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Key Resources

Bottom Line Recommendations: Suicidal Risk Screening and Assessment  (2021)

Bottom Line Recommendations: Suicidal Risk Screening and Assessment

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Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurence Katz & TREKK Network; and Dr. Susan Duffy, Dr. Vera Feuer & EIIC Network

Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurenc...

Bottom Line Recommendations for screening and assessment of suicide risk. September 2021, Version 1.0

Bottom Line Recommendations for screening and assessment of suicide risk. September 2021, Version 1.0

Evidence Repository: Suicidal Risk Screening and Assessment

Evidence Repository: Suicidal Risk Screening and Assessment

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Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurence Katz, Dr. Susan Duffy, Dr. Vera Feuer

Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurenc...

Recommandations de Base: Risque suicidaire: Dépistage & évaluation  (2022)

Recommandations de Base: Risque suicidaire: Dépistage & évaluation

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Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurence Katz & TREKK Network; and Dr. Susan Duffy, Dr. Vera Feuer & EIIC Network

Dr. Matthew Morrissette, Dr. Amanda Newton, Dr. Stephen Freedman, Dr. Laurenc...

Bottom line recommendations for screening and assessment of suicide risk. March 2022. Version 1.0

Bottom line recommendations for screening and assessment of suicide risk. March 2022. Version 1.0

Clinical guidelines

NICE guideline: feverish illness in children--assessment and initial management in children younger than 5 years.  (2013)

NICE guideline: feverish illness in children--assessment and initial management in children younger than 5 years.

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Davis T.

Davis T.

The National Institute for Health and Care Excellence (NICE) guideline for feverish illness in children (assessment and initial management in children younger than 5years) was partially updated in May 2013.1 Not all sections were reviewed, but the following were: the signs and symptoms of serious illness; the predictive value of tachycardia; the use of inflammatory markers; and the role of paracetamol and ibuprofen. The aim of the guideline is to optimise the management of young children with fever, and in particular to guide health professionals to recognise the signs of serious infection. The update made new recommendations based on current evidence. This guideline was developed by the National Collaborating Centre for Women's and Children's Health. They worked with the Guideline Development Group to review the evidence and write the recommendations.

The National Institute for Health and Care Excellence (NICE) guideline for feverish illness in children (assessment and initial management in children younger than 5years) was partially updated in May 2013.1 Not all sections were reviewed, but the following were: the signs and symptoms of serious illness; the predictive value of tachycardia; the use of inflammatory markers; and the role of paracetamol and ibuprofen. The aim of the guideline is to optimise the management of young children with fever, and in particular to guide health professionals to recognise the signs of serious infection. The update made new recommendations based on current evidence. This guideline was developed by the National Collaborating Centre for Women's and Children's Health. They worked with the Guideline Development Group to review the evidence and write the recommendations.

Systematic reviews

Fever in under 5s: assessment and initial management.  (2019)

Fever in under 5s: assessment and initial management.

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National Institute for Health and Care Excellence (NICE)

National Institute for Health and Care Excellence (NICE)

This guideline covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care. This guideline should be read in conjunction with the NICE guidelines on sepsis, neonatal infection, meningitis (bacterial) and meningococcal septicaemia in under 16s, urinary tract infection in under 16s, diarrhoea and vomiting caused by gastroenteritis in under 5s and antimicrobial prescribing for common infections.

This guideline covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care. This guideline should be read in conjunction with the NICE guidelines on sepsis, neonatal infection, meningitis (bacterial) and meningococcal septicaemia in under 16s, urinary tract infection in under 16s, diarrhoea and vomiting caused by gastroenteritis in under 5s and antimicrobial prescribing for common infections.

Cochrane Systematic Review: Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children

Cochrane Systematic Review: Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children

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Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B.

Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B.

Objectives: To assess the effectiveness and safety of palivizumab prophylaxis compared with placebo, or another type of prophylaxis, in reducing the risk of complications (hospitalisation due to RSV infection) in high-risk infants and children. To assess the cost-effectiveness (or cost-utility) of palivizumab prophylaxis compared with no prophylaxis in infants and children in different risk groups.

