelines

Clinical Guideline: Australasian bronchiolitis guideline  (2019)

Clinical Guideline: Australasian bronchiolitis guideline

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PREDICT Network: OBrien S, Borland ML, Cotterell E, Armstrong D, Babl Franz, Bauert P, Brabyn C, Garside L, Haskell L, Levitt D, McKay N, Neutze J, Schiller ...

PREDICT Network: OBrien S, Borland ML, Cotterell E, Armstrong D, Babl Franz, ...

Objective: to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population.

Clinical Guideline: Bronchiolitis in children: diagnosis and management  (2015)

Clinical Guideline: Bronchiolitis in children: diagnosis and management

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NICE guideline (NG9)

NICE guideline (NG9)

Objective: to help healthcare professionals diagnose bronchiolitis and identify if children should be cared for at home or in hospital. It describes treatments and interventions that can be used to help with the symptoms of bronchiolitis.

Clinical Guideline: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis  (2014)

Clinical Guideline: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis

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Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, ...

Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, J...

This guideline is a revision of the clinical practice guideline, Diagnosis and Management of Bronchiolitis, published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation.

Clinical Guideline: Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age  (2014)

Clinical Guideline: Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age

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Canadian Paediatric Society

Canadian Paediatric Society

The goals of this statement are to build on the comprehensive peer-reviewed AAP statement by incorporating new evidence published over the past eight years, while providing the clinician with recommendations to help guide diagnosis, monitoring and management of previously healthy children one to 24 months of age who present with signs of bronchiolitis.

Bronchiolitis  Overviews of systematic reviews

Overview of Systematic Reviews: Evidence Summary: Bronchiolitis  (2014)

Overview of Systematic Reviews: Evidence Summary: Bronchiolitis

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Alberta Research Centre for Health Evidence (ARCHE)

Alberta Research Centre for Health Evidence (ARCHE)

Evidence summary for the treatment and management of bronchiolitis.

Cochrane Summary: Antibiotics for bronchiolitis in children under two years of age  (2014)

Cochrane Summary: Antibiotics for bronchiolitis in children under two years of age

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Farley R, Spurling GK, Eriksson L, Del Mar CB

Farley R, Spurling GK, Eriksson L, Del Mar CB

This review summarizes evidence on the effect of antibiotics on clinical outcomes in children with bronchiolitis.

Cochrane Summary: Bronchodilators for bronchiolitis for infants with first-time wheezing  (2014)

Cochrane Summary: Bronchodilators for bronchiolitis for infants with first-time wheezing

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

This review summarizes the evidence about the effect of bronchodilators in infants with bronchiolitis.

Overview of Systematic Reviews: The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: An overview of reviews  (2014)

Overview of Systematic Reviews: The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: An overview of reviews

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Fernandes RM, Oleszczuk M, Woods CR, Rowe BH, Cates CJ, Hartling L.

Fernandes RM, Oleszczuk M, Woods CR, Rowe BH, Cates CJ, Hartling L.

Objective: To examine clinically relevant short-term safety outcomes related to acute single or recurrent systemic short-term (<2 weeks) corticosteroid use based on systematic reviews of acute respiratory conditions.

Cochrane Summary: Hypertonic saline solution administered via nebuliser for acute bronchiolitis in infants  (2013)

Cochrane Summary: Hypertonic saline solution administered via nebuliser for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

Objective: to assess the effects of nebulised hypertonic ( 3%) saline solution in infants with acute viral bronchiolitis.

Cochrane Summary: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age  (2013)

Cochrane Summary: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

Objective: to review the efficacy and safety of systemic and inhaled glucocorticoids in children with acute viral bronchiolitis.

Overview of Systematic Reviews: The Cochrane Library and the treatment of bronchiolitis in children: An overview of reviews  (2011)

Overview of Systematic Reviews: The Cochrane Library and the treatment of bronchiolitis in children: An overview of reviews

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Bialy L, Foisy M, Smith M, Fernandes RM

Bialy L, Foisy M, Smith M, Fernandes RM

This updated overview of reviews aims to synthesize evidence from the Cochrane Database of Systematic Reviews (CDSR) on the effectiveness and safety of 11 pharmacologic and non-pharmacologic treatments to improve bronchiolitis symptoms in outpatient, inpatient and intensive care populations.

Cochrane Summary: Epinephrine for acute viral bronchiolitis in children less than two years of age  (2011)

Cochrane Summary: Epinephrine for acute viral bronchiolitis in children less than two years of age

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Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen TP, Patel H, Fernandes RM

Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen...

Objective: to examine the efficacy and safety of epinephrine in children less than two with acute viral bronchiolitis.

Bronchiolitis  Systematic reviews

Meta-analysis: Efficacy of salbutamol in the treatment of infants with bronchiolitis: a meta-analysis of 13 studies  (2020)

Meta-analysis: Efficacy of salbutamol in the treatment of infants with bronchiolitis: a meta-analysis of 13 studies

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Cai Z, Lin Y, Liang J

Cai Z, Lin Y, Liang J

Objective: To systematically evaluate the clinical efficacy of salbutamol treatment in infants with bronchiolitis.

Systematic review: High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis  (2019)

Systematic review: High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis

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Lin, J. Z., Y.; Xiong, L.; Liu, S.; Gong, C.; Dai, J.

Lin, J. Z., Y.; Xiong, L.; Liu, S.; Gong, C.; Dai, J.

Objective: To determine whether treatment with CNHD is more effective than other non-invasive forms of treatment in pediatric patients who require respiratory support.

Cochrane Systematic Review: Continuous positive airway pressure (CPAP) for acute bronchiolitis in children  (2019)

Cochrane Systematic Review: Continuous positive airway pressure (CPAP) for acute bronchiolitis in children

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KR Jat, JL Mathew

KR Jat, JL Mathew

Objective: To assess the efficacy and safety of CPAP compared to no or sham CPAP in infants and children under three years of age with acute bronchiolitis.

Meta-analysis: Association of diagnostic criteria with urinary tract infection prevalence in bronchiolitis: a systematic review and meta-analysis  (2019)

Meta-analysis: Association of diagnostic criteria with urinary tract infection prevalence in bronchiolitis: a systematic review and meta-analysis

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McDaniel C, Ralston S, Lucas B, Schroeder AR

McDaniel C, Ralston S, Lucas B, Schroeder AR

Objective: To conduct a systematic review and meta-analysis examining the prevalence of UTI in infants with bronchiolitis when positive UA results are incorporated into the UTI definition.

Meta-analysis: Hypertonic saline in bronchiolitis and type 1 error: a trial sequential analysis  (2018)

Meta-analysis: Hypertonic saline in bronchiolitis and type 1 error: a trial sequential analysis

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Harrison W, Angoulvant F, House S, Gajdos V, Ralston SL

Harrison W, Angoulvant F, House S, Gajdos V, Ralston SL

Objective: to use TSA to determine if the existing literature base is sufficient to draw firm conclusions about the effectiveness of HS in bronchiolitis.

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants  (2017)

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C,Klassen TP

Zhang L, Mendoza-Sassi RA, Wainwright C,Klassen TP

Objective: to assess the effects of nebulizing hypertonic saline ( 3%) in infants with acute bronchiolitis.

Systematic Review: Nebulized hypertonic saline for acute bronchiolitis: A systematic review  (2015)

Systematic Review: Nebulized hypertonic saline for acute bronchiolitis: A systematic review

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Zhang L, Mendoza-Sassi RA, Klassen TP, Wainwright C.

Zhang L, Mendoza-Sassi RA, Klassen TP, Wainwright C.

Objective: The objective of this study was to assess the efficacy and safety of nebulized hypertonic saline (HS) in infants with acute bronchiolitis.

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants  (2015)

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants

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Liet JM, Ducruet T, Gupta V, Cambonie G

Liet JM, Ducruet T, Gupta V, Cambonie G

Objective: To assess heliox inhalation therapy in addition to standard medical care for acute bronchiolitis in infants with respiratory distress, as measured by clinical endpoints (in particular the rate of endotracheal intubation, the rate of emergency department discharge, the length of treatment for respiratory distress) and pulmonary function testing (mainly clinical respiratory scores).

Systematic Review: Antibiotics for bronchiolitis in children under two years of age  (2014)

Systematic Review: Antibiotics for bronchiolitis in children under two years of age

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Farley R, Spurling GK, Eriksson L, Del Mar CB

Farley R, Spurling GK, Eriksson L, Del Mar CB

Objective: to evaluate the effectiveness of antibiotics for bronchiolitis in children under two years of age compared to placebo or other interventions.

Systematic Review: Bronchodilators for bronchiolitis  (2014)

Systematic Review: Bronchodilators for bronchiolitis

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

Objective: to assess the effects of bronchodilators on clinical outcomes in infants (0 to 12 months) with acute bronchiolitis.

Cochrane Systematic Review: Bronchodilators for bronchiolitis  (2014)

Cochrane Systematic Review: Bronchodilators for bronchiolitis

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

Objective: To assess the effects of bronchodilators on clinical outcomes in infants (0 to 12 months) with acute bronchiolitis.

Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children  (2013)

Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

Objective: to review the efficacy and safety of systemic and inhaled glucocorticoids in children with acute viral bronchiolitis.

Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants  (2013)

Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

Objective: to assess the effects of nebulised hypertonic ( 3%) saline solution in infants with acute viral bronchiolitis.

Cochrane Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age  (2013)

Cochrane Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

Objective: To review the efficacy and safety of systemic and inhaled glucocorticoids in children with acute viral bronchiolitis.

Systematic Review: Epinephrine for bronchiolitis  (2011)

Systematic Review: Epinephrine for bronchiolitis

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Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen TP, Patel H, Fernandes RM

Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen...

Objective: to examine the efficacy and safety of epinephrine in children less than two with acute viral bronchiolitis.

Systematic Review: Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis  (2011)

Systematic Review: Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis

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Hartling L, Fernandes RM, Bialy L, Milne A, Johnson D, Plint A, Klassen TP, Vandermeer B

Hartling L, Fernandes RM, Bialy L, Milne A, Johnson D, Plint A, Klassen TP, V...

Objectives: to evaluate and compare the efficacy and safety of bronchodilators and steroids, alone or combined, for the acute management of bronchiolitis in children aged less than 2 years.

Bronchiolitis  Key studies

Key Study: Association of Fluid Overload with Clinical Outcomes in Critically Ill Children with Bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediatricos (BRUCIP) Study*  (2019)

Key Study: Association of Fluid Overload with Clinical Outcomes in Critically Ill Children with Bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediatricos (BRUCIP) Study*

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Flores-Gonzalez, J. C. V., C. M.; Yun Castilla, C.; Mayordomo-Colunga, J.; Quesada, S. P.; Martin Delgado, C. M.; Goni-Orayen, C.; Fernandez Carrion, F.; Vei...

Flores-Gonzalez, J. C. V., C. M.; Yun Castilla, C.; Mayordomo-Colunga, J.; Qu...

Objective: To our knowledge, few studies have examined the impact of fluid balance on clinical outcome in severe bronchiolitis. Our aim was to determine whether fluid overload was associated with adverse clinical outcomes in critically ill children with severe bronchiolitis.

Key Study: [Does heliox administered by low-flow nasal cannula improve respiratory distress in infants with respiratory syncytial virus acute bronchiolitis? A randomized controlled trial]  (2019)

Key Study: [Does heliox administered by low-flow nasal cannula improve respiratory distress in infants with respiratory syncytial virus acute bronchiolitis? A randomized controlled trial]

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Seliem, W and Sultan, AM

Seliem, W and Sultan, AM

Objective: To evaluate whether the use of heliox (79:21) delivered through a low flow nasal cannula would improve respiratory distress in infants with acute bronchiolitis caused by respiratory syncytial virus.

Key Study: Chest radiography in children hospitalized with bronchiolitis  (2019)

Key Study: Chest radiography in children hospitalized with bronchiolitis

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Wrotek A, Czajkowska M, Jackowska T

Wrotek A, Czajkowska M, Jackowska T

Objective: to evaluate the use of CR in children with bronchiolitis due to a lower respiratory tract infection (RSV-RTI) with respiratory syncytial virus (RSV) and the influence of CR on patient treatment during the 2010-2017 seasons.

Key Study: A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis  (2018)

Key Study: A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis

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Franklin, D. B., F. E.; Schlapbach, L. J.; Oakley, E.; Craig, S.; Neutze, J.; Furyk, J.; Fraser, J. F.; Jones, M.; Whitty, J. A.; Dalziel, S. R.; Schibler, A.

Franklin, D. B., F. E.; Schlapbach, L. J.; Oakley, E.; Craig, S.; Neutze, J.;...

Objective: To assess efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs).

Key Study: Heliox delivered by high flow nasal cannula improves oxygenation in infants with respiratory syncytial virus acute bronchiolitis  (2018)

Key Study: Heliox delivered by high flow nasal cannula improves oxygenation in infants with respiratory syncytial virus acute bronchiolitis

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Seliem, W. S., A. M.

Seliem, W. S., A. M.

Objective: to evaluate the hypothesis that use of heliox would result in improvement of gas exchange when used with high flow nasal cannula in infants with RSV acute bronchiolitis.

Key Study: Predicting escalated care in infants with bronchiolitis  (2018)

Key Study: Predicting escalated care in infants with bronchiolitis

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Freire

Freire

Objective: to identify predictors of "escalated care" in bronchiolitis.

Key Study: Predictors of critical care and mortality in bronchiolitis after emergency department discharge  (2018)

Key Study: Predictors of critical care and mortality in bronchiolitis after emergency department discharge

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Schuh S, Kwong J, Holder L, Graves E, Macdonald E, Finkelstein Y

Schuh S, Kwong J, Holder L, Graves E, Macdonald E, Finkelstein Y

Objectives:To identify the epidemiologic predictors and stratify the risk of critical care unit (CCU) admission or death in bronchiolitis following emergency department discharge. This information has not yet been explored.

