Dear CHIFA colleagues,
'Delayed recognition of deterioration is one of the most common contributing factors to preventable deaths in children presenting to hospital', says a paper in the current issue of The Lancet Child and Adolescent Health.
SUMMARY:
'Caregiver concern for clinical deterioration is associated with critical illness in paediatric patients and, after adjusting for variables including abnormal vital signs, had a strong association with ICU admission and mechanical ventilation. Rapid response systems should incorporate proactive assessment of parent or caregiver concerns for deterioration.'
CITATION: Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study
Mills, Erin et al.
The Lancet Child & Adolescent Health, Volume 9, Issue 7, 450 - 458
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(25)00098-7/fulltext
The study was in Australia and involved 73,845 children with eligible emergency department presentations.
COMMENT (NPW): On HIFA and CHIFA we have previously noted that '8 in 10 caregivers in developing countries do not know the two key symptoms of childhood pneumonia - fast and difficult breathing - which indicate the need for urgent treatment (only 1 in 3 children with pneumonia receive antibiotics - despite wide availability - and 800,000 consequently die each year) [ https://www.hifa.org/about-hifa/why-hifa-needed ]. It would be interesting to see the results of studies in other countries. Meanwhile, the authors of the current study say 'a parent or caregiver's concern that their child is “just not right” should always be taken seriously'. It would seem important to heed this warning in any setting.
CHIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org