Objectives: To assess the effectiveness and safety of palivizumab prophylaxis compared with placebo, or another type of prophylaxis, in reducing the risk of complications (hospitalisation due to RSV infection) in high-risk infants and children. To assess the cost-effectiveness (or cost-utility) of palivizumab prophylaxis compared with no prophylaxis in infants and children in different risk groups.

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

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

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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.

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.

Systematic Review: Meta-analysis to Determine Risk for Serious Bacterial Infection in Febrile Outpatient Neonates With RSV Infection  (2016)

Systematic Review: Meta-analysis to Determine Risk for Serious Bacterial Infection in Febrile Outpatient Neonates With RSV Infection

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Bonadio W, Huang F, Nateson S, Okpalaji C, Kodsi A, Sokolovsky S, Homel P

Bonadio W, Huang F, Nateson S, Okpalaji C, Kodsi A, Sokolovsky S, Homel P

This study aimed to analyze a large group of febrile neonates 28 days or younger who received outpatient sepsis evaluation and nasopharyngeal aspirate antigen testing (NPAT) for respiratory syncytial viral (RSV) infection to determine whether there is a clinically significant association between viral study results and risk for serious bacterial infection (SBI: bacterial meningitis, bacteremia, urinary tract infection, bacterial enteritis).

This study aimed to analyze a large group of febrile neonates 28 days or younger who received outpatient sepsis evaluation and nasopharyngeal aspirate antigen testing (NPAT) for respiratory syncytial viral (RSV) infection to determine whether there is a clinically significant association between viral study results and risk for serious bacterial infection (SBI: bacterial meningitis, bacteremia, urinary tract infection, bacterial enteritis).

Risk stratification and management of the febrile young child.  (2013)

Risk stratification and management of the febrile young child.

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Ishimine P.

Ishimine P.

Febrile young children present frequently to the emergency department. While most febrile children recover uneventfully, certain subgroups are at higher risk of serious infection. Febrile neonates require extensive diagnostic testing, antibiotic therapy, and hospital admission. Diagnostic testing can be utilized in older patients to identify children at low risk and high risk for serious infection. This information may assist in determining the treatment and disposition of these febrile children.

Febrile young children present frequently to the emergency department. While most febrile children recover uneventfully, certain subgroups are at higher risk of serious infection. Febrile neonates require extensive diagnostic testing, antibiotic therapy, and hospital admission. Diagnostic testing can be utilized in older patients to identify children at low risk and high risk for serious infection. This information may assist in determining the treatment and disposition of these febrile children.

Key studies

Key Study: Introduction of a simple guideline to improve neurological assessment in paediatric patients presenting with upper limb fractures  (2016)

Key Study: Introduction of a simple guideline to improve neurological assessment in paediatric patients presenting with upper limb fractures

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Marsh AG, Robertson JS, Godman A, Boyle J, Huntley JS

Marsh AG, Robertson JS, Godman A, Boyle J, Huntley JS

This study aimed to assess the improvement in documented neurological examination for children presenting with upper limb fractures following introduction of a simple guideline.

This study aimed to assess the improvement in documented neurological examination for children presenting with upper limb fractures following introduction of a simple guideline.

Key Study: Effect of the low risk ankle rule on the frequency of radiography in children with ankle injuries  (2013)

Key Study: Effect of the low risk ankle rule on the frequency of radiography in children with ankle injuries

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Boutis, K, Grootendorst, P, Willan, A, Plint, AC, Babyn, P, Brison, RJ, Sayal, A, Parker, M, Mamen, N, Schuh, S, Grimshaw, J, Johnson, D & Narayanan, U

Boutis, K, Grootendorst, P, Willan, A, Plint, AC, Babyn, P, Brison, RJ, Sayal...

Objective: To evaluate the effectivness of the Low Risk Ankle Rule in reducing the frequency of radiography in children with ankle injuries.

Objective: To evaluate the effectivness of the Low Risk Ankle Rule in reducing the frequency of radiography in children with ankle injuries.

