Profile of paediatric mental health presentations to Australian emergency departments in 2018.

Objectives: Paediatric mental health presentations to emergency departments (EDs) are rising. Rural/Regional mental health service users face structural barriers to accessing general and specialist treatment, including physical distance and local service capacity and funding constraints. However, differences in patient characteristics and treatment pathways between major city and rural/regional EDs remain unclear.

Computed Tomography Scan Rates and Outcomes in Children Risk-Stratified Using the PREDICT Guideline Algorithm for Risk Stratification of Mild and Moderate Head Injuries.

Objective: Since 2021, the PREDICT Guideline for Mild to Moderate Head Injuries in Children has been widely implemented across Australia and New Zealand. We set out to describe the application of the guideline's risk stratification using an existing database.

Methods: Secondary analysis of a large multicentre prospective data set of paediatric patients with head injuries.

Risk Factors for Severe Bronchiolitis in Australian and Aotearoa New Zealand Infants: A Systematic Review.

Aim: Bronchiolitis is the leading cause of hospital admission in Australasian infants. Infants with risk factors for severe disease may have a greater likelihood of prolonged hospitalisation and intensive care admission. This study aimed to synthesise the literature on risk factors for severe bronchiolitis in Australasian infants.

Australasian Bronchiolitis Guideline: 2025 Update.

Aim: To provide updated evidence-based clinical guidance in the management of infants with bronchiolitis presenting to emergency departments (EDs), general paediatric, or intensive care units (ICUs) in Australia and Aotearoa New Zealand (AoNZ) following the first publication in 2016.

Method: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) network guideline working group appraised, summarised, and updated evidence from 1 January 2000 to 24 January 2024 addressing 41 questions (30 from the 2016 guideline and 11 new questions for 2025). Recommendations were developed using GRADE methodology and revised after a period of external consultation.

Methodology of the Updated and Expanded Australasian Bronchiolitis Guideline.

Background: Bronchiolitis is the most common reason for hospital admission in infants in Australia and Aotearoa New Zealand (AoNZ), with care historically affected by practice variation, including use of ineffective therapies. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) developed the first Australasian (Australia, AoNZ) bronchiolitis guideline in 2016, providing evidence-based guidance on the management of infants (< 12 months of age), presenting or admitted to hospital with bronchiolitis. In 2022, PREDICT initiated a guideline update to include new evidence and expand the scope to include intensive care (up to intubation), management of SARS-CoV-2 co-infection, and respiratory syncytial virus prevention.

Agreement between face-to-face and photograph and video assessments in children with Bell's palsy: secondary analysis of a randomised controlled trial.

Objective: Bell's palsy is a sudden unilateral weakness of the facial muscles due to idiopathic lower motor neuron palsy of cranial nerve VII. We set out to determine the level of agreement in the severity of facial palsy based on the House-Brackmann scale between face-to-face assessment by clinicians, and independent clinician assessment of photographs and videos.

Design: Secondary analysis of children enrolled in a triple blind, randomised controlled trial assessing recovery rates following steroid treatment versus placebo for Bell's palsy who had photographs and videos recorded initially and at subsequent reviews.

Validation and Comparison of Pediatric Appendicitis Scores and Management Strategies (Project SPASMS): Protocol for a Prospective Multicenter Observational Study.

Background: Abdominal pain is a common reason for children to attend the Emergency Department (ED) with acute appendicitis being the most common surgical cause. Various clinical prediction scores (CPSs) have been developed to assist in determining the risk of appendicitis; however, CPSs have been inadequately validated in children and haphazardly adopted in Australia and New Zealand (ANZ) EDs.

Objective: This study aims to compare and validate various CPSs for diagnosing pediatric appendicitis in children presenting to ANZ EDs.

Clinical Debriefing Characteristics in Australian and New Zealand Paediatric Emergency Departments: A PREDICT Study Revisited.

Objective: Clinical debriefing (CD) in emergency medicine improves team performance and patient care outcomes. Its use in Australian and New Zealand paediatric emergency departments (PED) was first described in 2009. We aimed to delineate changes in CD over 15 years and explore the barriers and enablers.