Key Study: Lung ultrasound for the diagnosis of pneumonia in children with acute bronchiolitis  (2018)

Key Study: Lung ultrasound for the diagnosis of pneumonia in children with acute bronchiolitis

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Biagi C, Pierantoni L, Baldazzi M, Greco L, Dormi A, Dondi A, Faldella G, Lanari M

Biagi C, Pierantoni L, Baldazzi M, Greco L, Dormi A, Dondi A, Faldella G, Lan...

Objective: to assess the diagnostic accuracy and reliability of LUS for the detection of pneumonia in hospitalized children with bronchiolitis and to evaluate the agreement between LUS and CXR in diagnosing pneumonia in these patients.

Key Study: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial  (2017)

Key Study: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial

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Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddard B, Hilton J, Lee M, Mattes J

Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddar...

Objectives: Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has not been rigorously studied in randomised trials. This study aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen

Key Study: Effect of nebulized hypertonic saline treatment in emergenc departments on hospitalization rate for acute bronchiolitis: a randomized clinical trial  (2017)

Key Study: Effect of nebulized hypertonic saline treatment in emergenc departments on hospitalization rate for acute bronchiolitis: a randomized clinical trial

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Angoulvant F, Belletre X, Milcent K, et al

Angoulvant F, Belletre X, Milcent K, et al

Objective: To examine whether HS nebulization treatment would decrease the hospital admission rate among infants with a first episode of acute bronchiolitis.

Key Study: High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)  (2017)

Key Study: High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)

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Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, Baleine J,Durand S, Combes C, Douillard A, Cambonie G, Groupe Francophone de Ranimation et dU...

Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, Baleine J,Dur...

Objective: To assess oxygen delivery via high flow nasal cannula (HFNC).

Key Study: Effect of oxygen desaturations on subsequent medical visits in infants discharged from the emergency department with bronchiolitis  (2016)

Key Study: Effect of oxygen desaturations on subsequent medical visits in infants discharged from the emergency department with bronchiolitis

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Principi T, Coates AL, Parkin PC, Stephens D, DaSilva Z, Schuh S

Principi T, Coates AL, Parkin PC, Stephens D, DaSilva Z, Schuh S

Objective: To examine whether there is a difference in the proportion of unscheduled medical visits within 72 hours of emergency department discharge in infants with bronchiolitis who have oxygen desaturations to lower than 90% for at least 1 minute during home oximetry monitoring vs those without desaturations.

Key Study: Nasal irrigation with saline solution significantly improves oxygen saturation in infants with bronchiolitis  (2016)

Key Study: Nasal irrigation with saline solution significantly improves oxygen saturation in infants with bronchiolitis

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Schreiber S, Ronfani L, Ghirardo S, Minen F, Taddio A, Jaber M, Rizzello E, Barbi E

Schreiber S, Ronfani L, Ghirardo S, Minen F, Taddio A, Jaber M, Rizzello E, B...

Objective: To compare nasal irrigation using either isotonic 0.9% sodium chloride or hypertonic 3% sodium chloride with simple supportive care in infants with bronchiolitis.

Key Study: Use of intermittent vs continuous pulse oximetry for nonhypoxemic infants and young children hospitalized for bronchiolitis: a randomized controlled trial  (2015)

Key Study: Use of intermittent vs continuous pulse oximetry for nonhypoxemic infants and young children hospitalized for bronchiolitis: a randomized controlled trial

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McCulloh R, Koster M, Ralston S, Johnson M, Hill V, Koehn K, Weddle G, Alverson B

McCulloh R, Koster M, Ralston S, Johnson M, Hill V, Koehn K, Weddle G, Alvers...

Objective: To determine the effect of intermittent vs continuous pulse oximetry monitoring on hospital length of stay among nonhypoxemic infants and young children hospitalized for bronchiolitis.

Key Study: Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial  (2015)

Key Study: Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial

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Flores-Gonzlez JC, Matamala-Morillo MA, Rodrguez-Campoy P, Prez-Guerrero JJ, Serrano-Moyano B, Comino-Vazquez P, Palma-Zambrano E, Bulo-Concelln R, Santos-Sn...

Flores-Gonzlez JC, Matamala-Morillo MA, Rodrguez-Campoy P, Prez-Guerrero JJ, ...

Objective: To evaluate the efficacy of nebulized epinephrine in 3% hypertonic saline.

Key Study: Bronchiolitis of Infancy Discharge Study (BIDS): a multicentre, parallel-group, double-blind, randomised controlled, equivalence trial with economic evaluation  (2015)

Key Study: Bronchiolitis of Infancy Discharge Study (BIDS): a multicentre, parallel-group, double-blind, randomised controlled, equivalence trial with economic evaluation

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Cunningham S, Rodriguez A, Boyd KA, McIntosh E, Lewis SC, BIDS Collaborators Group

Cunningham S, Rodriguez A, Boyd KA, McIntosh E, Lewis SC, BIDS Collaborators ...

Objective: To compare the American Academy of Pediatrics guideline target of SpO2 90% with the Scottish Intercollegiate Guidelines Network target of SpO2 94%.

Key Study: Nebulised hypertonic saline (3%) among children with mild to moderately severe bronchiolitis--a double blind randomized controlled trial  (2015)

Key Study: Nebulised hypertonic saline (3%) among children with mild to moderately severe bronchiolitis--a double blind randomized controlled trial

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Khanal A, Sharma A, Basnet S, Sharma PR, Gami FC

Khanal A, Sharma A, Basnet S, Sharma PR, Gami FC

Objective: To Assess the efficacy of nebulised hypertonic saline (HS) (3%) among children with mild to moderately severe bronchiolitis.

Key Study: Effect of oximetry on hospitalization in bronchiolitis: a randomized clinical trial  (2014)

Key Study: Effect of oximetry on hospitalization in bronchiolitis: a randomized clinical trial

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Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, DaSilva Z, Willan A

Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, DaSilv...

Objective: To examine if infants with bronchiolitis whose displayed oximetry measurements have been artificially elevated 3 percentage points above true values experience hospitalization rates at least 15% lower compared with infants with true values displayed.

Key Study: Nasogastric hydration vs intravenous hydration for infants with bronchiolitis: a randomised trial  (2013)

Key Study: Nasogastric hydration vs intravenous hydration for infants with bronchiolitis: a randomised trial

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Oakley Ed, Borland M, () Babl F

Oakley Ed, Borland M, () Babl F

Objective: to assess whether intravenous hydration or nasogastric hydration is better for treatment of infants.

Key Study: Epinephrine and dexamethasone in children with bronchiolitis  (2009)

Key Study: Epinephrine and dexamethasone in children with bronchiolitis

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Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S, Bhatt M, Joubert G, Black KJ, Turner T, Whitehouse S, Klassen TP; Pediatric Em...

Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S...

This randomized, double-blind, placebo-controlled, clinical trial with a factorial design at multiple sites was undertaken to determine whether treatment with nebulized epinephrine, a short course of oral dexamethasone, or both resulted in a clinically important decrease in hospital admissions among infants with bronchiolitis who were seen in the emergency department.

Key Study: A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis  (2009)

Key Study: A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis

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Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Ungar WJ

Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Unga...

Objective:To carry out a cost-effectiveness analysis of omitting chest radiography in the diagnosis of infant bronchiolitis.

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis  (2007)

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis

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Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Malik B, Nelson KA, Bregstein JS, Brown KM, Denenberg MN, Lillis KA, Cimpello LB, T...

Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Mal...

The goal of this study was to determine the effectiveness of a single dose of oral dexamethasone in infants with moderate-to-severe bronchiolitis.

Key Study: Evaluation of the utility of radiography in acute bronchiolitis  (2007)

Key Study: Evaluation of the utility of radiography in acute bronchiolitis

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Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokanski M, Khaikin S, Dick P

Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokansk...

Objectives: to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given antibiotics after radiography.

Key Study: Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections  (2004)

Key Study: Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections

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Levine DA, Platt SL, Dayan PS, Macias CG, Zorc JJ, Krief W, Schor J, Bank D, Fefferman N, Shaw KN, Kuppermann N

Levine DA, Platt SL, Dayan PS, Macias CG, Zorc JJ, Krief W, Schor J, Bank D, ...

Objective: to determine the risk of SBI in young febrile infants who are infected with RSV compared with those without RSV infections.

Burns
Burns  Key Resources

Bottom Line Recommendations: Pediatric Thermal Burns  (2021)

Bottom Line Recommendations: Pediatric Thermal Burns

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Crombie T & Malic C and TREKK Network

Crombie T & Malic C and TREKK Network

Bottom line recommendations for the treatment and management of pediatric thermal burns - version 1.0. Published online: February 2021.

Recommandations de Base: Brûlures thermiques  (2021)

Recommandations de Base: Brûlures thermiques

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Crombie T & Malic C and TREKK Network

Crombie T & Malic C and TREKK Network

Bottom line recommendations for the treatment and management of pediatric thermal burns - en français. version 1.0. Published online: February 2021.

Burns Centre Consultation Guidelines  (2019)

Burns Centre Consultation Guidelines

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CritiCall Ontario

CritiCall Ontario

Guidelines for burns centre consultations.

Paediatric Burn Assessment  (2018)

Paediatric Burn Assessment

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Victorial Adult Burns Service at the Alfred

Victorial Adult Burns Service at the Alfred

Burns management guidelines for pediatric burn assessment.

Paediatric Burn Guidelines  (2018)

Paediatric Burn Guidelines

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Women's and Children's Hospital

Women's and Children's Hospital

Pediatric burn guidelines reference chart.

Pediatric Burn Referrals  (2017)

Pediatric Burn Referrals

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UBC Division of Plastic Surgery

UBC Division of Plastic Surgery

UBC Division of Plastic Surgery: Pediatric burn referrals.

Burns  Clinical guidelines

Burns / management of burn wounds  (2018)

Burns / management of burn wounds

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The Royal Children's Hospital Melbourne

The Royal Children's Hospital Melbourne

Guideline for the management of burn wounds.

ISBI Practice Guidelines for Burn Care  (2016)

ISBI Practice Guidelines for Burn Care

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ISBI Practice Guidelines Committee; Steering Subcommittee; Advisory Subcommittee

ISBI Practice Guidelines Committee; Steering Subcommittee; Advisory Subcommittee

ISBI 2014-2016 Practice guidelines for burn care.

Burns  Summaries of systematic reviews

Cochrane Summary: Antiseptics for Burns  (2017)

Cochrane Summary: Antiseptics for Burns

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Norman G, Christie J, Liu Z, Westby MJ, Jefferies JM, Hudson T, Edwards J, Mohapatra DP, Hassan IA, Dumville JC

Norman G, Christie J, Liu Z, Westby MJ, Jefferies JM, Hudson T, Edwards J, Mo...

Objective: To assess the effects and safety of antiseptics for the treatment of burns in any care setting.

Cochrane Summary: Antibiotics to prevent burn wounds becoming infected  (2013)

Cochrane Summary: Antibiotics to prevent burn wounds becoming infected

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Barajas-Nava LA, Lpez-Alcalde J, Roqu i Figuls M, Sol I, Bonfill Cosp X

Barajas-Nava LA, Lpez-Alcalde J, Roqu i Figuls M, Sol I, Bonfill Cosp X

Objective: To assess the effects of antibiotic prophylaxis on rates of burn wound infection.

Cochrane Summary: Dressings for treating superficial and partial-thickness burns  (2013)

Cochrane Summary: Dressings for treating superficial and partial-thickness burns

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Wasiak J, Cleland H, Campbell F, Spinks A

Wasiak J, Cleland H, Campbell F, Spinks A

Objective: To assess the effects of burn wound dressings on superficial and partial thickness burns.

Burns  Systematic reviews

Systematic Review: Comparative study of Silver Sulfadiazine with other materials for healing and infection prevention in burns: A systematic review and meta-analysis  (2018)

Systematic Review: Comparative study of Silver Sulfadiazine with other materials for healing and infection prevention in burns: A systematic review and meta-analysis

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Nmia HH, Carvalho VF, Isaac C, Souza F, Gemperli R, Paggiaro AO

Nmia HH, Carvalho VF, Isaac C, Souza F, Gemperli R, Paggiaro AO

Objective: The aim of this systematic review with meta-analysis was to compare the effect of Silver Sulfadiazine (SSD) with other new dressings, with or without silver, on healing and infection prevention in burns.

Review: Burn Care for Children  (2018)

Review: Burn Care for Children

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Sheridan RL

Sheridan RL

Objective: To provide an understanding of the practice of outpatient small burn care, and to present the concepts of inpatient burn care and long-term burn aftercare.

Review: Emergency management of burns: part 1  (2018)

Review: Emergency management of burns: part 1

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Stiles K

Stiles K

Objective: The aim of this article is to give an overview of burns trauma, and to describe the initial assessment and management of patients with these injuries in emergency departments (EDs). Part 1 of 2.

Review: Emergency management of burns: part 2  (2018)

Review: Emergency management of burns: part 2

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Stiles K

Stiles K

Objective: The aim of the two articles is to enhance emergency clinicians knowledge and confidence in burn management, and to build awareness of the life-changing implications of the initial clinical interventions in burn care. Part 2 of 2.

Review: Emergency Care of Pediatric Burns  (2018)

Review: Emergency Care of Pediatric Burns

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Strobel AM, Fey R

Strobel AM, Fey R

Objective: To review emergency care, management and prevention of pediatric burns.

