October 2024 Update

As we enter the most challenging period of the year for acute respiratory illness, we wish to share with you the simple summary of the guidelines and what research and audit has taught us, both locally, regionally and internationally.

Most children can be managed conservatively at home provided they are feeding, maintaining a reasonable urine output and having saturations in the ranges mentioned. Most patients do not require a CXR ,blood gases or any form of nebulised treatment, and oral antibiotics .

The HIGH RISK GROUPS are the ones we need to concentrate about particularly the population less than three months, those presenting with apneas or comorbidities like Chronic Lung Disease, Cardiac Disease, Muscle Disease and Trisomy 21.
Monitoring Saturation, Heart Rate and severity of recession much more useful than CXR .
As part of Antimicrobial stewardship, resist the temptation to use antibiotics, particularly if apyrexial, ask for senior review .

If we need to improve care we need to work as a collaborative across Primary Care, Paediatric A&E, Secondary Care, to avoid congestion due to inappropriate referral.