Prospective observational study to assess the performance accuracy of clinical decision rules in children presenting to emergency departments with possible cervical spine injuries: the Study of Neck Injuries in Children (SONIC).

Introduction: Paediatric cervical spine injury (CSI) is uncommon but can have devastating consequences. Many children, however, present to emergency departments (EDs) for the assessment of possible CSI. While imaging can be used to determine the presence of injuries, these tests are not without risks and costs, including exposure to radiation and associated life-time cancer risks.

Paediatric Emergency Department Mental Health and Behavioural Presentations in Australia Before and After the Onset of the COVID-19 Pandemic: Retrospective Observational Study.

Objectives: Although child and adolescent mental health and behavioural presentations to hospital emergency departments (EDs) increased during the first 2 years of the COVID-19 pandemic (2020 and 2021), little is known about the characteristics of these presentations. We aimed to compare demographic, clinical and psychosocial profiles of paediatric presentations to Australian EDs before and after the onset of the pandemic.

Methods: We conducted a retrospective observational study of 100 randomly sampled presentations by children (6-11-year-olds) and adolescents (12-17-year-olds) to 10 Australian EDs between 1 January and 31 December 2019 (pre-COVID-19) and 1 January and 31 December 2021 (COVID-19).

External Validation of the Phoenix Sepsis Score in Children With Suspected Community-Acquired Sepsis.

Importance: The novel Phoenix Sepsis Score and sepsis criteria were derived and validated using a multicountry dataset and proposed as a new definition for sepsis in children.

Objective: To externally validate the Phoenix Sepsis Score and sepsis criteria in a cohort of children hospitalized with suspected community-acquired sepsis.

Design, Setting, And Participants: This diagnostic study used data from the multicenter, multicountry Sepsis Epidemiology in Australian and New Zealand Emergency Departments (SENTINEL) study, collected from 2021 to 2023 and including 90-day follow-up.

Parent Attitudes to Research Without Prior Consent in Two Pediatric Emergency Clinical Trials in Australia: A Qualitative Study of Transcripts From 2017.

Objectives: Research in critically ill children poses challenges in acquiring prospective informed consent. International ethical guidelines generally have provisions to perform research without prior consent (RWPC) in circumstances where consent is not feasible, but there is a paucity of data regarding the community acceptance of this process. The objectives of the current study were to explore the attitudes and experiences of parents of children enrolled into trials to determine understanding and acceptability of RWPC to parents of children involved.

International Consensus Definition of 'Sport & Exercise' in Toddlers and Young Children, Children, and Adolescents.

Aim: The study aim was to develop an age-appropriate definition of sport and exercise in children and adolescents for use in concussion research and management.

Methods: A modified Delphi methodology, with three rounds and consensus defined a priori as ≥ 80% agreement.

Results: Thirty-one participants (13 male, 18 female) from 13 countries, including clinical psychologists, epidemiologists, implementation scientists, neurologists, neuropsychologists, neurosurgeons, paediatric emergency physicians, paediatricians, physiotherapists, rehabilitation physicians, speech-language pathologists, and sports medicine physicians came to a consensus that sport-related paediatric concussion extends beyond the sporting arena, and includes the school yard, playground, park, street, recreational site, and home; excludes non-accidental violence, assault, and passenger vehicle road trauma; may include falls; and age-group terminology includes Toddlers and Young Children (1-4 years), Children (5-12 years), and Adolescents (13 to < 18 years).

PEAChY-O: Pharmacological Emergency Management of Agitation in Children and Young People: A Randomized Controlled Trial of Oral Medication.

Study Objective: To determine whether oral olanzapine or oral diazepam was more effective at achieving behavioral containment for young people presenting to the emergency department with acute severe behavioral disturbance.

Methods: We conducted an open-label, multicenter, randomized controlled trial from October 22, 2021, to November 6, 2023. We enrolled young people aged between 9 and 17 years with acute severe behavioral disturbance deemed to require oral medication across 9 Australian emergency departments.

Consensus outcomes between health professionals and parents for oral corticosteroids in treating preschool wheeze: a multi-national survey and nominal group technique study.