Key Study: Functional outcome after air-stirrup ankle brace or fiberglass backslab for pediatric low-risk ankle fractures: a randomized observer-blinded controlled trial  (2012)

Key Study: Functional outcome after air-stirrup ankle brace or fiberglass backslab for pediatric low-risk ankle fractures: a randomized observer-blinded controlled trial

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Barnett, PL, Lee, MH, Oh, L, Cull, G & Babl, F

Barnett, PL, Lee, MH, Oh, L, Cull, G & Babl, F

Objective: To determine if the below-knee fiberglass posterior splint was as effective as the Air-Stirrup ankle brace in returning children with a low risk ankle fracture to their normal level of activity.

Objective: To determine if the below-knee fiberglass posterior splint was as effective as the Air-Stirrup ankle brace in returning children with a low risk ankle fracture to their normal level of activity.

Key Study: A randomized, controlled trial of a removable brace versus casting in children with low-risk ankle fractures  (2007)

Key Study: A randomized, controlled trial of a removable brace versus casting in children with low-risk ankle fractures

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Boutis, K, Willan, AR, Babyn, P, Narayanan, UG, Alman, B & Schuh, S

Boutis, K, Willan, AR, Babyn, P, Narayanan, UG, Alman, B & Schuh, S

Objective: To determine whether children who have low-risk ankle fractures that are treated with a removable ankle brace have at least as effective a recovery of physical function as those that are treated with a cast.

Objective: To determine whether children who have low-risk ankle fractures that are treated with a removable ankle brace have at least as effective a recovery of physical function as those that are treated with a cast.

Key Study: Cost Consequence Analysis of Implementing the Low Risk Ankle Rule in Emergency Departments  (2015)

Key Study: Cost Consequence Analysis of Implementing the Low Risk Ankle Rule in Emergency Departments

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Boutis, K, von Keyserlingk, C, Willan, A, Narayanan, UG, Brison, R, Grootendorst, P, Plint AC, Parker, M & Goeree, R

Boutis, K, von Keyserlingk, C, Willan, A, Narayanan, UG, Brison, R, Grootendo...

Objective: To examine the costs and consequences of implementing the Low Risk Ankle Rule.

Objective: To examine the costs and consequences of implementing the Low Risk Ankle Rule.

Key Study: Obesity Increases Risk of Loss of Reduction after Casting for Diaphyseal Fractures of the Radius and Ulna in Children: An Observational Cohort Study  (2017)

Key Study: Obesity Increases Risk of Loss of Reduction after Casting for Diaphyseal Fractures of the Radius and Ulna in Children: An Observational Cohort Study

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DeFrancesco CJ, Rogers BH, Shah AS

DeFrancesco CJ, Rogers BH, Shah AS

The objective of this study was to determine if high body mass index increases the risk of loss of reduction following closed reduction and casting for displaced concomitant fractures of the radial and ulnar shafts in pediatric patients.

The objective of this study was to determine if high body mass index increases the risk of loss of reduction following closed reduction and casting for displaced concomitant fractures of the radial and ulnar shafts in pediatric patients.

Key Study: Childhood Obesity Increases the Risk of Failure in the Treatment of Distal Forearm Fractures  (2016)

Key Study: Childhood Obesity Increases the Risk of Failure in the Treatment of Distal Forearm Fractures

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Auer RT, Mazzone P, Robinson L, Nyland J, Chan G

Auer RT, Mazzone P, Robinson L, Nyland J, Chan G

A retrospective case-controlled study was conducted to determine whether obesity is an independent risk factor for the failure of closed reduction and casting.

A retrospective case-controlled study was conducted to determine whether obesity is an independent risk factor for the failure of closed reduction and casting.

Key Study: The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants  (2017)

Key Study: The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants

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Nigrovic LE, Mahajan PV, Blumberg SM, Browne LR, Linakis JG, Ruddy RM, Bennett JE, Rogers AJ, Tzimenatos L, Powell EC, Alpern ER, Casper TC, Ramilo O, Kupper...

Nigrovic LE, Mahajan PV, Blumberg SM, Browne LR, Linakis JG, Ruddy RM, Bennet...

The objectives of this study were to assess the performance of the Yale Observation Scale score and unstructured clinician suspicion to identify febrile infants 60 days of age with and without serious bacterial infections.

The objectives of this study were to assess the performance of the Yale Observation Scale score and unstructured clinician suspicion to identify febrile infants 60 days of age with and without serious bacterial infections.

