Advanced paediatric life support, 3rd edn: Advanced Life Support Group. (pound25). BMJ Books, 2001. ISBN 0-7279-1554-1

Ferguson, J.

doi:10.1136/emj.19.2.186

Cited by 3 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Common clinical cut-offs were used for continuous data where possible (high temperature >37.8°C) 23 and were age-related if appropriate (age-specific heart and respiratory rates and blood pressure). 24 UK guidelines for low oxygen saturation level (≤95%) were used. 25 Given the large number of variables, continuous variables were dichotomised using 25 th or 75 th percentile cut-offs as appropriate.…”

Section: Methodsmentioning

confidence: 99%

Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study

Redmond

Turnbull²,

Stuart

et al. 2018

Br J Gen Pract

View full text Add to dashboard Cite

BackgroundClinicians commonly prescribe antibiotics to prevent major adverse outcomes in children presenting in primary care with cough and respiratory symptoms, despite limited meaningful evidence of impact on these outcomes.AimTo estimate the effect of children’s antibiotic prescribing on adverse outcomes within 30 days of initial consultation.Design and settingSecondary analysis of 8320 children in a multicentre prospective cohort study, aged 3 months to <16 years, presenting in primary care across England with acute cough and other respiratory symptoms.MethodBaseline clinical characteristics and antibiotic prescribing data were collected, and generalised linear models were used to estimate the effect of antibiotic prescribing on adverse outcomes within 30 days (subsequent hospitalisations and reconsultation for deterioration), controlling for clustering and clinicians’ propensity to prescribe antibiotics.ResultsSixty-five (0.8%) children were hospitalised and 350 (4%) reconsulted for deterioration. Clinicians prescribed immediate and delayed antibiotics to 2313 (28%) and 771 (9%), respectively. Compared with no antibiotics, there was no clear evidence that antibiotics reduced hospitalisations (immediate antibiotic risk ratio [RR] 0.83, 95% confidence interval [CI] = 0.47 to 1.45; delayed RR 0.70, 95% CI = 0.26 to 1.90, overall P = 0.44). There was evidence that delayed (rather than immediate) antibiotics reduced reconsultations for deterioration (immediate RR 0.82, 95% CI = 0.65 to 1.07; delayed RR 0.55, 95% CI = 0.34 to 0.88, overall P = 0.024).ConclusionMost children presenting with acute cough and respiratory symptoms in primary care are not at risk of hospitalisation, and antibiotics may not reduce the risk. If an antibiotic is considered, a delayed antibiotic prescription may be preferable as it is likely to reduce reconsultation for deterioration.

show abstract

Section: Methodsmentioning

confidence: 99%

Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study

Redmond

Turnbull²,

Stuart

et al. 2018

Br J Gen Pract

View full text Add to dashboard Cite

show abstract

“…This pragmatic cut-off was chosen prior to analysis to avoid severity variables with very low prevalence. We used accepted clinical cut offs (temperature > 37.8 °C, [ 23 ] capillary refill time (CRT) ≥3 s, [ 24 , 25 ] oxygen saturation ≤ 95% [ 26 ]) or 25th percentile or 75th percentile thresholds to dichotomise continuous data, and we used age-adjusted thresholds for heart and respiratory rates [ 27 ]. Given the large number of variables being tested, continuous outcomes were initially categorised to help interpret and contextualise the final model, a sensitivity analysis was then conducted to assess the distribution of these continuous variables if included in the model.…”

Section: Methodsmentioning

confidence: 99%

What gives rise to clinician gut feeling, its influence on management decisions and its prognostic value for children with RTI in primary care: a prospective cohort study

et al. 2018

View full text Add to dashboard Cite

BackgroundThe objectives were to identify 1) the clinician and child characteristics associated with; 2) clinical management decisions following from, and; 3) the prognostic value of; a clinician’s ‘gut feeling something is wrong’ for children presenting to primary care with acute cough and respiratory tract infection (RTI).MethodsMulticentre prospective cohort study where 518 primary care clinicians across 244 general practices in England assessed 8394 children aged ≥3 months and < 16 years for acute cough and RTI. The main outcome measures were: Self-reported clinician ‘gut feeling’; clinician management decisions (antibiotic prescribing, referral for acute admission); and child’s prognosis (reconsultation with evidence of illness deterioration, hospital admission in the 30 days following recruitment).ResultsClinician years since qualification, parent reported symptoms (illness severity score ≥ 7/10, severe fever < 24 h, low energy, shortness of breath) and clinical examination findings (crackles/ crepitations on chest auscultation, recession, pallor, bronchial breathing, wheeze, temperature ≥ 37.8 °C, tachypnoea and inflamed pharynx) independently contributed towards a clinician ‘gut feeling that something was wrong’. ‘Gut feeling’ was independently associated with increased antibiotic prescribing and referral for secondary care assessment. After adjustment for other associated factors, gut feeling was not associated with reconsultations or hospital admissions.ConclusionsClinicians were more likely to report a gut feeling something is wrong, when they were more experienced or when children were more unwell. Gut feeling is independently and strongly associated with antibiotic prescribing and referral to secondary care, but not with two indicators of poor child health.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0716-7) contains supplementary material, which is available to authorized users.

show abstract

Status epilepticus with fever: how common is meningitis?

Kneen

2005

Archives of Disease in Childhood

View full text Add to dashboard Cite

Advanced paediatric life support, 3rd edn: Advanced Life Support Group. (pound25). BMJ Books, 2001. ISBN 0-7279-1554-1

Cited by 3 publications

References 0 publications

Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study

Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study

What gives rise to clinician gut feeling, its influence on management decisions and its prognostic value for children with RTI in primary care: a prospective cohort study

Status epilepticus with fever: how common is meningitis?

Contact Info

Product

Resources

About