Systematic Review: A systematic review and meta-analysis of clinical outcomes associated with nanocrystalline silver use compared to alternative silver delivery systems in the management of superficial and deep partial thickness burns  (2017)

Systematic Review: A systematic review and meta-analysis of clinical outcomes associated with nanocrystalline silver use compared to alternative silver delivery systems in the management of superficial and deep partial thickness burns

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Nherera LM, Trueman P, Roberts CD, Berg L

Nherera LM, Trueman P, Roberts CD, Berg L

Objective: The purpose of this systematic review and meta-analysis was to assess the clinical effectiveness of nanocrystalline silver compared to alternative silver delivery systems (silver sulphadiazine [SSD] and silver nitrate) in adults and children with superficial and deep partial thickness burns.

Review: Pediatric burn resuscitation: past, present, and future  (2017)

Review: Pediatric burn resuscitation: past, present, and future

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Romanowski KS, Palmieri TL

Romanowski KS, Palmieri TL

Objective: To discuss the history of fluid resuscitation, current resuscitation practices, and future directions of resuscitation for the pediatric burn population.

Review: Pediatric Burn Resuscitation  (2016)

Review: Pediatric Burn Resuscitation

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Palmieri TL

Palmieri TL

Objective: The purpose of this article is to provide a foundation for initial assessment and management in burned children.

Review: Optimizing emergency management to reduce morbidity and mortality in pediatric burn patients  (2015)

Review: Optimizing emergency management to reduce morbidity and mortality in pediatric burn patients

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Haines E, Fairbrother H

Haines E, Fairbrother H

Objective: This article reviews methods for accurate classification and management of the full range of burns seen in pediatric patients.

Cochrane Systematic Review: Antibiotic prophylaxis for preventing burn wound infection  (2013)

Cochrane Systematic Review: Antibiotic prophylaxis for preventing burn wound infection

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Barajas-Nava LA, Lpez-Alcalde J, Roqu i Figuls M, Sol I, Bonfill Cosp X

Barajas-Nava LA, Lpez-Alcalde J, Roqu i Figuls M, Sol I, Bonfill Cosp X

Objective: To assess the effects of antibiotic prophylaxis on rates of burn wound infection.

Review: Use of Acticoat dressings in burns: what is the evidence?  (2010)

Review: Use of Acticoat dressings in burns: what is the evidence?

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Khundkar R, Malic C, Burge T

Khundkar R, Malic C, Burge T

Objective: To determine the level of evidence available in the literature in view of recent increased usage of Acticoat dressings in burns.

Review: Critical care of the burn patient: the first 48 hours  (2009)

Review: Critical care of the burn patient: the first 48 hours

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Latenser BA

Latenser BA

Objective: The goal of this concise review is to provide an overview of some of the most important resuscitation and monitoring issues and approaches that are unique to burn patients compared with the general intensive care unit population.

Burns  Key studies

Key study: Delayed Healing Associated with Silver Sulfadiazine Use for Partial Thickness Scald Burns in Children  (2018)

Key study: Delayed Healing Associated with Silver Sulfadiazine Use for Partial Thickness Scald Burns in Children

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Raymond SL, Zecevic A, Larson SD, Ruzic A, Islam S

Raymond SL, Zecevic A, Larson SD, Ruzic A, Islam S

Objective: The purpose of this study was to compare outcomes of three different dressings for pediatric partial-thickness scald burns.

Key study: Effectiveness of aspiration or deroofing for blister management in patients with burns: A prospective randomized controlled trial  (2018)

Key study: Effectiveness of aspiration or deroofing for blister management in patients with burns: A prospective randomized controlled trial

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Ro HS, Shin JY, Sabbagh MD, Roh SG, Chang SC, Lee NH

Ro HS, Shin JY, Sabbagh MD, Roh SG, Chang SC, Lee NH

Objective: To determine which treatment is the best option when encountering blisters while treating burn patients.

Key study: A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department  (2016)

Key study: A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department

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Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M

Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M

Objective: This study sought to determine whether silver sodium carboxymethyl cellulose dressing is a superior treatment to nanocrystalline silver-coated polyethylene dressing in pediatric patients with partial thickness burns.

Key study: Randomized controlled trial of three burns dressings for partial thickness burns in children  (2015)

Key study: Randomized controlled trial of three burns dressings for partial thickness burns in children

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Gee Kee EL, Kimble RM, Cuttle L, Khan A, Stockton KA

Gee Kee EL, Kimble RM, Cuttle L, Khan A, Stockton KA

Objective: This study compared the effects of three silver dressing combinations on small to medium size acute partial thickness burns in children, focusing on re-epithelialization time, pain and distress during dressing changes.

Key study: Discrepancy in Initial Pediatric Burn Estimates and Its Impact on Fluid Resuscitation  (2015)

Key study: Discrepancy in Initial Pediatric Burn Estimates and Its Impact on Fluid Resuscitation

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Goverman J, Bittner EA, Friedstat JS, Moore M, Nozari A, Ibrahim AE, Sarhane KA, Chang PH, Sheridan RL, Fagan SP

Goverman J, Bittner EA, Friedstat JS, Moore M, Nozari A, Ibrahim AE, Sarhane ...

Objective: To evaluate the differences between initial TBSA estimates and its impact on fluid resuscitation at an American Burn Associationverified pediatric burn center.

COVID19
COVID19  Key Resources

Fact Sheet: Pediatric COVID-19  (2021)

Fact Sheet: Pediatric COVID-19

Download

TREKK Network

TREKK Network

Fact sheet for the treatment and management of pediatric COVID-19 (novel coronavirus)

COVID-19 information and resources for paediatricians  (2021)

COVID-19 information and resources for paediatricians

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COVID-19 and Canadas Kids  (2021)

COVID-19 and Canadas Kids

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Canadian Association of Emergency Physicians - COVID-19 Information, Resources and Advocacy Centre  (2021)

Canadian Association of Emergency Physicians - COVID-19 Information, Resources and Advocacy Centre

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Emergency Medicine Cases: Practical COVID-19 resources for front line healthcare professionals  (2021)

Emergency Medicine Cases: Practical COVID-19 resources for front line healthcare professionals

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Fiche Dinformation: COVID-19 pdiatrique (nouveau coronavirus)  (2021)

Fiche Dinformation: COVID-19 pdiatrique (nouveau coronavirus)

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TREKK Network

TREKK Network

Fact sheet for the treatment and management of pediatric COVID-19 (novel coronavirus) - French

World Health Organization: Parenting in the time of COVID-19  (2020)

World Health Organization: Parenting in the time of COVID-19

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World Health Organization

World Health Organization

To help parents interact constructively with their children during this time of confinement, the World Health Organization created these six one-page tips for parents cover planning one-on-one time, staying positive, creating a daily routine, avoiding bad behaviour, managing stress, and talking about COVID-19. 

 

 

Clinical management of patients with moderate to severe COVID-19 - Interim guidance  (2020)

Clinical management of patients with moderate to severe COVID-19 - Interim guidance

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Government of Canada

Government of Canada

eMagazine No Mercy for the Coronas  (2020)

eMagazine No Mercy for the Coronas

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Looking for resources to understand the scientific realities of the COVID-19 virus and pandemic? Check out this children's science magazine, No Mercy for the Coronas, an engaging and accessible illustrated resource for kids (and parents!) to better understand viruses like COVID-19.
 
This e-magazine was created by La Liberté and POP Comm, and developed with the participation of scientists and researchers at Children’s Hospital Research Institute of Manitoba (CHRIM), University of Manitoba and St. Boniface Hospital Albrechtsen Research Centre’s Youth BIOlab Jeunesse.

No Mercy for the Coronas! is for all those who wish to offer children a scientifically reliable resource during this global health crisis affecting all ages and all aspects of society. You can read or download this free magazine in English or French.

Video: COVID-19 (updated)

Video: COVID-19 (updated)

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In this video Dr. Anthony Crocco (Sketchy EBM) outlines the symptoms of COVID-19, how to protect yourself and your family, what to do to be well and when to worry. This video is not a substitute for medical care. Please consult Public Health or your health professional for medical advice.

 

COVID19  Clinical guidelines

Guideline: COVID in children with diabetes  (2022)

Guideline: COVID in children with diabetes

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International Society for Pediatric and Adolescent Diabetes (ISPAD)

International Society for Pediatric and Adolescent Diabetes (ISPAD)

The International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2018 for management of diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state provide comprehensive guidance for management of DKA in young people. Intravenous infusion of insulin for treating DKA may necessitate intensive care unit admission in hospitals in some parts of the world. During the Coronavirus Disease 2019 (COVID-19) pandemic, ICU services may need to be prioritised for care of affected individuals

Consensus statement: Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts consensus statement.  (2020)

Consensus statement: Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts consensus statement.

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Shen K, Yang Y, Wang T, et al.

Shen K, Yang Y, Wang T, et al.

This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children.

Info page: What Does the Coronavirus Disease 2019 (COVID-19) Mean for Families?  (2020)

Info page: What Does the Coronavirus Disease 2019 (COVID-19) Mean for Families?

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Thompson LA, Rasmussen SA

Thompson LA, Rasmussen SA

Objective: To prepare families for COVID-19 in the US.

Info page: Coronavirus Disease 2019 (COVID-2019) Information for Pediatric Healthcare Providers.  (2020)

Info page: Coronavirus Disease 2019 (COVID-2019) Information for Pediatric Healthcare Providers.

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US Centers for Disease Control and Prevention.

US Centers for Disease Control and Prevention.

To inform pediatric healthcare providers of information available on children with COVID-19.

COVID19  Systematic reviews

Systematic review: Cardiovascular impact of COVID-19 with a focus on children: a systematic review.  (2020)

Systematic review: Cardiovascular impact of COVID-19 with a focus on children: a systematic review.

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Rodriguez-Gonzalez M, Castellano-Martinez A, Cascales-Poyatos HM, Perez-Reviriego AA.

Rodriguez-Gonzalez M, Castellano-Martinez A, Cascales-Poyatos HM, Perez-Revir...

Aim: To summarize the current knowledge about the potential cardiovascular involvement in pediatric COVID-19 in order to give a perspective on how to take care of them during the current pandemic emergency.

Systematic review: Characteristics of pediatric multi-system inflammatory syndrome (PMIS) associated with COVID-19: a meta-analysis and insights into pathogenesis.  (2020)

Systematic review: Characteristics of pediatric multi-system inflammatory syndrome (PMIS) associated with COVID-19: a meta-analysis and insights into pathogenesis.

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Zou H, Lu J, Liu J, et al.

Zou H, Lu J, Liu J, et al.

Objectives: There was an outbreak of pediatric multisystem inflammation syndrome (PMIS) was observed in multiple countries recently, and this syndrome was suspected to be associated with SARS-CoV-2 infection. At present, there is still no standardized diagnostic criteria and treatment regimen for PMIS, while the etiology and pathogenesis still remain unclear.

Systematic review: Clinical characteristics of COVID-19 in children: a systematic review.  (2020)

Systematic review: Clinical characteristics of COVID-19 in children: a systematic review.

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Yasuhara J, Kuno T, Takagi H, Sumitomo N.

Yasuhara J, Kuno T, Takagi H, Sumitomo N.

Objective: Our aim was to investigate the clinical characteristics of COVID-19 in children.

Systematic review: Clinical manifestations of children with COVID-19: a systematic review.  (2020)

Systematic review: Clinical manifestations of children with COVID-19: a systematic review.

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de Souza TH, Nadal JA, Nogueira RJN, Pereira RM, Brando MB

de Souza TH, Nadal JA, Nogueira RJN, Pereira RM, Brando MB

Objective: The aim of this study was to describe the clinical, laboratorial, and radiological characteristics of children with COVID-19.

Systematic review: COVID-19 in 7780 pediatric patients: a systematic review.  (2020)

Systematic review: COVID-19 in 7780 pediatric patients: a systematic review.

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Hoang A, Chorath K, Moreira A, et al.

Hoang A, Chorath K, Moreira A, et al.

Objective: This review characterizes clinical symptoms, laboratory, and imaging findings, as well as therapies provided to confirmed pediatric cases of COVID-19.

Systematic review: Epidemiological and clinical characteristics of COVID-19 in children: a systematic review and meta-analysis.  (2020)

Systematic review: Epidemiological and clinical characteristics of COVID-19 in children: a systematic review and meta-analysis.

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Li B, Zhang S, Zhang R, Chen X, Wang Y, Zhu C.

Li B, Zhang S, Zhang R, Chen X, Wang Y, Zhu C.

Objective: This systematic review with meta-analysis aimed to evaluate the epidemiological spectrum and clinical characteristics of children infected with SARS-CoV-2.

Systematic review: Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view.  (2020)

Systematic review: Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view.

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Junior H, Sakano TMS, Rodrigues RM, et al.

Junior H, Sakano TMS, Rodrigues RM, et al.

Objective: Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease (COVID-19) is a rare and challenging diagnosis requiring early treatment. The diagnostic criteria involve clinical, laboratory, and complementary tests. This review aims to draw pediatrician attention to this diagnosis, suggesting early treatment strategies, and proposing a pediatric emergency care flowchart.

Systematic review: Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2: a systematic review.  (2020)

Systematic review: Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2: a systematic review.

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Abrams JY, Godfred-Cato SE, Oster ME, et al.

Abrams JY, Godfred-Cato SE, Oster ME, et al.

Objective: To develop a more comprehensive description of multisystem inflammatory syndrome in children (MIS-C), a novel syndrome linked to severe acute respiratory syndrome coronavirus 2, by conducting a systematic analysis of studies from different settings that used various inclusion criteria.

Systematic review: Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: a systematic review and meta-analysis.  (2020)

Systematic review: Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: a systematic review and meta-analysis.

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Badal S, Bajgain KT, Badal S, Thapa R, Bajgain BB, Santana MJ.

Badal S, Bajgain KT, Badal S, Thapa R, Bajgain BB, Santana MJ.

Introduction: The novel coronavirus pandemic is an ongoing challenge faced by the public and health care systems around the globe. Majority of information and evidence gathered so far regarding COVID-19 has been derived from data and studies in adult populations. Crucial information regarding the characterization, clinical symptomatology, sequelae, and overall outcomes in the pediatric population is lacking. As such, we aimed to conduct a comprehensive meta-analysis and systematic review to collect and analyze current evidence about COVID-19 in the pediatric population.

