Paediatrics

Pertussis Infection in Children QIP: Raising Awareness Amongst Clinicians (2025)

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Type of publication:

Conference abstract

Author(s):

*Khallaf L.; *Muniu S.; *Sakremath R.; *Lee S.

Citation:

Archives of Disease in Childhood. Conference: Royal College of Paediatrics and Child Health Conference, RCPCH 2025. Glasgow United Kingdom. 110(Supplement 1) (pp A301-A302), 2025. Date of Publication: 01 Jun 2025.

Abstract:

Why did you do this work? Pertussis is a highly infectious preventable disease caused by Bordetella pertussis. Young infants under 3 months of age remain at the highest risk of severe disease with 9 reported infant deaths this year in the United Kingdom.1 We aim to raise awareness about pertussis infection among clinicians in our Paediatric Department through education. What did you do? Educational sessions were delivered from February to March 2024. Data was collected using pre- and post-session questionnaires to assess clinician's knowledge. The questionnaire included symptoms, signs, management and complications of pertussis infection. A teaching presentation was given in the first cycle. In the second cycle, an informative poster was displayed throughout our department. Data was collected and analysed using Microsoft Excel. The effectiveness of the education tool delivered was evaluated. What did you find? There were 11 participants in the first cycle and 9 in the second cycle. All participants in cycle 1 understood pertussis infection and its complications and recognised the importance of exclusion from nursery/school. In cycle 2, all demonstrated knowledge of pertussis symptoms and knew it was a notifiable disease. In the first cycle, many participants, 63% (7 out of 11 participants), were unaware of the process for requesting a pertussis test in our department, which improved slightly to 55% (5 out of 9 participants) in the second cycle. Additionally, the rate of incorrect responses decreased between cycles for several topics: the incubation period of pertussis (54.5% in cycle 1 versus 33% in cycle 2), the appropriate timing for requesting the test (18% versus 11%), and knowledge of first-line antibiotics (36% versus 22%). The rate of incorrect responses increased between cycle 1 and cycle 2, rising from 27% to 33% for the need of prophylaxis treatment and 27% to 44% for the exclusion of asymptomatic contacts. Despite interventions, knowledge of the latter showed no improvement between the two cycles. Following cycle 1, significant improvements were noted, with 100% correct responses for how to request a pertussis test, appropriate timing for ordering the tests, and the incubation period. Both cycles demonstrated improvement as all participants knew the first-line antibiotic treatment for pertussis. What does it mean? Although our sample size was small, our project showed that the overall knowledge of our clinicians improved in the 2 cycles. Ongoing education is needed to improve awareness of pertussis infection, especially during the winter months.

DOI: 10.1136/archdischild-2025-rcpch.413

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Magnet ingestion in children in the United Kingdom: a national prospective observational surveillance study (2025)

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Type of publication:

Journal article

Author(s):

Neville J.J.; Lyttle M.D.; Messahel S.; Parkar S.; Mytton J.; Hall N.J.; Brooker H.; Varnam R.; Putt-Willis D.; Smith M.; Smith L.; Yusuf I.; Dean N.; Patel D.; Rahman M.; Vooght E.; Parveen R.; Shirley-Mansell L.; Cresner R.; Cromarty T.; Broomfield R.; Bayreuther J.; Bethell G.; Major C.; Barling J.; Wilson V.; Maney J.; Wilson K.; Ratnaraj D.; Divakaran D.; Hickey J.; Ranasinghe D.; Foster A.; Martin B.; Walker R.; Jones C.; Soans E.; Monk A.; Rahman A.; Tambudze K.; Hopgood D.; Downes A.; Nasreen T.; Preskey S.; Long J.; Adamson J.; Henderson R.; Andreassen H.; Chadwick H.L.; Towart G.; Abdelhafiz K.; O'Connor E.; Carlyle D.; Tubman L.; Wallace K.; Mohamed A.; Siner S.; Fissler S.; Mcleish S.; Tolhurst-Cleaver M.; Fletcher S.; Russell M.; Winrow K.; Taylor J.; Armitage A.; Geoghegan K.; Buckle R.; Wood S.; Tremarco L.; Collins V.; Egginton D.; Simpson G.; Dowsett S.; Djendow F.; Jarman H.; Edyta K.; Dotchin M.; Potter S.; Kamaraj K.; Fagelnor A.; Dadnam C.; Shafiq A.; Lewis S.; Zarifa I.; Craigie R.; Aldridge P.; Veeraragavan N.; Haslam Z.; Carney A.; Rimmer G.; Jones S.; Richardson S.; Riddick L.; McCourt E.; Azad-Karim A.; Quigley K.; Yassin S.; Merrick V.; Salter R.; Yoshida R.; Bass J.; Vincent E.; Healy C.; Jones E.; Ball E.; Azam A.; Ryan E.; Bedoya S.; Keers S.; Blaney E.; Peacock P.; Hartshorn S.; Cash V.; Snelson E.; Coles V.; Stacey A.; Zuhairy S.; Chandler L.; Pinedo J.; Bradley A.; Gate V.; *Sanlon N.; *Juttiga U.; *Marsh A.; *Okeke C.; *Ali N.; Ramlakhan S.; Subramanian T.; Haffenden V.; Obire J.; Hartin D.; Darlow N.; Beeby D.; Francis R.; Basu S.; Saxena A.; Jeropoulos R.; Hegan A.; Browning J.; Craven E.; Foster S.;

