Background Western Australia (WA) public health measures to eradicate SARS‐CoV‐2 resulted in a secondary reduction in paediatric respiratory syncytial virus (RSV) admissions. Following an absent expected 2020 winter peak, RSV‐positive admissions surged during the summer of 2020. Aim This report examines the number of RSV‐positive admissions and severities across 36 months to better understand this out‐of‐season epidemic. Methods A retrospective observational study was performed assessing the number and severity of RSV‐related respiratory hospitalisations at a peripheral paediatric centre from March 2018 to February 2021. Data were extracted from the hospital clinical database. Results The total number of included participants was n = 294. The total number of RSV hospitalisations in SY (study year) 2018 (March 2018 to February 2019), SY 2019 (March 2019 to February 2020) and SY 2020 (March 2020 to February 2021) was 67, 98 and 129, respectively. Prior to SARS‐CoV‐2, RSV hospitalisations were highest during the winter months. In SY 2020, there were 0 RSV hospitalisations during winter, while 101 admissions in the following summer season. The proportion of admissions requiring respiratory support was significantly reduced in SY 2020 (34.1%) compared to SY 2018 (46.9%, P = 0.050) and SY 2019 (55.2%, P = 0.004). The median length of stay (LOS) in 2020 was 2.0 which was significantly reduced from 2018 and 2019 which was 3.0, P = 0.001; and 3.0, P < 0.001, respectively. Conclusion Following a period of RSV absence, there was an unprecedented surge in admission, however, with lower severity and shorter LOS.
ObjectivesThe top causes of adolescents’ mortality in Australia and worldwide are mostly preventable and many stem from psychosocial difficulties. The HEEADSSS screening is a widely accepted screening tool in assessing young people’s psychosocial wellbeing. This retrospective audit was done to evaluate the service implementation of an electronic-HEEADSSS (e-HEEADSSS) screening system in a regional hospital’s paediatric in-patient setting in Western Australia. The aim is to examine and compare the uptake rate of conventional HEEADSSS screening in 2018 and e-HEEADSSS screening in 2019, and to examine the relevant outcome and disclosure rate by the young person.MethodsThis retrospective audit (pre-post cross sectional study) is reported using the STROBE guideline. It was done over two different time frames: Pre e-HEEADSSS implementation (September–December 2018) and Post e-HEEADSSS implementation (September–December 2019). Inclusion criteria includes: All paediatric inpatients aged 12–16 years old. Exclusion criteria includes: Admission under other disciplines or clinically unstable/unsuitable patients. The uptake rate of conventional-HEEADSSS (2018) in comparison to e-HEEADSSS screening (2019) was examined. Other relevant data was extracted and analysed.ResultsThe sample size pre-implementation was 26 while post-implementation was 24. The uptake rate increased from 12% (conventional-HEEADSSS) to 54% (e-HEEADSSS), a 450% increment with the e-HEEADSSS system implementation (Fisher Exact Test, p=0.005). More than half of young people who completed their e-HEEADSSS screening had concerns/flags which required management by the clinicians. 86% of patients in the e-HEEADSSS group with concerns/flags were acted appropriately by the treating clinicians prior to discharge. The overall disclosure rate of e-HEEADSSS was 93% with highest disclosure rate for ‘Drugs’ domain.ConclusionsThere is significant increase in uptake rate with high disclosure rate using e-HEEADSSS screening device when compared to conventional HEEADSSS screening in the paediatric in-patient setting. The e-HEEADSSS is a better screening tool for in-patient setting and should be implemented widely.
Background: Sepsis is a major cause of mortality and morbidity in neonates. With the improvement in health care standards, the incidence of neonatal Early Onset Sepsis (EOS) has reduced significantly. A recent Web-based EOS-calculator has been introduced with the aim to reduce the use of IV antibiotics in neonates. The role of the EOS-calculator has yet to be ascertained in this regional Special Care Nursery (SCN) in Western Australia. This study aims at examining the local incidence of culture proven EOS and the role of the EOS calculator. Method: It is a retrospective study examining all newborns 35 weeks gestation throughout 2019 (JaneDec 2019) who received IV-antibiotics. The local incidence of culture-proven EOS was established and applied onto the EOS calculator. The recommended management by the EOS-calculator was cross-examined with the local EOS guideline. Overall proportion of reduction in IV antibiotics use was formulated. Other relevant laboratory data extracted was analysed with Pearson's correlation test with the EOS scores. Results: Total included sample was n Z 252 with an annual birth of 1880s indicating 13.4% of all neonates born throughout year 2019 was treated with IV antibiotics. The local incidence of culture-proven EOS was 0.5/1000. By applying the EOS-calculator, a significant reduction of IV antibiotics usage from 13.4% to 3.9% (z value 10.4, p < 0.0001) could be achieved in this cohort. Sixty three percent of neonates who received IV antibiotics in this cohort were classified as 'clinically well' based on the EOS-calculator. Conclusion:The EOS-calculator could reduce the use of IV antibiotics in the neonatal population significantly in this regional SCN (from 13.4% to 3.9%). Judicial use of IV antibiotics is
An extremely preterm infant is one born at less than 27 weeks’ gestation. Over time, survival rates in this population have improved. This cohort remains at high risk of mortality and life-long morbidity. The birth of extremely preterm infants is an important public health issue and one which concerns neonatologists, paediatricians, general practitioners and parents alike. This paper aims to provide guidance for the antenatal discussion between clinicians and expectant families and may serve as a template to facilitate open communication.
A 14-year-old adolescent was referred to a regional paediatric outpatient clinic with anosmia by her family doctor in Western Australia. The patient has no recollection of her previous ability to smell, suggesting the possibility of congenital anosmia. She was assessed in the paediatric outpatient clinic. A “noncontrast high-resolution MRI-brain scan with Anosmia-Protocol” was requested as the first-line investigation of choice by the treating paediatrician. The MRI was reported as “absence of olfactory tracts with preserved olfactory bulb volume.” We report an extremely rare case of “isolated agenesis of the olfactory tract with intact olfactory bulbs” and discuss the clinical approach in bedside assessment of isolated congenital anosmia (ICA). Congenital anosmia can be a presentation of olfactory bulb aplasia; however, little is known about isolated olfactory tract agenesis and its treatment options. The patient was counselled on the diagnosis and safety advice provided.
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