COVID19  Key studies

Key study: Pointofcare lung ultrasound findings in the pediatric emergency clinic during the COVID19 pandemic.  (2021)

Key study: Pointofcare lung ultrasound findings in the pediatric emergency clinic during the COVID19 pandemic.

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Tre E, Korkmaz MF, Aksoy FD, et al.

Tre E, Korkmaz MF, Aksoy FD, et al.

Objective: To describe our experience concerning lung ultrasound (LUS) in the pediatric emergency clinic, and to investigate the diagnostic value of LUS in coronavirus disease-2019 (COVID-19).

Key study: Asymptomatic cases in a family cluster with SARS-CoV-2 infection  (2020)

Key study: Asymptomatic cases in a family cluster with SARS-CoV-2 infection

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Wu X, Li T, Ou X, et al

Wu X, Li T, Ou X, et al

Objective: To report the findings from different types of clinical specimens collected from 82 infected individuals

Key study: SARS-CoV-2 Infection in Children.  (2020)

Key study: SARS-CoV-2 Infection in Children.

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Lu X, Zhang L, Du H, et al

Lu X, Zhang L, Du H, et al

Objective: In order to determine the spectrum of disease in children, we evaluated children infected with SARS-CoV-2 and treated at the Wuhan Childrens Hospital, the only center assigned by the central government for treating infected children under 16 years of age in Wuhan.

Key study: A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features  (2020)

Key study: A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features

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Jiehao C, Jing X, Daojiong L, et al

Jiehao C, Jing X, Daojiong L, et al

Objective: To report the clinical and epidemiological features in children with coronavirus diseases (COVID) in China.

Key study: Clinical features of paediatric patients with COVID-19: a report of two family clusters.  (2020)

Key study: Clinical features of paediatric patients with COVID-19: a report of two family clusters.

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Ji L, Chao S, Wang Y, et al.

Ji L, Chao S, Wang Y, et al.

Objective: To retrospectively review two confirmed pediatric cases from two family clusters. Both clinical features and laboratory examination results of the children and their family members were described.

Key study: Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China.  (2020)

Key study: Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China.

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Dong Y, Mo X, Hu Y, et al.

Dong Y, Mo X, Hu Y, et al.

Objective: This study examined the epidemiological characteristics and transmission patterns of 2143 pediatric patients with COVID-19, using a retrospective analytical approach.

Key study: Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China  (2020)

Key study: Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China

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Wei M, Yuan J, Liu Y, et al.,

Wei M, Yuan J, Liu Y, et al.,

Objective: For this retrospective study, authors identified all hospitalized infants diagnosed with COVID-19 infection between December 8, 2019, and February 6, 2020, in China and described demographic, epidemiologic, and clinical features.

Key study: Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children  (2020)

Key study: Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children

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Hong H et al.,

Hong H et al.,

Objective: To describe the clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children

Key study: Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020.  (2020)

Key study: Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020.

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Korean Society of Infectious Diseases, Korean Society of Pediatric Infectious Diseases, Korean Society of Epidemiology, et al

Korean Society of Infectious Diseases, Korean Society of Pediatric Infectious...

Objective: This report summarizes the epidemiologic features and the snapshots of the outbreak in the Republic of Korea from January 19 and March 2, 2020.

Key study: Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single centers observational study.  (2020)

Key study: Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single centers observational study.

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Sun D, Li H, Lu X, et al.,

Sun D, Li H, Lu X, et al.,

Objective: To describe the clinical features of severe pediatric patients with COVID-19.

Key study: Clinical presentation and virological assessment of hospitalized cases of coronavirus disease 2019 in a travel-associated transmission cluster.  (2020)

Key study: Clinical presentation and virological assessment of hospitalized cases of coronavirus disease 2019 in a travel-associated transmission cluster.

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Woelfel R, Corman VM, Guggemos W, et al.,

Woelfel R, Corman VM, Guggemos W, et al.,

Objective: To study the viral load courses by RT-PCR in oro- and nasopharyngeal swabs, sputum, stool, blood, and urine in nine hospitalized cases. Infectious virus was detected by cell culture.

Key study: Acral cutaneous lesions in the time of COVID-19.  (2020)

Key study: Acral cutaneous lesions in the time of COVID-19.

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Recalcati S, Barbagallo T, Frasin LA, et al.

Recalcati S, Barbagallo T, Frasin LA, et al.

Objective: We report here on peculiar (perniosislike) skin lesions, unreported in the previous years, observed in young outpatients visited in our dermatologic unit in the last 4 weeks of COVID19 pandemic (MarchApril 2020).

Key study: Children with Covid-19 in pediatric emergency departments in Italy.  (2020)

Key study: Children with Covid-19 in pediatric emergency departments in Italy.

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Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Public Emergency Departments (CONFIDENCE) Research Group

Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Public Emergency Depa...

Objective: The Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) study involved a cohort of 100 Italian children younger than 18 years of age with Covid-19 confirmed by reverse-transcriptasepolymerase-chain-reaction testing of nasal or nasopharyngeal swabs who were assessed between March 3 and March 27 in 17 pediatric emergency departments. Here, we describe the results of the CONFIDENCE study and compare them with those from three cohorts in previously published analyses.

Key study: Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients.  (2020)

Key study: Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients.

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PiccoloV,NeriI, FilippeschiC, et al.

PiccoloV,NeriI, FilippeschiC, et al.

Objective: We have recently noticed an outbreak of chilblainlike lesions in Italy contemporarily to COVID19 epidemic. Due to the wellknown lockdownrelated difficulties to visit the patients, we created a Google form aimed to collect information about patients presenting with these singular clinical findings. An easy to access and quick tool was chosen by the investigators in order to permit the other colleagues to spend the least amount of time, given the severe health emergency.

Key study: The characteristics of household transmission of COVID-19.  (2020)

Key study: The characteristics of household transmission of COVID-19.

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Li W, Zhang B, Lu J, et al.

Li W, Zhang B, Lu J, et al.

Objective: Since December 2019, SARS-CoV-2 has extended to most parts of China with >80 000 cases and to at least 100 countries with >60 000 international cases as of 15 March 2020. Here we used a household cohort study to determine the features of household transmission of COVID-19.

Key study: Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.  (2020)

Key study: Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.

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Casas CG, Catal A, Hernndez GC, et al.

Casas CG, Catal A, Hernndez GC, et al.

Objectives: To describe the cutaneous manifestations of COVID-19 disease and to relate them to other clinical findings.

Key study: Assessment of 135794 pediatric patients tested for severe scute respiratory syndrome coronavirus across the United States.  (2020)

Key study: Assessment of 135794 pediatric patients tested for severe scute respiratory syndrome coronavirus across the United States.

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Bailey LC, Razzaghi H, Burrows EK, et al.

Bailey LC, Razzaghi H, Burrows EK, et al.

Objective: To describe testing for SARS-CoV-2 and the epidemiology of infected patients.

Key study: Baseline characteristics, management, and outcomes of 55,270 children and adolescents diagnosed with COVID-19 and 1,952,693 with influenza in France, Germany, Spain, South Korea and the United States: an international network cohort study.  (2020)

Key study: Baseline characteristics, management, and outcomes of 55,270 children and adolescents diagnosed with COVID-19 and 1,952,693 with influenza in France, Germany, Spain, South Korea and the United States: an international network cohort study.

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Duarte-Salles T, Vizcaya D, Pistillo A, et al.

Duarte-Salles T, Vizcaya D, Pistillo A, et al.

Objectives To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children/adolescents diagnosed or hospitalized with COVID-19. Secondly, to describe health outcomes amongst children/adolescents diagnosed with previous seasonal influenza. Design International network cohort.

Key study: Cardiac abnormalities seen in pediatric patients during the SARS-CoV2 pandemic: an international experience.  (2020)

Key study: Cardiac abnormalities seen in pediatric patients during the SARS-CoV2 pandemic: an international experience.

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Clark BC, Sanchez-de-Toledo J, Bautista-Rodriguez C, et al.

Clark BC, Sanchez-de-Toledo J, Bautista-Rodriguez C, et al.

Objective: To describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi-system inflammatory syndrome (MIS-C) during the SARS-CoV2 pandemic.

Key study: COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.  (2020)

Key study: COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.

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Gtzinger F, Santiago-Garca B, Noguera-Julin A, et al.

Gtzinger F, Santiago-Garca B, Noguera-Julin A, et al.

Objective: This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic.

Key study: Severe acute respiratory syndrome coronavirus 2 clinical syndromes and predictors of disease severity in hospitalized children and youth.  (2020)

Key study: Severe acute respiratory syndrome coronavirus 2 clinical syndromes and predictors of disease severity in hospitalized children and youth.

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Fernandes DM, Oliveira CR, Guerguis S, et al.

Fernandes DM, Oliveira CR, Guerguis S, et al.

Objective: To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity.

Key study: Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome.  (2020)

Key study: Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome.

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Pereira MFB, Litvinov N, Farhat SCL, et al.

Pereira MFB, Litvinov N, Farhat SCL, et al.

Objectives: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C).

Key study: A case series of pediatric croup with COVID-19.  (2020)

Key study: A case series of pediatric croup with COVID-19.

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Venn AMR, Schmidt JM, Mullan PC.

Venn AMR, Schmidt JM, Mullan PC.

Objective: We describe three previously healthy children, admitted from our emergency department (ED) to our free-standing children's hospital, as the first documented cases of croup as a manifestation of SARS-CoV-2 infection.

Key study: Anosmia and ageusia: not an uncommon presentation of COVID-19 infection in children and adolescents.  (2020)

Key study: Anosmia and ageusia: not an uncommon presentation of COVID-19 infection in children and adolescents.

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Mak PQ, Chung KS, Wong JS, Shek CC, Kwan MY.

Mak PQ, Chung KS, Wong JS, Shek CC, Kwan MY.

Objective: We report three cases of pediatric patients with COVID-19 infection who presented with anosmia and/or ageusia.

Summary: Emergency preparedness and response: multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19).  (2020)

Summary: Emergency preparedness and response: multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19).

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Centers for Disease Control and Prevention

Centers for Disease Control and Prevention

Objective: Providing 1) background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 2) a case definition for this syndrome.

Key study: Characteristics and outcomes of children with Coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units.  (2020)

Key study: Characteristics and outcomes of children with Coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units.

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Shekerdemian L, Mahmood N, Wolfe K, et al.

Shekerdemian L, Mahmood N, Wolfe K, et al.

Objective To provide an early description and characterization of COVID-19 infection in North American PICUs, focusing on mode of presentation, presence of comorbidities, severity of disease, therapeutic interventions, clinical trajectory, and early outcomes.

Summary: Coronavirus disease 2019 in children United States, February 12-April 2, 2020.  (2020)

Summary: Coronavirus disease 2019 in children United States, February 12-April 2, 2020.

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US Centers for Disease Control and Prevention

US Centers for Disease Control and Prevention

Objective: To describe COVID-19 in children and adolescents in the United States.

Key study: Pediatric critical care and COVID19.  (2020)

Key study: Pediatric critical care and COVID19.

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Gonzlez-Dambrauskas S, Vsquez-Hoyos P, Camporesi A, et al.

Gonzlez-Dambrauskas S, Vsquez-Hoyos P, Camporesi A, et al.

Objective: We provide preliminary insights into our first 17 children from 10 PICUs in Chile, Colombia, Italy, Spain, and the United States.

Key study: Clinical characteristics of children with Coronavirus disease 2019 in Hubei, China.  (2020)

Key study: Clinical characteristics of children with Coronavirus disease 2019 in Hubei, China.

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Zheng F, Liao C, Fan Q, et al.

Zheng F, Liao C, Fan Q, et al.

Objective: The objective of this study is to describe the clinical characteristics of 25 hospitalized pediatric COVID-19.

Key study: Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding  (2020)

Key study: Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding

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Xu Y, Li X, Zhu B, et al.

Xu Y, Li X, Zhu B, et al.

Objective: We report epidemiological and clinical investigations on ten pediatric SARS-CoV-2 infection cases confirmed by real-time reverse transcription PCR assay of SARS-CoV-2 RNA.

Cannabis Intoxication
Cannabis Intoxication  Key Resources

Recommandations de Base: Intoxication au cannabis  (2022)

Recommandations de Base: Intoxication au cannabis

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Dr. Kaitlin Hogue, Dr. Neil Desai and TREKK Network

Dr. Kaitlin Hogue, Dr. Neil Desai and TREKK Network

Bottom Line Recommendations for treatment and management of cannabis intoxication. Published online March 2022. 

Formes et modes de consommation du cannabis  (2022)

Formes et modes de consommation du cannabis

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Dr. Kaitlin Hogue, Dr. Neil Desai, Danica Irwin and TREKK Network

Dr. Kaitlin Hogue, Dr. Neil Desai, Danica Irwin and TREKK Network

Formulations andmethods of delivery table for cannabis. Uploaded online: March 2022

Bottom Line Recommendations: Cannabis Intoxication  (2021)

Bottom Line Recommendations: Cannabis Intoxication

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Dr. Kaitlin Hogue, Dr. Neil Desai and TREKK Network

Dr. Kaitlin Hogue, Dr. Neil Desai and TREKK Network

Bottom line recommendations for cannabis intoxication. Published online: December 2021

Formulations and Methods of Delivery: Cannabis  (2021)

Formulations and Methods of Delivery: Cannabis

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Dr. Kaitlin Hogue, Dr. Neil Desai, Danica Irwin and TREKK Network

Dr. Kaitlin Hogue, Dr. Neil Desai, Danica Irwin and TREKK Network

Formulations and methods of delivery table for cannabis. Uploaded 2021-12-06

Cannabis Intoxication  Clinical guidelines

Clincal Practice Guildeline: Addressing Pediatric Cannabis Exposure  (2019)

Clincal Practice Guildeline: Addressing Pediatric Cannabis Exposure

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American College of Medical Toxicology

American College of Medical Toxicology

The purpose of this was to outline recommendations for clincians treating pediatric patients with actue cannabis intoxication.