Citation:

Archives of Disease in Childhood. (no pagination), 2025. Article Number: archdischild-2024-328195. Date of Publication: 2025. [epub ahead of print]

Abstract:

Objective: Magnet ingestion in children and young people (CYP) is associated with significant harm. We aimed to describe the incidence, circumstances and outcomes of magnet ingestion in CYP in the United Kingdom (UK). Design(s): Prospective multicentre observational surveillance study. <br/>Setting(s): UK secondary and tertiary level hospitals in urban and rural settings. Patient(s): CYP <=16 years of age who ingested >=1 magnet. Intervention(s): Data were collected regarding demographics, circumstances surrounding ingestion, clinical features and management. The primary outcome was the incidence of magnet ingestion in the UK. Result(s): Between 1 May 2022 and 30 April 2023, 366 cases of magnet ingestion were recorded, of which 314 met eligibility (median age 8.7 years (IQR 5.1-12.0)). The incidence of magnet ingestion in the UK was at least 2.4/100 000 (95% CI 2.2 to 2.7) CYP per year. CYP sourced magnets from toys (38%), and magnet products were predominantly purchased by parents or caregivers (19%). Magnet-related injuries occurred in 23 (7%) cases, and surgery was undertaken in 32 (10%). Single magnet ingestions did not cause magnet-related injury. Swallowing greater numbers of magnets associated with an increased risk of injury (OR 1.1 (95% CI 1.0 to 1.2), p=0.002). CYP were asymptomatic in 75% of cases, but clinical features on presentation were associated with an increased risk of injury (OR 3.8 (95% CI 1.4 to 10.3), p=0.008). Conclusion(s): While magnet ingestion in children is uncommon, ingestion of multiple magnets can cause injuries requiring surgery. Greater public and clinician awareness of the associated risks is warranted. This study can inform public health interventions and evidence-based guidelines.

DOI: 10.1136/archdischild-2024-328195

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Glycerol intoxication syndrome in young children, following the consumption of slush ice drinks (2025)

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Type of publication:

Journal article

Author(s):

Brothwell, Shona Lc; Fitzsimons, Patricia E; Gerrard, Adam; Schwahn, Bernd C; Stockdale, Christopher; Bowron, Ann; Anderson, Mark; Hart, Claire E; Hannah, Romanie; Ritchie, Francesca; *Deshpande, Sanjeev A; Sreekantam, Srividya; Watts, Gemma; Yap, Sufin; Mundy, Helen; Veiraiah, Aravindan; Collins, Abigail; Cozens, Alison; Morris, Andrew A; Crushell, Ellen.

Citation:

Archives of Disease in Childhood. 2025 Mar 11. [epub ahead of print]

Abstract:

INTRODUCTION: Slush ice drinks are commonly available refreshments, aimed at children and young people. Glycerol is used to maintain the slush effect in the absence of a high sugar content.

OBJECTIVE: To describe a series of children who became acutely unwell shortly after consuming a slush ice drink; their presentation mimics specific inherited metabolic diseases (IMDs).

METHODS: A retrospective case review of 21 children who presented to centres across the UK and Ireland from 2009 through 2024 was carried out.