Prospective evaluation of the risk of serious bacterial infection in children who present to the emergency department with hyperpyrexia (temperature of 106 degrees F or higher).  (2006)

Prospective evaluation of the risk of serious bacterial infection in children who present to the emergency department with hyperpyrexia (temperature of 106 degrees F or higher).

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Trautner BW, Caviness AC, Gerlacher GR, Demmler G, Macias CG.

Trautner BW, Caviness AC, Gerlacher GR, Demmler G, Macias CG.

The purpose of this study was to determine (1) the risk of serious bacterial infection in children with hyperpyrexia and (2) whether clinical presentation can identify hyperpyrexic patients at risk for serious bacterial infection.

The purpose of this study was to determine (1) the risk of serious bacterial infection in children with hyperpyrexia and (2) whether clinical presentation can identify hyperpyrexic patients at risk for serious bacterial infection.

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TREKKing Through Friendly Manitoba

May 23, 2014, 9:38 am to 9:38 am  | Blog  | Team: News and Events 


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TREKK update from Terry Klassen

Mar 21, 2013, 11:23 am to 12:30 pm  | Blog  | Team: News and Events 
Tags: Emergency Medicine, Evidence-Based Medicine, Pediatrics, Research


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New Resource- Suicidal Risk Screening & Assessment

Posted: Oct 14, 2021  | Announcement  | Team: News and Events 
Tags: Suicidal Risk Assessment


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February is Psychology Month

Posted: Feb 01, 2023  | Announcement  | Team: News and Events 


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September 10th is World Suicide Prevention Day.

Posted: Sep 08, 2023  | Announcement  | Team: News and Events 


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New study: Do IV Fluids affect risk of Cerebral Edema in DKA?

Posted: Jun 18, 2018  | Announcement  | Team: News and Events 


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New Bottom Line Recommendations: Urinary Tract Information

Posted: Aug 20, 2019  | Announcement  | Team: News and Events 


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Predicting the duration of post-concussion symptoms

Posted: Mar 10, 2016  | Announcement  | Team: News and Events 


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Needs Assessment Guidelines and Updates

Posted: Dec 21, 2011  | Project  | Team: Needs Assessment  


view 23 more matching info pages

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TREKK Needs Assessment publication in CJEM

Posted: Jan 23, 2017  | Announcement  | Team: News and Events 


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Pediatric Respiratory Assessment Measure (PRAM) App

Posted: Dec 08, 2015  | Announcement  | Team: News and Events 


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MyHEARTSMAP- Mental Health Self Assessment Tool  (External Event )

Posted: Jan 11, 2022  | Announcement  | Team: News and Events 
Tags: Mental Health, MyHEARTSMAP


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Blog Series

Posted: Mar 12, 2013  | Series  | Team: News and Events 


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A summer project to find online resources

Posted: Jun 24, 2013  | Blog  | Team: News and Events 


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New Bottom Line Recommendation: Anaphylaxis

Posted: Sep 10, 2018  | Announcement  | Team: News and Events 


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Podcast: Pediatric Procedural Sedation

Posted: Feb 09, 2016  | Announcement  | Team: News and Events 
Tags: Procedural Sedation, Procedural Pain


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New Resources for Multisystem Trauma

Posted: Jul 14, 2020  | Announcement  | Team: News and Events 


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Canadian Anaphylaxis Action Plan for Kids

Posted: Feb 25, 2019  | Announcement  | Team: News and Events 


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Building a connection: TREKK and NENA

Posted: Jun 30, 2015  | Blog  | Team: News and Events 


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New PedsPac!

Posted: Jan 31, 2019  | Announcement  | Team: News and Events 


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A qualitative ‘TREKK’ across Newfoundland

Posted: Oct 29, 2013  | Blog  | Team: News and Events 
Tags: Research


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New PedsPacs!

Posted: Dec 20, 2018  | Announcement  | Team: News and Events 


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Brain Awareness Week

Posted: Mar 15, 2021  | Announcement  | Team: News and Events 


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Webinar: Mobilizing knowledge to improve pediatric health care

Posted: Mar 29, 2016  | Announcement  | Team: News and Events 



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