Paediatric emergency research is hampered by a number of barriers that can be overcome by a multicentre approach. In 2004, an Australia and New Zealand-based paediatric emergency research network was formed, the Paediatric Research in Emergency Departments International Collaborative (PREDICT). The founding sites include all major tertiary children's hospital EDs in Australia and New Zealand and a major mixed ED in Australia. PREDICT aims to provide leadership and infrastructure for multicentre research at the highest standard, facilitate collaboration between institutions, health-care providers and researchers and ultimately improve patient outcome. Initial network-wide projects have been determined. The present article describes the development of the network, its structure and future goals.

Objective: To compare the various paediatric weight estimation methods (Advanced Pediatric Life Support, Broselow Tape, Argall, and Best Guess) and parental estimate to measured weight. Patients and method: A convenience sample of children aged 1-11 years who presented to the emergency department over a 6 month period were eligible for inclusion. Data collected included height, age, ethnicity, parent estimate of weight and measured weight. Body mass index (BMI) was calculated. The outcome of interest was agreement between estimated weight and measured weight for each method. Data were analysed by descriptive statistics and performance of each weight estimation method was compared using mean difference (MD), root mean square error (RMSE) and agreement within 10%. Results: 410 cases were included in this study. The median age was 4 years, there were more boys (54.4%), and the majority of cases were of Caucasian ethnicity (74.9%). The mean BMI of the sample was 17 kg/m 2 and mean actual weight was 21.2 kg. Parent estimate was the most accurate method with 78% of parent estimates within 10% of measured weight and the lowest mean difference (20.6 kg) and RMSE (3.1 kg). The Broselow tape was the most accurate of the other methods, with 61% of estimations within 10% of measured weight. Conclusion: Parental estimation of weight is more accurate than the other weight estimation methods studied. When this is not available, the Broselow tape is the most accurate alternative method.

This is the first description of the epidemiology of patient presentations to major paediatric ED in Australia and New Zealand. It details baseline data important to future collaborative studies and for planning health services for children.

No abstract

Convulsive status epilepticus is an important neurological emergency, with many children experiencing prolonged seizures in both the prehospital and hospital phases. Persistent seizure activity beyond 40 minutes contrasts with current published guidelines. There is a need to adopt a widely accepted approach to the management of children who fail to respond to standard anticonvulsant therapy.

This prioritisation process has established a list of research questions, which will inform multicentre PEM research in Australia and New Zealand. It has also emphasised the importance of the translation of new knowledge.

CPG recommendations and reported physician practice for mild to moderate paediatric asthma management were broadly similar across PREDICT sites and consistent with national guidelines. Practice was highly variable for severe to critical asthma and probably reflects limitations of available evidence. Areas of controversy, in particular the comparative efficacy of intravenous bronchodilators, would benefit from multi-centre trials. Collaborative development of CPGs should be considered.

Medication was used for infants with bronchiolitis frequently and variably in Australia and New Zealand. Medication use increased with age. Better strategies for translating evidence into practice are needed.