RESULTS: Almost all of the children (93%) became unwell within 60 min of slush ice drink consumption. None had any relevant past medical history. The median age at presentation was 3 years 6 months (range 2 years – 6 years 9 months). Presenting features include acute decrease in consciousness (94%), hypoglycaemia (95%), metabolic (lactic) acidosis (94%), pseudohypertriglyceridaemia (89%) and hypokalaemia (75%). Glyceroluria was present in all acute urine organic acid samples. No underlying IMD was found in the 14 patients who underwent further enzymatic or genetic testing. The majority (95%) subsequently avoided slush ice drinks and did not have reoccurrence.

CONCLUSION: Consumption of slush ice drinks containing glycerol may cause a clinical syndrome of glycerol intoxication in young children, characterised by decreased consciousness, hypoglycaemia, lactic acidosis, pseudohypertriglyceridaemia and hypokalaemia. This mimics inherited disorders of gluconeogenesis and glycerol metabolism. Clinicians and parents should be alert to the phenomenon, and public health bodies should ensure clear messaging regarding the fact that younger children,
especially those under 8 years of age, should avoid slush ice drinks containing glycerol.

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Evaluating the lasting effects of teaching sudden unexpected death in infancy and childhood (SUDIC) through simulation (2023)

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Type of publication:Conference abstract

Author(s):Layman S.; Beatty C.; Williams C.; *Belfitt A.; Copeman A.

Citation:Archives of Disease in Childhood. Conference: Royal College of Paediatrics and Child Health Conference, RCPCH 2023. Glasgow United Kingdom. 108(Supplement 2) (pp A276-A277), 2023. Date of Publication: July 2023.

Abstract:Objectives Paediatricians play a vital role in managing and facilitating investigations in sudden unexpected death in infancy or childhood (SUDIC). SUDIC is a rare occurrence, and many paediatric trainees and consultants have very little experience of the process. The SUDIC simulation course was created due to recommendations by The Kennedy Report. The aim of the course was to bridge the gap between knowledge and clinical experience for senior paediatric trainees and consultants in the West Midlands in managing SUDIC. To assess the longevity of learning from the course, a survey was disseminated to all previous candidates. Its aim was to understand how important the simulation course had been in improving paediatricians' confidence and understanding of the SUDIC process when they were involved in a SUDIC after attending the course. Methods Candidate sign-in sheets were retrospectively reviewed for the 17 SUDIC courses run since January 2016. 195 previous candidates were invited to complete a survey via email. Our aim was to evaluate how the course had impacted subsequent experience of the SUDIC process. Specific questions were included to assess how confident candidates had been in various roles in the SUDIC process using a combination of multiple-choice, free-text, and Likert scales. Results 43% of respondents had been a senior paediatric registrar when they attended. Other candidates were consultants, nurses, or more junior paediatricians. 43% had attended between 1-5 SUDIC events since the course, with 4% having attended more than 10. 47% had been involved in examining the body. 40% involved in an unsuccessful resuscitation and SUDIC investigations, and 43% explained the SUDIC process to bereaved parents. 100% agreed that the course had improved their confidence in explaining the SUDIC process, taking a SUDIC history and performing SUDIC investigations. 94% felt confident in contributing to the child death process with 89% feeling confident in examining the body. Candidates particularly valued the multi-professional approach to the course, especially working with police officers. With further thematic analysis of free text responses, candidates most often reported lasting benefits to supporting and communicating with the family, and understanding the practicalities of the SUDIC process. Conclusion Participation in a SUDIC simulation course is an important educational experience, which continues to be relevant to participants and their clinical practice many years after they have attended. Our survey suggests that simulation-based education is an excellent modality to facilitate learning around the SUDIC process for paediatricians and other health professionals involved.

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Improved efficiency and safety ED Paediatric Storeroom (2022)

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Type of publication:
Service improvement case study

Author(s):
*Abi Kelly (Sister) and *Pauline Roberts (Housekeeper)

Citation:
SaTH Improvement Hub, September 2022

Abstract:
The ED Paediatric is a new facility and the storeroom is small and requires 5s intervention as the storeroom is often cluttered, making it difficult to maintain IPC standards, while at the same time, maintaining a safe working environment. To be successful, it will be necessary to involve EDC operators, HCAs, Nursing Staff and Housekeepers.

Link to PDF poster [no password required]

Improve completion of Fluid and Solid balance charts in Paediatrics PRH (2023)

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Type of publication:
Service improvement case study

Author(s):
*Aisha Noor (FY1) *Farhah Anuar (FY1)

Citation:
SaTH Improvement Hub, March 2023

Abstract:
To improve completion of Fluid balance charts for Paediatric patients at PRH by 30% by 06th May 2023.

Link to PDF poster [no password required]