damianroland.bsky.social - Profile | ThreadSky | a Reddit-style client for Bluesky

My latest publication on how poor SIRS sepsis screening criteria are in Children (modelled on the CAP-IT pneumonia study) Hopefully there is now enough for @NICEComms to re-consider its decision to not review Sepsis guidance for < 16 years journals.lww.com/pidj/fulltex... #Sepsis

submitted 3 days ago • 0 comments

In children a procalcitonin (PCT) guided algorithm didn't reduce iv antibiotic duration treatment & is non-inferior to usual care. ⚠️ Evidence doesn't support use of PCT algorithms where effective paediatric antibiotic stewardship programmes are established ⚠️ www.sciencedirect.com/science/arti...

submitted 11 days ago • 0 comments

Safety Netting in primary care: Managing the low incidence, high uncertainty of severe illness bjgp.org/content/bjgp... (follow up to "Safety netting in the consultation" www.bmj.com/content/378/...) I'm not a GP (but was written with GPs) Vomiting point applies in ED as well!

submitted 22 days ago • 0 comments

Our latest BronchSTART publication! "Maternal views on RSV vaccination during the first season of implementation in England & Scotland" Significant difference in vaccinated & unvaccinated groups in perceptions of access to the vaccine. www.thelancet.com/journals/lan...

submitted 24 days ago • 0 comments

This is a fascinating study of how patient flow gets discussed and addressed in hospital operations management meetings.

submitted 25 days ago • 0 comments

Large ⬆️in children & young people admitted to acute medical wards for mental health concerns over a 10-year period Further work needed to factors driving these trends and how to improve care for CYP with mental health concerns admitted to medical wards www.sciencedirect.com/science/arti...

submitted 31 days ago • 0 comments

How do staff work in NHS hospital operations management meetings to support resilience in everyday service delivery? A qualitative study Results perhaps not unexpected but perhaps a structure to allow feedback, assessment & improvement.... link.springer.com/article/10.1... #Qcommunity

submitted 33 days ago • 0 comments

Fantastic article by Dr. Rachel Jenner et al. I’m been guilty of the adultification of young people in whom I’ve managed as older than the child they are. Safeguarding, vulnerability and mental health issues make this a very complex area with no easy answers. adc.bmj.com/content/earl...

submitted 43 days ago • 0 comments

Great post on Likelihood Ratios by St.Emlyns www.stemlynsblog.org/podcast-like... Challenge is we don’t write guidance (local or national) with LR in mind. Cinician may entirely appropriately not treat for tonsillitis via LR but can be criticised if poor outcome as guidance only binary.

submitted 43 days ago • 0 comments

So after a winter break the @UKHSA data feed is back! Some good news: Influenza (flu) may have peaked Some pause for thought: Admission rates not falling rapidly #FLU

submitted 45 days ago • 1 comment

Great advice from a pediatrician that also applies when working with adult patients and in any leadership situation.

submitted 49 days ago • 2 comments

Observation is an investigation My #DFTB23 Keynote talk. Spoiler: The decision to observe needs to be an active one, not just a process to avoid making a decision. www.youtube.com/watch?v=wtIw...

submitted 51 days ago • 1 comment

Cold versus the Flu youtube.com/shorts/mB5lE...

submitted 52 days ago • 0 comments

Theory of Mind issues mean that explaining the same thing repeatedly i.e. “Let me look at your hand” …won’t help because their framework for understanding differs from yours. Need to is emphasise the importance of linking actions to logic dontforgetthebubbles.com/communic8-ei...

submitted 53 days ago • 0 comments

Knowing WHICH patients will respond to an inflated latex glove is THE skill (the skill is not that you can blow up a latex glove and make it into a chicken) dontforgetthebubbles.com/communic8-ei...

submitted 53 days ago • 0 comments

My New Years Blog 2024/25 Communic8: Eight Universal Leadership Lessons from the Children’s Emergency Department dontforgetthebubbles.com/communic8-ei...

submitted 54 days ago • 0 comments

Too much made of airline versus hospital safety comparisons but aviation can get it very wrong too Always two sides to every story but to forget passengers AND also not remove their luggage like taking wrong person to theatre but still doing wrong site surgery… www.bbc.co.uk/news/article...

submitted 56 days ago • 1 comment

This seemed like a lifetime ago…

submitted 61 days ago • 0 comments

So #RSV definitely out of 'surge' - both in relation to positivity and admission rates. Just note the 80 and over rates though - I suspect this contributes to the significant winter pressures for Adults in January. But what about #Flu...

submitted 63 days ago • 1 comment

Great #paperinapic

submitted 65 days ago • 0 comments

"Early warning scores: a system designed in a hospital ward is unlikely to work in general practice" www.bmj.com/content/387/... My short response to a recent (well designed) study showing application of a inpatient chart in primary care doesn't really show any meaningful benefit.

