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Damian Roland Profile picture
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Jun 30 • 3 tweets • 1 min read
First abstract

Should 16-17 year olds be cared for in paediatric or adult emergency departments?

Thorny question which we should have been grappling with long before COVID!

In this study from Kings they involved Young People in answering this question...

#RCPCH22
16 and 17 years would like more signposting and care navigation.

They would like staff to support their basic needs better

Data from Kings suggest they get a faster decision in a Children’s ED with an increased chance of being discharged.

#RCPCH22
Interesting show of hands on question: “do you give young people a choice?”

Only spattering of arms going up in a full room

#RCPCH22

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More from @Damian_Roland

Damian Roland Profile picture
Oct 1, 2021
Time for a Bronchiolitis round up courtesy of @UKHSA

[Bronchiolitis is caused by a virus called RSV]

The international data has very interesting implications for us!

Remember you can follow #Bronchstart study data here: beta.microreact.org/project/cTkH24…

@PERUKItweep @MyMicroreact
So USA saw a sharp increase for 3-4 weeks followed by a subsequent decrease in detections.
Peak was similar to 2019 season however began in May (c.f. normal September-October).
Increase sustained until early September 2021, a longer peak than the previous year. Image
Canada has had an increase in number of RSV positive tests than usual for the same time period (grey dash is 6 year average)

This is in keeping with decreased immunity (children not exposed in 2020) along with the current increase in social mixing. ImageImage
Read 9 tweets
Damian Roland Profile picture
Feb 25, 2021
Now good evidence to back up the worldwide reports of out-of-season surges of bronchiolitis.

This should cause significant reflection in the UK paediatric community as rapid service response may be needed at a time when staff in a traditional summer 'down time'

/thread
In November 2020 the Western Australian surveillance programme demonstrated a rapid rise in respiratory syncytial virus (RSV) cases.

RSV causes bronchiolitis, a common respiratory infection, in children less than one year old.

This was interesting as case numbers were not only occurring in the summer (unusual as it is normally a winter illness) but also at a much greater frequency (up to double normal seasonal levels)

The reasons for this aren't clear but was thought to be a rebound effect of lockdown
Read 7 tweets
Damian Roland Profile picture
Jan 3, 2021
The SAGE Children’s Task and Finish Group: update to 4th Nov 2020 paper on children & schools is used a lot to justify shutting schools.

assets.publishing.service.gov.uk/government/upl…

This isn’t what document suggests but highlights the challenges that current exist.

It’s not black and white.
Worth noting that teachers no more at risk (at time of publication) than other professions.
But also that 12-16 and 17- 24 had higher positive rates.

There is widespread geographical variation. This makes it difficult to apply a one size fits all solution.
Read 4 tweets
Damian Roland Profile picture
Jan 2, 2021
Do my level best not to propagate mis-information - which this from @bbc5live definitely is- but now this tweet has had over 1 million views I think important all in child health make absolutely clear we are not seeing a nationwide wave of #COVID19 induced illness in children.
And apologies to Laura Duffel as this is aimed directly at @bbc5live who have placed no context on this statement, I suspect knowing it would be likely to raise eyebrows.

Exactly everything we don’t need from journalism at present.
And to be crystal clear, the tweet was worded as to be technically correct. This is what frustrates me most.

The lack of a second, or linked tweet, highlighting the correct context demonstrates to me this was being deliberately provocative.
Read 4 tweets
Damian Roland Profile picture
Jun 27, 2020
There has been justifiable concern about the impact of #COVID19, and particularly the lockdown, on children.

Our @LancetChildAdol paper evaluates delayed presentations to Emergency Departments (and it's not what you think)

thelancet.com/journals/lanch…

/Thread
Early reports from Italy highlighted significant concern with children presenting late to hospital and coming to harm.

It's important to note in some of these cases advice not to present had come from previous contact with medical professionals

thelancet.com/journals/lanch…
Anecodote and early reports in the UK supported this but it's important to recognise there is no definition of delayed presentation

There is no gold standard to suggest when a parent should bring a child to hospital
Read 15 tweets

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