Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion

被引:4
|
作者
Lillitos, Peter J. [1 ,2 ]
Lyttle, Mark D. [3 ,4 ]
Roland, Damian [5 ,6 ]
Powell, Colin V. E. [7 ,8 ]
Sandell, Julian [9 ]
Rowland, Andrew G. [10 ,11 ]
Chapman, Susan M. [12 ,13 ]
Maconochie, Ian K. [2 ,14 ]
机构
[1] Royal Hosp Sick Children, Acute Receiving Unit, Edinburgh EH9 1LF, Midlothian, Scotland
[2] Imperial Coll NHS Trust, Dept Paediat Emergency Med, London, England
[3] Bristol Royal Hosp Children, Paediat Emergency Dept, Bristol, Avon, England
[4] Univ West England, Acad Dept Emergency Care, Bristol, Avon, England
[5] Univ Leicester, SAPPHIRE Grp, Dept Hlth Sci, Leicester, Leics, England
[6] Univ Hosp Leicester NHS Trust, Paediat Emergency Med Leicester Acad PEMLA Grp, Childrens Emergency Dept, Leicester, Leics, England
[7] Cardiff Univ, Sch Med, Cardiff, S Glam, Wales
[8] Sidra Med, Dept Emergency Med, Doha, Al Rayyan, Qatar
[9] Poole Hosp NHS Trust, Dept Paediat, Poole, Dorset, England
[10] Univ Salford, Sch Hlth & Soc, Salford, Lancs, England
[11] Pennine Acute Hosp NHS Trust, North Manchester Gen Hosp, Emergency Dept, Manchester, Lancs, England
[12] Great Ormond St Hosp Sick Children, Gulf Reg Off, London, England
[13] UCL Great Ormond St Inst Child Hlth, London, England
[14] Imperial Coll London, Fac Med, London, England
关键词
EARLY WARNING SYSTEMS; TRIGGER SYSTEMS; CHILDREN; DELPHI; PEWS;
D O I
10.1136/emermed-2018-207802
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist. Objectives To establish standardised significant illness endpoints for use in determining the performance accuracy of PEWS and safety systems in emergency departments (ED), using a consensus of expert opinion in the UK and Ireland. Design Between July 2017 and February 2018, three online Delphi rounds established a consensus on 'significant' clinical conditions, derived from a list of common childhood illness/injury ED presentations. Conditions warranting acute hospital admission in the opinion of the respondent were defined as 'significant', using a 5-point Likert scale. The consensus was a priori >= 80% (positive or negative). 258 clinical conditions were tested. Participants and settings Eligible participants were consultants in acute or EM paediatrics, or adult EM, accessed via 53 PERUKI (Paediatric Emergency Research in the UK and Ireland)'s research collaborative sites, and 27 GAPRUKI (General and Adolescent Paediatric Research in the UK and Ireland)'s sites, 17 of which overlap with PERUKI. Main outcome measures To create a list of conditions regarded as 'significant'with >= 80% expert consensus. Results 43 (68%) of 63 PERUKI and GAPRUKI sites responded; 295 experts were invited to participate. Participants in rounds 1, 2 and 3 were 223 (76%), 177 (60%) and 148 (50%), respectively; 154 conditions reached positive consensus as 'significant'; 1 condition reached a negative consensus (uncomplicated Henoch-Schonlein purpura); and 37 conditions achieved nonconsensus. Conclusions A list of significant childhood conditions has been created using UK and Irish expert consensus, for research purposes, for the first time. This will be used as the benchmark endpoint list for future research into PEWS/safety systems performance in EDs.
引用
收藏
页码:685 / 690
页数:6
相关论文
共 50 条
  • [1] Hyperkalemia management in the emergency department: An expert panel consensus
    Rafique, Zubaid
    Peacock, Frank
    Armstead, Terra
    Bischof, Jason J.
    Hudson, Joanna
    Weir, Matthew R.
    Neuenschwander, James
    JOURNAL OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS OPEN, 2021, 2 (05)
  • [2] Clinical and Genetic Evaluation of People with or at Risk of Hereditary ATTR Amyloidosis: An Expert Opinion and Consensus on Best Practice in Ireland and the UK
    Gillmore, Julian D.
    Reilly, Mary M.
    Coats, Caroline J.
    Cooper, Rob
    Cox, Helen
    Coyne, Mark R. E.
    Green, Andrew J.
    McGowan, Ruth
    Moody, William E.
    Hawkins, Philip N.
    ADVANCES IN THERAPY, 2022, 39 (06) : 2292 - 2301
  • [3] Clinical and Genetic Evaluation of People with or at Risk of Hereditary ATTR Amyloidosis: An Expert Opinion and Consensus on Best Practice in Ireland and the UK
    Julian D. Gillmore
    Mary M. Reilly
    Caroline J. Coats
    Rob Cooper
    Helen Cox
    Mark R. E. Coyne
    Andrew J. Green
    Ruth McGowan
    William E. Moody
    Philip N. Hawkins
    Advances in Therapy, 2022, 39 : 2292 - 2301
  • [4] The Taxonomy of Emergency Department Consultations-Results of an Expert Consensus Panel
    Kessler, Chad S.
    Asrow, Alexandra
    Beach, Christopher
    Cheung, Dickson
    Fairbanks, Rollin J.
    Lammers, John C.
    Tibbles, Carrie
    Wears, Robert
    Woods, Robert
    Schuur, Jeremiah D.
    ANNALS OF EMERGENCY MEDICINE, 2013, 61 (02) : 161 - 166
  • [5] Establishing an expert opinion framework for lung volume reduction in Ireland: a Delphi consensus technique
    Mulryan, Kathryn
    Sorensen, Jan
    Redmond, Karen
    IRISH JOURNAL OF MEDICAL SCIENCE, 2024, 193 (02) : 843 - 849
  • [6] Establishing an expert opinion framework for lung volume reduction in Ireland: a Delphi consensus technique
    Kathryn Mulryan
    Jan Sorensen
    Karen Redmond
    Irish Journal of Medical Science (1971 -), 2024, 193 : 843 - 849
  • [7] DIAGNOSIS AND MANAGEMENT OF BILE ACID DIARRHOEA: UK CONSENSUS SURVEY OF EXPERT OPINION AND PRACTICE
    Walters, Julian
    Arasaradnam, Ramesh
    Andreyev, Jervoise
    GUT, 2019, 68 : A169 - A169
  • [8] Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa
    Broccoli, Morgan C.
    Moresky, Rachel
    Dixon, Julia
    Muya, Ivy
    Taubman, Cara
    Wallis, Lee A.
    Hynes, Emilie J. Calvello
    BMJ GLOBAL HEALTH, 2018, 3 (01):
  • [9] Definition of the bed-guiding ward in an emergency department: expert consensus statements for clinical acute and emergency medicine
    Michels, Guido
    Wrede, Christian
    Busch, Hans-Joerg
    Brachmann, Matthias
    Pin, Martin
    Dormann, Harald
    Moeckel, Martin
    Dodt, Christoph
    NOTFALL & RETTUNGSMEDIZIN, 2023, 26 (05): : 326 - 330
  • [10] Emergency Department visits for mild traumatic brain injury in early childhood
    Rose, S.
    Levine, D.
    Shi, J.
    Wheeler, K.
    Stanley, R.
    Beauchamp, M.
    ANNALS OF NEUROLOGY, 2022, 92 : S185 - S186