Cannabis Intoxication  Systematic reviews

Systematic Review: Unintentional Cannabis Ingestion in Children: A Systematic Review  (2017)

Systematic Review: Unintentional Cannabis Ingestion in Children: A Systematic Review

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Richards JRS, N. E.; Moulin, A. K.

Richards JRS, N. E.; Moulin, A. K.

To analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome.

Systematic Review: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatmenta Systematic Review  (2017)

Systematic Review: Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatmenta Systematic Review

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Sorensen, C. J., DeSanto, K., Borgelt, L., Phillips, K. T., & Monte, A. A

Sorensen, C. J., DeSanto, K., Borgelt, L., Phillips, K. T., & Monte, A. A

To summarize the available evidence on CHS diagnosis, pathophysiology, and treatment.

Cannabis Intoxication  Key studies

Key Study: Increased Testing and Health Care Costs for Pediatric Cannabis Exposures  (2019)

Key Study: Increased Testing and Health Care Costs for Pediatric Cannabis Exposures

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Bashqoy FH, J. W.; Reiter, P. D.; Wang, G. S.; Borgelt, L. M.

Bashqoy FH, J. W.; Reiter, P. D.; Wang, G. S.; Borgelt, L. M.

This study aimed to evaluate the process of identifying marijuana exposure in a children's hospital emergency department and compare the cost of diagnostic testing and procedures.

Key Study: Acute cannabis toxicity  (2019)

Key Study: Acute cannabis toxicity

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Noble MJH, K.; Hendrickson, R. G.

Noble MJH, K.; Hendrickson, R. G.

We describe the clinical effects of, and products associated with, acute exposures to cannabis during the early legalization period of recreational cannabis in Oregon and Alaska.

Key Study: A 21st Century Problem: Cannabis Toxicity in a 13-Month-Old Child  (2019)

Key Study: A 21st Century Problem: Cannabis Toxicity in a 13-Month-Old Child

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Levene RJP-C, Elza; Wolfram, Sigrid

Levene RJP-C, Elza; Wolfram, Sigrid

We report the case of a 13-month-old female presenting with self-limiting altered mental status and lethargy, with a subsequent diagnosis of tetrahydrocannabinol exposure on confirmatory urine gas chromatography-mass spectrometry.

Key Study: Synthetic Cannabinoid Exposure in Adolescents Presenting for Emergency Care  (2018)

Key Study: Synthetic Cannabinoid Exposure in Adolescents Presenting for Emergency Care

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Gilley MB, J.; Calello, D. P.; Wax, P.; Finkelstein, Y.; Toxicology Investigators, Consortium

Gilley MB, J.; Calello, D. P.; Wax, P.; Finkelstein, Y.; Toxicology Investiga...

The objective of this study was to characterize the clinical picture and management of synthetic cannabinoid exposure in a cohort of adolescents.

Key Study: Marijuana Misadventures in Children: Exploration of a Dose-Response Relationship and Summary of Clinical Effects and Outcomes  (2018)

Key Study: Marijuana Misadventures in Children: Exploration of a Dose-Response Relationship and Summary of Clinical Effects and Outcomes

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Heizer JWB, L. M.; Bashqoy, F.; Wang, G. S.; Reiter, P. D.

Heizer JWB, L. M.; Bashqoy, F.; Wang, G. S.; Reiter, P. D.

This study aimed to explore a dose-response relationship of delta-9-tetrahydrocannabinol (THC) in THC-nave children after unintentional acute exposure and compare clinical outcomes with non-nave children.

Key Study: Cannabis Intoxication Case Series: The Dangers of Edibles Containing Tetrahydrocannabinol  (2018)

Key Study: Cannabis Intoxication Case Series: The Dangers of Edibles Containing Tetrahydrocannabinol

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Vo KTH, H.; Li, K.; Ho, R. Y.; Wu, A. H. B.; Lynch, K. L.; Smollin, C. G.

Vo KTH, H.; Li, K.; Ho, R. Y.; Wu, A. H. B.; Lynch, K. L.; Smollin, C. G.

Cannabis and its principal active constituent, 9-tetrahydrocannabinol (THC), are increasingly available as edibles resembling commercially available food products. In this case series, we describe a population of predominantly pediatric patients who were inadvertently exposed to a THC-containing product in San Francisco.

Key Study: Intoxicacin por cannabis en menores de 3 aos  (2018)

Key Study: Intoxicacin por cannabis en menores de 3 aos

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Pinedo-Painous IG-R, Roser; Valls-Lafon, Anna; Muoz-Santanach, David; Martnez-Snchez, Lidia

Pinedo-Painous IG-R, Roser; Valls-Lafon, Anna; Muoz-Santanach, David; Martnez...

We present a retrospective, descriptive study of patients aged 3 years or younger who were treated for cannabis poisoning in a pediatric emergency department between 2012 and 2017.

Key Study: Longitudinal associations of social cognition and substance use in childhood and early adolescence: findings from the Avon Longitudinal Study of Parents and Children  (2018)

Key Study: Longitudinal associations of social cognition and substance use in childhood and early adolescence: findings from the Avon Longitudinal Study of Parents and Children

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Fluharty, M. E., Heron, J., & Munaf, M. R

Fluharty, M. E., Heron, J., & Munaf, M. R

We investigated both directions of association within an adolescent birth cohort: the association of social cognition with subsequent substance use, and the association of early substance use with subsequent social cognition

Key Study: Unintentional Cannabis Intoxication in Toddlers  (2017)

Key Study: Unintentional Cannabis Intoxication in Toddlers

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Claudet IM, S.; Labadie, M.; Manin, C.; Michard-Lenoir, A. P.; Eyer, D.; Dufour, D.; Marie-Jeanne Study, Group

Claudet IM, S.; Labadie, M.; Manin, C.; Michard-Lenoir, A. P.; Eyer, D.; Dufo...

We sought to evaluate the French national trend of admissions for unintentional cannabis intoxication in children over an 11-year period (20042014).

Key Study: A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach?  (2017)

Key Study: A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach?

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Claudet, I., Le Breton, M., Brhin, C., & Franchitto, N

Claudet, I., Le Breton, M., Brhin, C., & Franchitto, N

We carried out a retrospective cohort study of children admitted to a pediatric emergency department due to unintentional cannabis exposure over a 10-year period from 2004 to 2014.

Key Study: Drug Misuse in Adolescents Presenting to the Emergency Department  (2017)

Key Study: Drug Misuse in Adolescents Presenting to the Emergency Department

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Finkelstein YG, G.; Hutson, J. R.; Armstrong, J.; Baum, C. R.; Wax, P.; Brent, J.; Toxicology Investigators, Consortium

Finkelstein YG, G.; Hutson, J. R.; Armstrong, J.; Baum, C. R.; Wax, P.; Brent...

Drug misuse is a disturbing, common practice among youth. One in 4 American adolescents reports consuming prescription medications without a clinical indication. We sought to explore current trends of drug misuse in adolescents.

Key Study: Acute intoxication caused by synthetic cannabinoids 5F-ADB and MMB-2201: A case series  (2017)

Key Study: Acute intoxication caused by synthetic cannabinoids 5F-ADB and MMB-2201: A case series

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Barcelo BP, S.; Lopez-Corominas, V.; Gomila, I.; Yates, C.; Busardo, F. P.; Pellegrini, M.

Barcelo BP, S.; Lopez-Corominas, V.; Gomila, I.; Yates, C.; Busardo, F. P.; P...

Here, we report five cases of acute intoxication by synthetic cannabinoids 5F-ADB and MMB-2201 with analytical confirmation

Key Study: Detecting biomarkers of secondhand marijuana smoke in young children  (2017)

Key Study: Detecting biomarkers of secondhand marijuana smoke in young children

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Wilson, K. M., Torok, M. R., Wei, B., Wang, L., Robinson, M., Sosnoff, C. S., & Blount, B. C.

Wilson, K. M., Torok, M. R., Wei, B., Wang, L., Robinson, M., Sosnoff, C. S.,...

We studied children ages 1 mo to 2 y hospitalized with bronchiolitis in Colorado from 2013 to 2015.

Key Study: Unintentional Pediatric Exposures to Marijuana in Colorado, 2009-2015  (2016)

Key Study: Unintentional Pediatric Exposures to Marijuana in Colorado, 2009-2015

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George SamWang,MD1,2; Marie-ClaireLe Lait,MS2; Sara J.Deakyne,MPH3; et al

George SamWang,MD1,2; Marie-ClaireLe Lait,MS2; Sara J.Deakyne,MPH3; et al

To compare the incidence of pediatric marijuana exposures evaluated at a children's hospital and regional poison center (RPC) in Colorado before and after recreational marijuana legalization and to compare population rate trends of RPC cases for marijuana exposures with the rest of the United States.

Key Study: Marijuana exposure among children younger than siz years in the United States  (2016)

Key Study: Marijuana exposure among children younger than siz years in the United States

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Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA

Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA

This study investigates marijuana exposures among children <6 years old in the United States using data from the National Poison Data System.

Key Study: Synthetic Cannabinoid Exposure  (2016)

Key Study: Synthetic Cannabinoid Exposure

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Adair AG, Spencer C.; Greeley, Christopher S.; Coleman, Ryan D.; Shekerdemian, Lara S.

Adair AG, Spencer C.; Greeley, Christopher S.; Coleman, Ryan D.; Shekerdemian...

We present 2 cases of actual or highly suspected synthetic cannabinoid exposure in 2 pediatric patients to demonstrate the wide range of symptoms that can be present in these patients.

Key Study: Treat plays trick on a 3-year-old boy  (2016)

Key Study: Treat plays trick on a 3-year-old boy

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Thuy Trang JNC, Arthur K.

Thuy Trang JNC, Arthur K.

Presents a case study of a 3 year old with acute cannabis intoxication.

Key Study: Changes in Cannabis Potency Over the Last 2 Decades (19952014): Analysis of Current Data in the United States  (2016)

Key Study: Changes in Cannabis Potency Over the Last 2 Decades (19952014): Analysis of Current Data in the United States

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ElSohly, M. A., Mehmedic, Z., Foster, S., Gon, C., Chandra, S., & Church, J. C.

ElSohly, M. A., Mehmedic, Z., Foster, S., Gon, C., Chandra, S., & Church,...

This report examines the concentration of cannabinoids in illicit cannabis products seized by the U.S. Drug Enforcement Administration over the last 2 decades, with particular emphasis on (9)-tetrahydrocannabinol and cannabidiol.

Key Study: Non-Smoker Exposure to Secondhand Cannabis Smoke. I. Urine Screening and Confirmation Results  (2015)

Key Study: Non-Smoker Exposure to Secondhand Cannabis Smoke. I. Urine Screening and Confirmation Results

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Cone, E. J., Bigelow, G. E., Herrmann, E. S., Mitchell, J. M., LoDico, C., Flegel, R., & Vandrey, R

Cone, E. J., Bigelow, G. E., Herrmann, E. S., Mitchell, J. M., LoDico, C., Fl...

A systematic study was conducted of smoke exposure on drug-free participants.

Key Study: Non-smoker exposure to secondhand cannabis smoke II: Effect of room ventilation on the physiological, subjective, and behavioral/cognitive effects.  (2015)

Key Study: Non-smoker exposure to secondhand cannabis smoke II: Effect of room ventilation on the physiological, subjective, and behavioral/cognitive effects.

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Herrmann, E. S., Cone, E. J., Mitchell, J. M., Bigelow, G. E., LoDico, C., Flegel, R., & Vandrey, R.

Herrmann, E. S., Cone, E. J., Mitchell, J. M., Bigelow, G. E., LoDico, C., Fl...

This report examines the concentration of cannabinoids in illicit cannabis products seized by the U.S. Drug Enforcement Administration over the last 2 decades, with particular emphasis on (9)-tetrahydrocannabinol and cannabidiol.

Key Study: Nonsmoker Exposure to Secondhand Cannabis Smoke. III. Oral Fluid and Blood Drug Concentrations and Corresponding Subjective Effects  (2015)

Key Study: Nonsmoker Exposure to Secondhand Cannabis Smoke. III. Oral Fluid and Blood Drug Concentrations and Corresponding Subjective Effects

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Cone, E. J., Bigelow, G. E., Herrmann, E. S., Mitchell, J. M., LoDico, C., Flegel, R., & Vandrey, R.

Cone, E. J., Bigelow, G. E., Herrmann, E. S., Mitchell, J. M., LoDico, C., Fl...

The study was designed to produce extreme cannabis smoke exposure conditions tolerable to drug-free nonsmokers

Key Study: Accidental pediatric ingestions of medical marijuana: a 4-year poison center experience  (2015)

Key Study: Accidental pediatric ingestions of medical marijuana: a 4-year poison center experience

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Lovecchio, F., & Heise, C. W

Lovecchio, F., & Heise, C. W

A study of incidental pediatric cannabis consumption over a 4-year period.

Key Study: A cannabinoid-intoxicated child treated with dexmedetomidine: a case report  (2015)

Key Study: A cannabinoid-intoxicated child treated with dexmedetomidine: a case report

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Cipriani, F., Mancino, A., Pulitan, S. M., Piastra, M., & Conti, G.

Cipriani, F., Mancino, A., Pulitan, S. M., Piastra, M., & Conti, G.

To our knowledge, this is the first reported case of dexmedetomidine use to support a cannabis intoxicated patient.