submitted 69 days ago • 0 comments

Many thanks to @dennisrenmd.bsky.social for inviting me to speak on the PHOENIX score for the Skeptics' Guide to Emergency Medicine! thesgem.com/2024/12/sgem...

submitted 69 days ago • 1 comment

Sepsis Alert! #SGEMPeds returns tomorrow with a new episode on the Phoenix Criteria. Tune in for a great episode because we have some special guests joining us...https://buff.ly/3ZBIqpO #EBM #FOAMed #PedSky #MedSky #EMedSky #ICUSky @thesgem.bsky.social @damianroland.bsky.social

submitted 72 days ago • 1 comment

So bad news for #RSV 2024/25 it's not quite met the dizzy heights of 2019/20... ....great news for everyone working in acute and emergency care though! #bronchiolitis

submitted 73 days ago • 1 comment

Acknowledging every winter feels worse than the last - interesting data to support anecdote that it feels tougher than normal out there. RSV not only peaking to record levels (still incredible how closely it is tracking 2019) but does seem more virulent this year Hopefully will peak ? next week 🤞

submitted 78 days ago • 1 comment

These are very useful... Children & Young Persons: Advice & Guidance templates Helpful Vade Mecum for simple management strategies (Constipation and Eczema examples but many other in the document) HT @rcpch.bsky.social view.officeapps.live.com/op/view.aspx...

submitted 78 days ago • 1 comment

Does #RSV feel just that little more vexatious this year? Or is it your memory playing tricks on you... Actually might be the former! www.gov.uk/government/s... (and still not at peak compared to 2019 yet) 🙄

submitted 82 days ago • 1 comment

Thank you Lucy! @lSUPP0RTrights.bsky.social is an amazing programme of work www.isupportchildrensrights.com Worth a look for any department undertaking interventions on children and young people

submitted 85 days ago • 0 comments

Nice piece by @apsmunro on the divisive term 'immunity debt' & our recent paper looking at ED attendances across Europe. alasdairmunro.substack.com/p/what-is-im... "Surge of Pediatric Respiratory Tract Infections after the COVID19 Pandemic" www.sciencedirect.com/science/arti... 👀 look at UTIs 👀

submitted 86 days ago • 0 comments

Deadline extended to 9am, 4th Dec. Applications welcome from docs, nurses or AHPs who care for adults with learning disability as part of their regular work. Fully funded places available, but might be last year of funding, so a good time to apply! #MedSky #FOAMed www.rcp.ac.uk/events-and-e...

submitted 89 days ago • 0 comments

Why does it need to have #sky in it or have I missed a principle of how hashtags work here? We’ll never resolve the American/English linguistic issue so personally think #childhealth is a broad church to fit everything into But ultimately I think the solution will just emerge from the CoP…

submitted 91 days ago • 1 comment

👇 I hadn’t realised. It is disappointing not to include children’s voices in the consultation. Their views are important and do matter. How can we ensure they are represented? change.nhs.uk/en-GB/

submitted 91 days ago • 0 comments

Talking on how I think decision making since #COVID19 has altered in Paediatric Emergency Medicine next week at Excellence in Paediatrics (eip-pediatrics-conference.ineip.org) Nearly 5 years on have we reset completely or is expectation management in healthcare altered forever? Thoughts #PEMSky?

submitted 91 days ago • 2 comments

Lower cost, more comfort, makes sense.

submitted 95 days ago • 0 comments

Hey UK Health Security Agency - data from the national flu and COVID19 surveillance reports is amazing www.gov.uk/government/s... BUT I can't marry the data presented for 2024/25 with that from 2023/24 Shouldn't the positivity rates for 2019/20 be the same in both?

submitted 92 days ago • 0 comments

"Healthy Children are a generation of prevention" HT Ellen Duke (NHS England CYP Nursing Lead) #NHS10yearplan

submitted 94 days ago • 0 comments

At a @NHS 10 Year plan event Disappointing to find the online portal isn't available to under 16s change.nhs.uk/en-GB/ If we are allowing children to access social media I think we should trust them to use a website...

submitted 94 days ago • 1 comment

Further evidence that in Paediatric Emergency Medicine it's that simple things that work "Buddy taping after reduction of displaced extra-articular phalangeal finger fractures in children: a randomized controlled trial" journals.sagepub.com/doi/full/10.... #PEMsky

submitted 95 days ago • 1 comment

So looks like it would be possible to create an emergency and acute paediatric feed on here bsky.app/feeds Any ideas on keywords and best way of curating it? Would be nice to create a new community of practice!

submitted 96 days ago • 1 comment