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Titolo:
An evidence and consensus based guideline for acute diarrhoea management
Autore:
Armon, K; Stephenson, T; MacFaul, R; Eccleston, P; Werneke, U;
Indirizzi:
Univ Nottingham, Sch Human Dev, Acad Div Child Hlth, Nottingham NG7 2UH, England Univ Nottingham Nottingham England NG7 2UH , Nottingham NG7 2UH, England Pinderfields Gen Hosp, Wakefield, England Pinderfields Gen Hosp Wakefield England ds Gen Hosp, Wakefield, England Maudsley Hosp, London SE5 8AZ, England Maudsley Hosp London England SE5 8AZ dsley Hosp, London SE5 8AZ, England
Titolo Testata:
ARCHIVES OF DISEASE IN CHILDHOOD
fascicolo: 2, volume: 85, anno: 2001,
pagine: 132 - 141
SICI:
0003-9888(200108)85:2<132:AEACBG>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
ORAL REHYDRATION THERAPY; INTRAVENOUS REHYDRATION; BACTERIAL DIARRHEA; YOUNG-CHILDREN; UNITED-STATES; ROTAVIRUS GASTROENTERITIS; CHILDHOOD GASTROENTERITIS; HOSPITAL ADMISSIONS; CLINICAL-FEATURES; DEHYDRATION;
Keywords:
diarrhoea; gastroenteritis; Delphi consensus; guideline;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
69
Recensione:
Indirizzi per estratti:
Indirizzo: Armon, K Univ Nottingham, Sch Human Dev, Acad Div Child Hlth, Nottingham NG7 2UH, England Univ Nottingham Nottingham England NG7 2UH ham NG7 2UH, England
Citazione:
K. Armon et al., "An evidence and consensus based guideline for acute diarrhoea management", ARCH DIS CH, 85(2), 2001, pp. 132-141

Abstract

Objective-To develop an evidence and consensus based guideline for the management of the child who presents to hospital with diarrhoea (with or without vomiting), a common problem representing 16% of all paediatric medical attenders at an accident and emergency department. Clinical assessment, investigations (biochemistry and stool culture in particular), admission, and treatment are addressed. The guideline aims to aid junior doctors in recognising children who need admission for observation and treatment and those who may safely go home. Evidence-A systematic review of the literature was performed. Selected articles were appraised, graded, and synthesised qualitatively. Statements on recommendation were generated. Consensus-An anonymous, postal Delphi consensus process was used. A panel of 39 selected medical and nursing staff were asked to grade their agreement with the generated statements. They were sent the papers, appraisals, andliterature review. On the second and third rounds they were asked to re-grade their agreement in the light of other panellists' responses. Consensus was predefined as 83% of panellists agreeing with the statement. Recommendations-Clinical signs useful in assessment of level of dehydration were agreed. Admission to a paediatric facility is advised for children who show signs of dehydration. For those with mild to moderate dehydration, estimated deficit is replaced over four hours with oral rehydration solution (glucose based, 200-250 mOsm/l) given "little and often". A nasogastric tube should be used if fluid is refused and normal feeds started following rehydration. Children at high risk of dehydration should be observed to ensure at least maintenance fluid is tolerated. Management of more severe dehydration is detailed. Antidiarrhoeal medication is not indicated. Validation-The guideline has been successfully implemented and evaluated in a paediatric accident and emergency department.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 11:57:19