Key Study: The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update  (2015)

Key Study: The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update

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Ammerman, S., Ryan, S., Adelman, W. P., & THE COMMITTEE ON SUBSTANCE ABUSE, T. C. O. A.

Ammerman, S., Ryan, S., Adelman, W. P., & THE COMMITTEE ON SUBSTANCE ABUS...

This technical report updates the 2004 American Academy of Pediatrics technical report on the legalization of marijuana

Key Study: Dangerous Relationships: Asthma and Substance Abuse  (2013)

Key Study: Dangerous Relationships: Asthma and Substance Abuse

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Caponnetto, P., Auditore, R., Russo, C., Alamo, A., Campagna, D., Demma, S., & Polosa, R

Caponnetto, P., Auditore, R., Russo, C., Alamo, A., Campagna, D., Demma, S., ...

The review emphasizes the importance for clinicians to be alert to the possibility of this substance as a precipitating factor for acute asthma.

Key Study: The Pharmacologic and Clinical Effects of Medical Cannabis  (2013)

Key Study: The Pharmacologic and Clinical Effects of Medical Cannabis

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Borgelt, L. M., Franson, K. L., Nussbaum, A. M., & Wang, G. S.

Borgelt, L. M., Franson, K. L., Nussbaum, A. M., & Wang, G. S.

This article will describe the pharmacology of cannabis, effects of various dosage formulations, therapeutics benefits and risks of cannabis for pain and muscle spasm, and safety concerns of medical cannabis use.

Key Study: Acute intoxication caused by a synthetic cannabinoid in two adolescents  (2012)

Key Study: Acute intoxication caused by a synthetic cannabinoid in two adolescents

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Heath TSB, Z.; Thompson, A. J.; Tecklenburg, F. W.

Heath TSB, Z.; Thompson, A. J.; Tecklenburg, F. W.

In this report, we describe two adolescent patients admitted after they inhaled K2, resulting in loss of consciousness, tachycardia, and diffuse pain.

Key Study: Drug use and screening in pediatric trauma  (2011)

Key Study: Drug use and screening in pediatric trauma

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Martin KLV, K. N.; Girotti, M. J.; Stewart, T. C.; Parry, N. G.

Martin KLV, K. N.; Girotti, M. J.; Stewart, T. C.; Parry, N. G.

This article will describe the pharmacology of cannabis, effects of various dosage formulations, therapeutics benefits and risks of cannabis for pain and muscle spasm, and safety concerns of medical cannabis use.

Key Study: Sensitivity and Specificity of Urinary Cannabinoid Detection With Two Immunoassays After Controlled Oral Administration of Cannabinoids to Humans.  (2008)

Key Study: Sensitivity and Specificity of Urinary Cannabinoid Detection With Two Immunoassays After Controlled Oral Administration of Cannabinoids to Humans.

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Grauwiler, S. B., Drewe, J., & Scholer, A.

Grauwiler, S. B., Drewe, J., & Scholer, A.

This study aims to describe trends in substance use and screening in the Canadian pediatric trauma population.

Key Study: Ataxia and shaking in a 2-year-old girl: acute marijuana intoxication presenting as seizure.  (2005)

Key Study: Ataxia and shaking in a 2-year-old girl: acute marijuana intoxication presenting as seizure.

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Bonkowsky, J. L., Sarco, D., & Pomeroy, S. L

Bonkowsky, J. L., Sarco, D., & Pomeroy, S. L

This is a case study of a young girl experiencing cannabis usage.

Key Study: Urine drug screens in overdose patients do not contribute to immediate clinical management  (2001)

Key Study: Urine drug screens in overdose patients do not contribute to immediate clinical management

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Montague REG, R. F.; Lewis, J. H.; Shenfield, G. M.

Montague REG, R. F.; Lewis, J. H.; Shenfield, G. M.

A prospective study assessed whether routine urine drug screens might alter the management of overdose patients.

Key Study: Substance abuse in adolescent trauma  (1993)

Key Study: Substance abuse in adolescent trauma

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Loiselle JMB, M. D.; Templeton, J. M., Jr.; Schwartz, G.; Drott, H.

Loiselle JMB, M. D.; Templeton, J. M., Jr.; Schwartz, G.; Drott, H.

To determine if there is a significant prevalence of drug or alcohol use among adolescents evaluated for significant acute trauma.

Caring for Children with Developmental and Intellectual Disabilities
Caring for Children with Developmental and Intellectual Disabilities  Key Resources

Bottom Line: Autism and the Hospital Emergency Room: A Practical Guide for Health Professionals to Meet the Needs of Individuals with Autism Spectrum Disorders  (2021)

Bottom Line: Autism and the Hospital Emergency Room: A Practical Guide for Health Professionals to Meet the Needs of Individuals with Autism Spectrum Disorders

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Center for Autism & Related Disabilities (CARD)

Center for Autism & Related Disabilities (CARD)

A practical guide for health professionals to meet the needs of individuals with Autism Spectrum Disorder.

Bottom Line Recommendations: Caring for Children with Developmental and Intellectual Disabilities in the ED  (2019)

Bottom Line Recommendations: Caring for Children with Developmental and Intellectual Disabilities in the ED

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Hanlon-Dearman, A, Stevenson, M and TREKK Network

Hanlon-Dearman, A, Stevenson, M and TREKK Network

Bottom line recommendations for caring for children with developmental and intellectual disabilities in the ED. Published online: Feb 2020, v 1.1

Recommandations de Base: Dficience intellectuelle et troubles du dveloppement  (2019)

Recommandations de Base: Dficience intellectuelle et troubles du dveloppement

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Hanlon-Dearman, A, Stevenson, M and TREKK Network

Hanlon-Dearman, A, Stevenson, M and TREKK Network

Bottom line recommendations for caring for children with developmental and intellectual disabilities in the ED. Published online: Feb 2020, v 1.1

Executive Summary: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies  (2016)

Executive Summary: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Emerg...

Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

This executive summary is an overview of the common clinical challenges pediatric caregivers face when a child or adolescent presents with a psychiatric chief complaint or emergency.

Executive Summary: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms  (2016)

Executive Summary: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Emerg...

Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

This executive summary is an overview of the common clinical challenges pediatric caregivers face when a mental health condition may be an unclear or complicating factor in a non-mental health ED presentation.

Bottom Line: Autism Information for Paramedics and Emergency Room Staff  (2005)

Bottom Line: Autism Information for Paramedics and Emergency Room Staff

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Gammicchia C, Johnson C, Autism Society

Gammicchia C, Johnson C, Autism Society

Information for paramedics and emergency room staff on providing services to a person on the autism spectrum.

Caring for Children with Developmental and Intellectual Disabilities  Clinical guidelines

Clinical Practice Guideline: Autism Spectrum Disorder: Updated Guidelines from the American Academy of Pediatrics  (2020)

Clinical Practice Guideline: Autism Spectrum Disorder: Updated Guidelines from the American Academy of Pediatrics

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American Academy of Pediatrics

American Academy of Pediatrics

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting one in 59 children in the United States and other industrialized nations. In addition to behavior issues, ASD is associated with seizures, gastrointestinal concerns, sleep difficulties, and mental health issues that can profoundly impact the quality of life of children and their families. The American Academy of Pediatrics (AAP) has published updated guidelines for diagnosis and treatment of ASD.

Position Statement: Post-diagnostic management and follow-up care for autism spectrum disorder  (2019)

Position Statement: Post-diagnostic management and follow-up care for autism spectrum disorder

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Ip A, Zwaigenbaum L, Brian J

Ip A, Zwaigenbaum L, Brian J

Paediatricians and other primary care providers are well positioned to provide or coordinate ongoing medical and psychosocial care and support services for children with autism spectrum disorder (ASD). This statement provides recommendations and information on a range of interventions and resources, to help paediatric care providers optimize care for children with ASD and support their families. The management of ASD includes treating medical and psychiatric co-morbidities, behavioural and developmental interventions, and providing supportive social care services to enhance quality of life for affected children and families.

Clinical Practice Guideline: Clinical Practice Guidelines for Autism Spectrum Disorders  (2019)

Clinical Practice Guideline: Clinical Practice Guidelines for Autism Spectrum Disorders

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Subramanyam AA, Mukherjee A, Dave M, Chavda K.

Subramanyam AA, Mukherjee A, Dave M, Chavda K.

These guidelines have been framed after an amalgamation of expert guidelines across the globe, and existing practices in India, as outlined by experts in the field. Due to the lack of systematic research in the field of autism in India, the evidence of the said practices is not documented, which becomes a limitation of these guidelines. The good part is that India has an indigenous tool for assessment, which has been recommended by the Government of India, which we have attached as an Appendix 1.

Clinical Practice Guideline: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies  (2016)

Clinical Practice Guideline: Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Emerg...

Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

Part 1 of the report discusses the common clinical issues that may be encountered in caring for children and adolescents presenting to the emergency department or primary care setting with a mental health condition or emergency.

Clinical Practice Guideline: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms  (2016)

Clinical Practice Guideline: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

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Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Emerg...

Chun TH, Mace SE, Katz ER, American Academy of Pediatrics Committee on Pediat...

Part 2 of the report discusses the challenges a pediatric clinician may face when evaluating patients with a mental health condition, which may be contributing to or a complicating factor for a medical or indeterminate clinical presentation.

Clinical Practice Guideline: Autism and developmental disability: Management of distress/agitation  (2015)

Clinical Practice Guideline: Autism and developmental disability: Management of distress/agitation

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Royal Children's Hospital Melbourne

Royal Children's Hospital Melbourne

The aim of this guideline is to provide clinical practice tips for the inpatient management of anxiety, and agitation in young people with developmental disabilities (including autism) who may require medical or surgical care.

Guidelines: Agitation Treatment for Pediatric Emergency Patients  (2008)

Guidelines: Agitation Treatment for Pediatric Emergency Patients

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Hilt RJ, Woodward TA, Henderson SW, Jellinek MS

Hilt RJ, Woodward TA, Henderson SW, Jellinek MS

Guideline based on a review of the existing literature & review of expert opinions for the management of agitated children in an emergency department setting.

Guidelines: Guidelines for Managing the Client with Intellectual Disabilites in the Emergency Room  (2002)

Guidelines: Guidelines for Managing the Client with Intellectual Disabilites in the Emergency Room

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University of Toronto, Centre for Addiction and Mental Health

University of Toronto, Centre for Addiction and Mental Health

These guidelines outline ways to optimize the clinical encounter, provide a framework for understanding & assessing the complex medical and mental health issues that arise for persons with intellectual disabilities, and provide a systematic way to evaluate the best approach to treatment and triage.

Caring for Children with Developmental and Intellectual Disabilities  Systematic reviews

Review: A Scoping Review of Targeted Interventions and Training to Facilitate Medical Encounters for School-Aged Patients with an Autism Spectrum Disorder  (2021)

Review: A Scoping Review of Targeted Interventions and Training to Facilitate Medical Encounters for School-Aged Patients with an Autism Spectrum Disorder

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Kouo JL, Kouo TS.

Kouo JL, Kouo TS.

Individuals with an autism spectrum disorder (ASD) have a greater number of healthcare provider interactions than individuals without ASD. The obstacles to patient-centered care for this population, which include inflexibility of hospital environments, limited resources, and inadequate training, has been documented. However, there is little knowledge on efforts to address such concerns. A scoping review was conducted and the systematic search of the literature resulted in 23 relevant studies. The predominant themes include the use of data collection instruments, application of evidence-based practices and resources, and training of providers. The results of this review have implications for practitioners and future research to adapt and improve upon the provision of medical care for individuals with ASD across the lifespan.

Review: Medical Encounters for Youth With Autism Spectrum Disorder: A Comprehensive Review of Environmental Considerations and Interventions  (2019)

Review: Medical Encounters for Youth With Autism Spectrum Disorder: A Comprehensive Review of Environmental Considerations and Interventions

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Straus J, Coburn S, Maskell S, Pappagianopoulos J, Cantrell K.

Straus J, Coburn S, Maskell S, Pappagianopoulos J, Cantrell K.

Approximately 1 in 59 youth are currently diagnosed with autism spectrum disorder (ASD), a neurodevelopmental disorder. In comparison to typically developing peers, youth with ASD encounter hospitalization at higher rates due to their heightened health care needs. While visiting the hospital is a stressor for youth with neurotypical needs, the experience contains unique challenges for those with ASD. This systematic literature review highlights research that considers the psychosocial impact of the hospital environment on the coping and adjustment of youth with ASD. Specifically, the review focuses on recommendations and interventions that may be used by health care professionals while supporting this population as they encounter the health care system. Ninety-six articles were identified as meeting inclusion and exclusion criteria. The findings suggest that practicing clinicians should implement a wide variety of interventions for youth with ASD including diversion techniques, comfort positions, and picture schedules. Although there are published evidence-based interventions for supporting youth with ASD in the hospital, most clinicians lack ASD-specific training. This article concludes with recommendations for future research.

Review: See-Hear-Feel-Speak: A Protocol for Improving Outcomes in Emergency Department Interactions With Patients With Autism Spectrum Disorder  (2019)

Review: See-Hear-Feel-Speak: A Protocol for Improving Outcomes in Emergency Department Interactions With Patients With Autism Spectrum Disorder

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Samet D, Luterman S.

Samet D, Luterman S.

The presentation of children and adolescents with autism in the emergency department (ED) poses a unique set of challenges to clinicians and their teams, which have not yet been met. Children and adolescents with autism spectrum disorder (ASD) are more likely than their age and ethnically matched counterparts to visit both pediatric and general EDs and are more likely to use it for primary care complaints and dental care and to present for psychiatric concerns including suicidality. Despite the higher relative frequency, individuals with ASD demonstrate lower patient satisfaction, lower healthcare self-efficacy, and higher odds of unmet healthcare needs related to physical health, mental health, health maintenance, and vaccination. This can be ameliorated by simple strategies regarding communication, sensory and environmental modification, and distraction. After performing a literature review of existing evidence-based recommendations via PubMed as well as resources from autism advocacy and self-advocacy groups, we compiled a 4-step system: "See-Hear-Feel-Speak" an approach conducive to learning with the goal of enabling clinicians and their teams to facilitate patient-centered encounters with pediatric patients with ASD. The protocol meets the practicality requirements defined by published research.