Objective: To obtain priority consensus for outcome measures of oral corticosteroid treatment of preschool wheeze that represent stakeholder groups.

Design: (1) A systematic review to identify a set of outcome measures; (2) an international survey for healthcare professionals (HCPs) and a nominal group meeting with parents; (3) a final consensus nominal group meeting with key HCPs (trial investigators and paediatric emergency medicine clinicians) and the same parent group.

Main Outcome Measures: Consensus priority of treatment outcome measures, outcome minimal clinically important differences (MCIDs) and level of concerns about adverse effects.

Impact of time to antibiotics on clinical outcome in paediatric febrile neutropenia: a target trial emulation of 1685 episodes.

Background: Prompt antibiotic administration for febrile neutropenia (FN) is standard of care, and targets of time to antibiotics (TTA) <60 min are common. We sought to determine the effect of TTA ≥60 versus <60 min on adverse outcomes (intensive care unit (ICU) admission or death) in children with cancer and FN. Effect modification by a decision rule that predicts infection (AUS-rule) and bacteraemia were also investigated.

Study of pediatric appendicitis scores and management strategies: A prospective observational feasibility study.

Objective: The objective was to investigate the feasibility of prospectively validating multiple clinical prediction scores (CPSs) for pediatric appendicitis in an Australian pediatric emergency department (ED).

Methods: A literature search was conducted to identify potential CPSs and a single-center prospective observational feasibility study was performed between November 2022 and May 2023 to evaluate the performance of identified CPSs. Children 5-15 years presenting with acute right-sided or generalized abdominal pain and clinician suspicion of appendicitis were included.

Assessing the predictors for paediatric intensive care unit for inter-hospital transfer patients on high-flow nasal cannula or continuous positive airway pressure ventilation at a tertiary Australian paediatric hospital.

Objective: The aim of the present study was to assess the predictors of need for paediatric intensive care unit (PICU) admission for inter-hospital transfer patients to a tertiary paediatric hospital ED on high flow (HF) or continuous positive airway pressure (CPAP) ventilation.

Methods: Single-centre retrospective study of patients transferred to the state's tertiary paediatric hospital. Demographic information and disease management information was obtained.

Pediatric sport and nonsport concussions presenting to emergency departments: injury circumstances, characteristics, and clinical management.

Objective: The aim of this study was to compare injury circumstances, characteristics, and clinical management of emergency department (ED) presentations for sports-related concussion (SRC) and non-SRC.

Methods: This multicenter prospective observational study identified patients 5-17 years old who presented to EDs within 24 hours of head injury, with one or more signs or symptoms of concussion. Participants had a Glasgow Coma Scale score of 13-15 and no abnormalities on CT (if performed).

Appraisal of Australian and New Zealand paediatric sepsis guidelines.

Objective: Clinical practice guidelines (CPGs) are an important tool for the management of children with sepsis. The quality, consistency and concordance of Australian and New Zealand (ANZ) childhood sepsis CPGs with the Australian Commission on Safety and Quality in Healthcare (ACSQHC) sepsis clinical care standards and international sepsis guidelines is unclear.

Methods: We accessed childhood sepsis CPGs for all ANZ states and territories through Paediatric Research in Emergency Departments International Collaborative members.

Facial Function in Bell Palsy in a Cohort of Children Randomized to Prednisolone or Placebo 12 Months After Diagnosis.

Background: Information on the medium-term recovery of children with Bell palsy or acute idiopathic lower motor neuron facial paralysis is limited.

Methods: We followed up children aged 6 months to <18 years with Bell palsy for 12 months after completion of a randomized trial on the use of prednisolone. We assessed facial function using the clinician-administered House-Brackmann scale and the modified parent-administered House-Brackmann scale.

Pragmatic Adaptive Trial for Respiratory Infection in Children (PATRIC) Clinical Registry protocol.

Introduction: Acute respiratory infections (ARI) are the most common cause of paediatric hospitalisation. There is an urgent need to address ongoing critical knowledge gaps in ARI management. The Pragmatic Adaptive Trial for Respiratory Infections in Children (PATRIC) Clinical Registry will evaluate current treatments and outcomes for ARI in a variety of paediatric patient groups.