Review: Youth With Autism Spectrum Disorder in the Emergency Department  (2018)

Review: Youth With Autism Spectrum Disorder in the Emergency Department

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Lytle S, Hunt A, Moratschek S, Hall-Mennes M, Sajatovic M.

Lytle S, Hunt A, Moratschek S, Hall-Mennes M, Sajatovic M.

Youth (aged 0-17 years) with ASD were up to 30 times more likely to present to the ED than youth without ASD. Individuals with ASD who visited the ED were older, more likely to have public insurance, and more likely to have nonurgent ED visits. For youth with ASD, up to 13% of visits were for behavioral or psychiatric problems, whereas for youth without ASD less than 2% were for psychiatric problems. ASD youth were more likely to present for externalizing problems or psychotic symptoms. Youth with ASD were also likely to have repeat visits to the ED and more likely to be admitted to a psychiatric unit or medical floor than youth without ASD.

Review: Understanding and Improving Care for Individuals with Intellectual and Developmental Disabilities in the Emergency Department  (2014)

Review: Understanding and Improving Care for Individuals with Intellectual and Developmental Disabilities in the Emergency Department

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Lusky Y, Lake JK, Durbin J, Perry A, Bullock H, Morris S, Lee JS

Lusky Y, Lake JK, Durbin J, Perry A, Bullock H, Morris S, Lee JS

The aim of this review was to provide an overview of existing research on patterns and predictors of emergency department use among persons with intellectual and developmental disabilities, to summarize what is known about the care received and to describe interventions to improve emergency care.

Review: Management of agitation in individuals with autism spectrum disorders in the emergency department  (2014)

Review: Management of agitation in individuals with autism spectrum disorders in the emergency department

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McGonigle JJ, Venkat A, Beresford C, Campbell TP, Gabriels RL

McGonigle JJ, Venkat A, Beresford C, Campbell TP, Gabriels RL

This article describes the challenges that inidividuals with autism spectrum disorder face when receiving treatment in crisis and emergency settings.

Systematic Review: Children with autism spectrum disorder at a pediatric hospital: a systematic review of the literature  (2013)

Systematic Review: Children with autism spectrum disorder at a pediatric hospital: a systematic review of the literature

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Johnson NL, Rodriguez D

Johnson NL, Rodriguez D

This review describes the behaviors of hospitalized children with autism spectrum disorder that health care providers find challenging.

Review: Caring for the child with an autism spectrum disorder in the acute care setting  (2010)

Review: Caring for the child with an autism spectrum disorder in the acute care setting

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Scarpinato N, Bradley J, Kurbjun K, Bateman X, Holtzer B, Ely B

Scarpinato N, Bradley J, Kurbjun K, Bateman X, Holtzer B, Ely B

This article explores the challenges that patients with autism spectrum disorders face when hospitalized and provides assessment strategies and plan-of-care suggestions for nursing caregivers.

Review: Caring for children and adolescents with autism who require challenging procedures  (2002)

Review: Caring for children and adolescents with autism who require challenging procedures

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Souders MC, Freeman KG, DePaul D, Levy SE

Souders MC, Freeman KG, DePaul D, Levy SE

This review developed strategies for providing nursing care for children with autism or autistic spectrum disorders that incorporated theories and knowledge from disciplines of nursing, child development, psychology, applied behavior analysis, and pain management.

Caring for Children with Developmental and Intellectual Disabilities  Key studies

Key Study: Effectiveness of Adaptive Care Plans for Children with Developmental Disabilities During Outpatient Clinic Appointments  (2021)

Key Study: Effectiveness of Adaptive Care Plans for Children with Developmental Disabilities During Outpatient Clinic Appointments

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Liddle M, Sonnentag TL.

Liddle M, Sonnentag TL.

Children with developmental disabilities require more medical experiences than typically-developing children and struggle to cooperate with healthcare encounters. Adaptive care plans, delivered by child life specialists, are individualized patient-centered plans created to address the challenges that children with developmental disabilities experience. The current study evaluated if adaptive care plans affect the psychosocial outcomes of children with ASD compared to those with other developmental disabilities. One-hundred and sixty children between 3 and 18 years of age (child's Mage = 8.10, SD = 3.75) participated. Although children with developmental disabilities who had adaptive care plans did not generally experience less psychosocial distress; children with ASD who had adaptive care plans experienced fewer challenges with anxiety and coping compared to children with ASD who did not have adaptive care plans.

Key Study: An Australian Cross-Sectional Survey of Parents' Experiences of Emergency Department Visits Among Children with Autism Spectrum Disorder  (2021)

Key Study: An Australian Cross-Sectional Survey of Parents' Experiences of Emergency Department Visits Among Children with Autism Spectrum Disorder

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Garrick A, Lee ML, Scarffe C, Attwood T, Furley K, Bellgrove MA, et al.

Garrick A, Lee ML, Scarffe C, Attwood T, Furley K, Bellgrove MA, et al.

Parents of children with ASD who had attended an Australian emergency department (ED; n = 421) completed a questionnaire relating to their experiences in the ED, including (1) child's reason for presentation and existing comorbidities, (2) quality of care during the visit (3) child's behaviour during visit, e.g. sensory responses to the ED environment, and disruptive behaviours. Children with comorbid ASD and intellectual disability were more likely to present with gastrointestinal issues and seizures, while those with comorbid ASD and oppositional defiant disorder were more likely to present with self-injury. ED staff awareness of ASD-related issues, including communication and expression of pain, were common difficulties for parents. The ED environment (e.g. lights, sounds, waiting areas), exacerbated child anxiety and led to disruptive behaviour.

Key Study: Assessing Ease of Delivering Emergency Care for Patients with Autism Spectrum Disorders.  (2021)

Key Study: Assessing Ease of Delivering Emergency Care for Patients with Autism Spectrum Disorders.

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Kouo T, Bharadwaj N, Kouo J, Tackett S, Ryan L.

Kouo T, Bharadwaj N, Kouo J, Tackett S, Ryan L.

The aim of this study was to develop a method for objectively assessing the delivery of care to children with autism spectrum disorder (ASD) in the emergency department (ED). The TCI reflects difficulty accomplishing core tasks necessary to complete an ED visit. Children with ASD have higher TCIs than neurotypical controls, which puts them at higher risk for care disruptions. Evaluation of initiatives to improve quality of care for children with ASD should focus not only on metrics of overall experience and satisfaction but also how these initiatives affect the ability to effectively administer care.

Key Study: Emergency mental health presentations in children with autism spectrum disorder and attention deficit hyperactivity disorder.  (2021)

Key Study: Emergency mental health presentations in children with autism spectrum disorder and attention deficit hyperactivity disorder.

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Bourke EM, Say DF, Carison A, Hill A, Craig S, Hiscock H, et al

Bourke EM, Say DF, Carison A, Hill A, Craig S, Hiscock H, et al

To characterise the key features and management of young people presenting to the emergency department (ED) with a mental health (MH) complaint and a known diagnosis of autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD).

Key Study: Case Studies of Challenges in Emergency Care for Children With Autism Spectrum Disorder.  (2021)

Key Study: Case Studies of Challenges in Emergency Care for Children With Autism Spectrum Disorder.

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Gray JM, Roback MG.

Gray JM, Roback MG.

Autism spectrum disorder (ASD) affects more than 1% of children in the United States, with the rate of new diagnoses climbing significantly in the last 15 years. Emergent conditions and subsequent visits to the emergency department (ED) can be particularly challenging for children with ASD, most of whom also have comorbidities in addition to their deficits in social communication and interaction. In the emergency setting, these conditions can cause a range of behaviors that result in challenges for health care providers and may result in suboptimal experiences for children with ASD and their families. We present the ED course of 3 children with ASD to illustrate these challenges, emphasize successful strategies, and highlight opportunities for improvement.

Key Study: Caring for Children With Autism in an Emergency Department Setting  (2021)

Key Study: Caring for Children With Autism in an Emergency Department Setting

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Mannenbach MS, Passe RL, Lovik KK, Larson EM, Laudon SM, Naeve A, et al.

Mannenbach MS, Passe RL, Lovik KK, Larson EM, Laudon SM, Naeve A, et al.

Patients with autism spectrum disorder (ASD) and other developmental delays represent a unique patient population. We described a cohort of children with ASD cared for in an emergency department (ED) setting and the specific health care resources used for their care. The care for children with ASD varied with age and health care issues. There was a high prevalence of psychiatric complaints, and many of these children were boarded in the ED waiting for an inpatient psychiatric bed. Those with psychiatric complaints were more likely to have multiple tests ordered and were more likely to be admitted.

Key Study: An Exploration of Emergency Department Visits for Home Unintentional Injuries Among Children With Autism Spectrum Disorder for Evidence to Modify Injury Prevention Guidelines  (2021)

Key Study: An Exploration of Emergency Department Visits for Home Unintentional Injuries Among Children With Autism Spectrum Disorder for Evidence to Modify Injury Prevention Guidelines

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Jones V, Ryan L, Rooker G, Debinski B, Parnham T, Mahoney P, et al.

Jones V, Ryan L, Rooker G, Debinski B, Parnham T, Mahoney P, et al.

Current childhood injury prevention guidance is anchored by a child's age. For example, children are considered at high risk for falls at ages 4 years and less, and guidance for prevention focuses on these ages. However, these guidelines may not be adequate for children with autism spectrum disorders (ASD). Analyses suggest that unintentional home injury prevention for children with ASD may require prevention guidance extended through older ages.

Key Study: Patient- and Family-Centered Care in the Emergency Department for Children With Autism  (2020)

Key Study: Patient- and Family-Centered Care in the Emergency Department for Children With Autism

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Nicholas DB, Muskat B, Zwaigenbaum L, Greenblatt A, Ratnapalan S, Kilmer C, et al.

Nicholas DB, Muskat B, Zwaigenbaum L, Greenblatt A, Ratnapalan S, Kilmer C, e...

Emergency department (ED) care processes and environments impose unique challenges for children with autism spectrum disorder (ASD). The implementation of patient- and family-centered care (PFCC) emerges as a priority for optimizing ED care. In this article, as part of a larger study, we explore PFCC in the context of ASD. Our aims were to examine how elements of PFCC were experienced and applied relative to ED care for children with ASD. Findings amplify PFCC as integral to effectively serving children with ASD and their families in the ED. Resources that specifically nurture PFCC emerge as practice and program priorities.

Key Study: Brief Report: Knowledge and Confidence of Emergency Medical Service Personnel Involving Treatment of an Individual with Autism Spectrum Disorder.  (2017)

Key Study: Brief Report: Knowledge and Confidence of Emergency Medical Service Personnel Involving Treatment of an Individual with Autism Spectrum Disorder.

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Wachob D, Pesci LJ.

Wachob D, Pesci LJ.

In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD. The results found that autism-specific training and resources were associated with higher comfort levels, but not knowledge. It was also determined that newer and younger professionals had higher knowledge and comfort when compared to the more experienced and older professionals.

Key Study: Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study.  (2017)

Key Study: Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study.

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Lunsky Y, Weiss JA, Paquette-Smith M, Durbin A, Tint A, Palucka AM, et al.

Lunsky Y, Weiss JA, Paquette-Smith M, Durbin A, Tint A, Palucka AM, et al.

To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD). A combination of individual and contextual variables may be important for targeting preventative community-based supports for individuals with ASD and their families. In particular, attention should be paid to how caregiver supports, integrative crisis planning and community-based services may assist in preventing or minimising ED use for this vulnerable population.

Key Study: Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder  (2016)

Key Study: Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder

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Kalb LG, Vasa RA, Ballard ED, Woods S, Goldstein M, Wilcox HC

Kalb LG, Vasa RA, Ballard ED, Woods S, Goldstein M, Wilcox HC

This study aims to use nationally-representative emergency department data to characterize injury-related ED visits among youth with autism spectrum disorder.

Key Study: Parent and health care provider perspectives related to disclosure of autism spectrum disorder in pediatric emergency departments  (2016)

Key Study: Parent and health care provider perspectives related to disclosure of autism spectrum disorder in pediatric emergency departments

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Muskat B, Greenblatt A, Nicholas DB, Ratnapalan S, Cohen-Silver J, Newton AS, Craig WR, Kilmer C, Zwaigenbaum L

Muskat B, Greenblatt A, Nicholas DB, Ratnapalan S, Cohen-Silver J, Newton AS,...

This qualitative study utilized a grounded theory approach and analyzed data from parents and health care providers related to autism spectrum disorder disclosure within two Canadian pediatric emergency departments.

Key Study: Toward Practice Advancement in Emergency Care for Children With Autism Spectrum Disorder  (2016)

Key Study: Toward Practice Advancement in Emergency Care for Children With Autism Spectrum Disorder

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Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Cohen-Silver J, Sharon RF, Greenblatt A, Kilmer C

Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Cohen-Silver J, Sh...

The objective of this study was to identify stakeholder perspectives in determining clinical priorities and recommendations to guide emergency department service delivery for children with autism spectrum disorder.

Key Study: Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder  (2016)

Key Study: Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder

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Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Kilmer C, Greenblatt A, Roberts W, Cohen-Silver J

Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Kilmer C, Greenbla...

In this study, parents and their children with autism spectrum disorder shared their perspectives on emergency department care.

Key Study: Perspectives of Health Care Providers Regarding Emergency Department Care of Children and Youth with Autism Spectrum Disorder  (2016)

Key Study: Perspectives of Health Care Providers Regarding Emergency Department Care of Children and Youth with Autism Spectrum Disorder

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Zwaigenbaum L, Nicholas DB, Muskat B, Kilmer C, Newton AS, Craig WR,Ratnapalan S, Cohen-Silver J, Greenblatt A, Roberts W, Sharon R

Zwaigenbaum L, Nicholas DB, Muskat B, Kilmer C, Newton AS, Craig WR,Ratnapala...

This study aimed to characterize the perspectives of health professionals who care for children with autism spectrum disorder in the emergency department, and to determine what strategies could optimize care.

Key Study: Autism comes to the hospital: the experiences of patients with autism spectrum disorder, their parents and health-care providers at two Canadian paediatric hospitals  (2015)

Key Study: Autism comes to the hospital: the experiences of patients with autism spectrum disorder, their parents and health-care providers at two Canadian paediatric hospitals

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Muskat B, Burnham Riosa P, Nicholas DB, Roberts W, Stoddart KP, Zwaigenbaum L

Muskat B, Burnham Riosa P, Nicholas DB, Roberts W, Stoddart KP, Zwaigenbaum L

The purpose of this study was to understand the hospital experiences of children and youth with autism spectrum disorder, their families and their health-care providers, in order to inform hospital-based care.

Key Study: Parent and provider perspectives on procedural care for children with autism spectrum disorders  (2014)

Key Study: Parent and provider perspectives on procedural care for children with autism spectrum disorders

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Davignon MN, Friedlaender E, Cronholm PF, Paciotti B, Levy SE

Davignon MN, Friedlaender E, Cronholm PF, Paciotti B, Levy SE

The aim of this study was to identify parent and provider perspectives on barriers and facilitators to procedural care for children with autism spectrum disorders.

Key Study: Development and evaluation of educational materials for pre-hospital and emergency department personnel on the care of patients with autism spectrum disorder  (2014)

Key Study: Development and evaluation of educational materials for pre-hospital and emergency department personnel on the care of patients with autism spectrum disorder

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McGonigle JJ, Migyanka JM, Glor-Scheib SJ, Cramer R, Fratangeli JJ, Hegde GG, Shang J, Venkat A

McGonigle JJ, Migyanka JM, Glor-Scheib SJ, Cramer R, Fratangeli JJ, Hegde GG,...

This study describes the development of education materials on ASD and the results of training of emergency medical services and emergency department personnel.

Key Study: Psychiatric-related emergency department visits among children with an autism spectrum disorder  (2012)

Key Study: Psychiatric-related emergency department visits among children with an autism spectrum disorder

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Kalb LG, Stuart EA, Freedman B, Zablotsky B, Vasa R

Kalb LG, Stuart EA, Freedman B, Zablotsky B, Vasa R

This study aimed to examine the prevalence and characteristics of psychiatry-related emergency department visits among children with autism spectrum disorder, including the specific reason for visit, as well as the influence of insurance type.

Key Study: Injury treatment among children with autism or pervasive developmental disorder  (2008)

Key Study: Injury treatment among children with autism or pervasive developmental disorder

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McDermott S, Zhou L, Mann J

McDermott S, Zhou L, Mann J

This study examined the difference in the frequency and type of injury for children with autism and pervasive developmental disorder compared with typically developing peers.

Concussion
Concussion  Key Resources

Bottom Line Recommendations: Concussion 2022  (2022)

Bottom Line Recommendations: Concussion 2022

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Dr. Roger Zemek, Dr. Jennifer Dawson & TREKK Network

Dr. Roger Zemek, Dr. Jennifer Dawson & TREKK Network

Bottom line recommendations for the treatment and management of concussion. Updated: February 2022

 

Recommendations de Base: Commotion cérébrale  (2022)

Recommendations de Base: Commotion cérébrale

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Dr. Roger Zemek, Dr. Jennifer Dawson & TREKK Network

Dr. Roger Zemek, Dr. Jennifer Dawson & TREKK Network

Bottom line recommendations for the treatment and management of pediatric concussion. Posted May 2022. 

Bottom Line: Management of Acute Symptoms Algorithm  (2021)

Bottom Line: Management of Acute Symptoms Algorithm

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Ontario Neurotrauma Foundation

Ontario Neurotrauma Foundation

This document is intended to guide health care professionals in diagnosing and managing pediatric concussion. See Page 48 of this document for the Management of Acute Symptoms Algorithm (Tool 2.1).

Bottom Line: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5)  (2017)

Bottom Line: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5)

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Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenbogen RG, Echemendia RJ, Makdissi M, Sills A, Iverson GL, Dvorak J, McCrory P, Meeuw...

Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenboge...

The Child SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The Child SCAT5 is to be used for evaluating Children aged 5 to 12 years. For athletes aged 13 years and older, please use the SCAT5.

Bottom Line: The Sport Concussion Assessment Tool 5th Edition (SCAT5)  (2017)

Bottom Line: The Sport Concussion Assessment Tool 5th Edition (SCAT5)

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Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, Makdissi M, Sullivan SJ, Broglio SP, Raftery M, Schneider K, Kissick J, McCrea M, Dvora...

Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, Makdiss...

The SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The SCAT5 is to be used for evaluating athletes aged 13 years and older. For children aged 12 years or younger, please use the Child SCAT5.

Bottom Line: Acute Concussion Evaluation (ACE): Physician/Clinician Office Version  (2006)

Bottom Line: Acute Concussion Evaluation (ACE): Physician/Clinician Office Version

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Goia G, Collins M

Goia G, Collins M

The ACE is intended to provide an evidence-based clinical protocol to conduct an initial evaluation and diagnosis of patients (both children and adults) with known or suspected mild traumatic brain injury.

Infographic: Concussion

Infographic: Concussion

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ECHO Research and ARCHE

ECHO Research and ARCHE

A concussion is a brain injury. Any child or teen who gets hit in the head, face, neck, or body has a chance of getting a concussion. Concussions can happen to anyone from falling, during sports, or car accidents.

Concussion  Clinical guidelines

Living Guideline For Pediatric Concussion Care  (2022)

Living Guideline For Pediatric Concussion Care

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FoundationLiving Guideline for Pediatric Concussion Care (PedsConcussion)

Guideline: Telemedicine and Virtual Concussion Care  (2022)

Guideline: Telemedicine and Virtual Concussion Care

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Living Guideline for Pediatric Concussion Care (PedsConcussion)

Guideline: Considerations for Telemedicine and Virtual Care Algorithm  (2022)

Guideline: Considerations for Telemedicine and Virtual Care Algorithm

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FoundationLiving Guideline for Pediatric Concussion Care (PedsConcussion)

Concussions and Head Injuries in Children: Care Instructions  (2020)

Concussions and Head Injuries in Children: Care Instructions

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Resources on Concussion in a Virtual Environment (Recover)

Resources on Concussion in a Virtual Environment (Recover)

RECOVER (Resources on Concussion in a Virtual Environment) was a study being conducted by researchers at Alberta Health Services, the University of Calgary and the University of Alberta. To improve outcomes for children with concussion who are seen in emergency departments, the study developed tools to help physicians and nurses provide better care and to help families to learn more about, assess, and monitor concussion.

Guidelines: Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children  (2018)

Guidelines: Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

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Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Based on a previous systematic review of the literature, this guideline includes 19 sets of recommendations on diagnosis, prognosis, and management/treatment of pediatric mTBI. Each recommendation was assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence.

Consensus Statement: Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016  (2017)

Consensus Statement: Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016

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McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA, Ellenbogen R, Emery C, Engebrets...

McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cas...

The 2017 Concussion in Sport Group (CISG) consensus statement is designed to build on the principles outlined in the previous statements and to develop further conceptual understanding of sport-related concussion (SRC) using an expert consensus-based approach.

Guidelines: Standards for Post-Concussion Care: from diagnosis to the interdisciplinary concussion clinic  (2017)

Guidelines: Standards for Post-Concussion Care: from diagnosis to the interdisciplinary concussion clinic

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The Concussion Advisory Subcommittee of the Ontario Neurotrauma Foundation

The Concussion Advisory Subcommittee of the Ontario Neurotrauma Foundation

A pathway of post-concussion care was developed that would be applicable across the province to patients while accounting for the vast regional differences.

Concussion  Summaries of systematic reviews

Multimedia: Heads Up App (2013)

Multimedia: Heads Up App (2013)

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National Center for Injury Prevention and Control,

National Center for Injury Prevention and Control,

The Heads Up app will help you learn how to spot and what to do if you think your child or teen has a concussion or other serious brain injury.

Concussion  Systematic reviews

Systematic review: Aerobic exercise for sport-related concussion: a systematic review and meta-analysis  (2020)

Systematic review: Aerobic exercise for sport-related concussion: a systematic review and meta-analysis

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Langevin P, Frmont P, Fait P, Dub MO, Bertrand-Charrette M, Roy JS.

Langevin P, Frmont P, Fait P, Dub MO, Bertrand-Charrette M, Roy JS.

The objective of this systematic review is to assess the effects of symptom-limited aerobic exercise programs compared with control interventions on symptom intensity in individuals with sports-related concussion.

Systematic review: Effectiveness of return to activity and return to school protocols for children postconcussion: a systematic review  (2020)

Systematic review: Effectiveness of return to activity and return to school protocols for children postconcussion: a systematic review

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DeMatteo C, Bednar ED, Randall S, Falla K.

DeMatteo C, Bednar ED, Randall S, Falla K.

Objective: To determine the effects of following return to activity (RTA) and return to school (RTS) protocols on clinical outcomes for children with concussion. The 12 subquestions of this review focus on the effectiveness of protocols, guidelines and recommendations, and the evidence supporting content of the protocols including rest, exercise and school accommodations.

Systematic review: Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery  (2020)

Systematic review: Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery

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Luther M, Poppert Cordts KM, Williams CN

Luther M, Poppert Cordts KM, Williams CN

Objectives: Sleep is vital for brain development and healing after injury, placing children with sleep-wake disturbances (SWD) after traumatic brain injury (TBI) at risk for worse outcomes. We conducted a systematic review to quantify SWD after pediatric TBI including prevalence, phenotypes, and risk factors. We also evaluated interventions for SWD and the association between SWD and other posttraumatic outcomes.

Systematic review: A systematic review of sleep-wake disturbances in childhood traumatic brain injury: relationship with fatigue, depression, and quality of life  (2019)

Systematic review: A systematic review of sleep-wake disturbances in childhood traumatic brain injury: relationship with fatigue, depression, and quality of life

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Botchway EN, Godfrey C, Anderson V, Catroppa C.

Botchway EN, Godfrey C, Anderson V, Catroppa C.

Objective: To systematically appraise the literature on the prevalence, types, and predictors of sleep-wake disturbances (SWD), and on the relationship between SWD, fatigue, depression, and quality of life in children and adolescents with traumatic brain injury (TBI).

Systematic review: Pediatric traumatic brain injury and antisocial behavior: are they linked? A systematic review  (2019)

Systematic review: Pediatric traumatic brain injury and antisocial behavior: are they linked? A systematic review

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Bellesi G, Barker ED, Brown L, Valmaggia L.

Bellesi G, Barker ED, Brown L, Valmaggia L.

This review aimed to explore systematically previous literature on the association between TBI before the age of 19 and severe behavioral problems such as violence, aggression and assault.

Systematic review: What factors must be considered in return to school following concussion and what strategies or accommodations should be followed? A systematic review  (2019)

Systematic review: What factors must be considered in return to school following concussion and what strategies or accommodations should be followed? A systematic review

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Purcell LK, Davis GA, Gioia GA.

Purcell LK, Davis GA, Gioia GA.

Objective: To evaluate the evidence regarding (1) factors affecting return to school (RTS) and (2) strategies/accommodations for RTS following a sport-related concussion (SRC) in children and adolescents.

Systematic review: A systematic review of criteria used to define recovery from sport-related concussion in youth athletes  (2018)

Systematic review: A systematic review of criteria used to define recovery from sport-related concussion in youth athletes

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Haider MN, Leddy JJ, Pavlesen S, et al.

Haider MN, Leddy JJ, Pavlesen S, et al.

Objective: The Concussion in Sport Group guidelines recommend a multifaceted approach to help clinicians make return to sport decisions. The purpose of this study was to identify the most common multifaceted measures used to define clinical recovery from sport-related concussion in young athletes (high school and/or college level) and to summarise existing knowledge of criteria used to make return to sport decisions.

Systematic review: A systematic review of neuroimaging findings in children and adolescents with sports-related concussion  (2018)

Systematic review: A systematic review of neuroimaging findings in children and adolescents with sports-related concussion

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Chamard E, Lichtenstein JD.

Chamard E, Lichtenstein JD.

The aim of this review is to systematically explore the literature on magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), functional magnetic resonance imaging (fMRI), and cortical thickness following SRC in children and adolescents.

Systematic review: Chronic post-traumatic headache in children and adolescents: systematic review of prevalence and headache features  (2018)

Systematic review: Chronic post-traumatic headache in children and adolescents: systematic review of prevalence and headache features

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Shaw L, Morozova M, Abu-Arafeh I.

Shaw L, Morozova M, Abu-Arafeh I.

The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents.

Systematic review: Diagnosis and management of mild traumatic brain injury in children: a systematic review  (2018)

Systematic review: Diagnosis and management of mild traumatic brain injury in children: a systematic review

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Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Objective: To conduct a systematic review of the pediatric mTBI literature to serve as the foundation for an evidence-based guideline with clinical recommendations associated with the diagnosis and management of pediatric mTBI.

Systematic review: Imaging in pediatric concussion: a systematic review  (2018)

Systematic review: Imaging in pediatric concussion: a systematic review

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Schmidt J, Hayward KS, Brown KE, et al.

Schmidt J, Hayward KS, Brown KE, et al.

Objective: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered.

Systematic review: The age variable in childhood concussion management: a systematic review  (2018)