The differential diagnosis of hypernatraemia in children, with ...

More documents

Recommendations

Info

The Diagnosis of Salt Poisoning Leading to Hypematraemia in Children – September 2009 6. Error by professional 7. Side effect of treatment initiated by patient 8. Side effect of treatment initiated by parent 9. Side effect of treatment initiated by other 10. Side effect of treatment initiated by professional 11. Side effect of treatment, unclear by whom initiated 12. Side effect of a medical condition The peer reviewers were also given the option of specifying any other category not in this list. Peer reviewers were identified as either having experience in salt handling, or in child protection, or both. Each case report was peer reviewed by at least two reviewers, one with expertise in salt handling and the other in child protection. The one case report of accidental ingestion of salt by two very young children was given to all peer reviewers, together with a case report of voluntary salt ingestion by an adult. Altogether 60 cases of either accidental or non-accidental salt poisoning in children where there was any information on the individual child were subjected to peer review. The largest case series 3 of 12 children with non-accidental salt poisoning had to be excluded from peer review, as it was not possible except in one case (which was also reported separately) 13 to identify information on each individual child. Peer reviewers were permitted to seek the views of colleagues if they wished, but not to confer with the other peer reviewers of their cases. Each peer reviewed case where the authors concluded the cause was child abuse was also ranked using the Cardiff group’s rankings above. The comparisons are: Cardiff ranking category 1 (8 cases): • both peer reviewers agreed beyond reasonable doubt in 3 cases; • both peer reviewers agreed, one on balance of probability & the other beyond reasonable doubt in 4 cases; • one agreed beyond reasonable doubt, the other did not feel able to tell, in 1 case. Cardiff ranking category 2 (5 cases): • both peer reviewers agreed, one on balance of probability & the other beyond reasonable doubt in 1 case; • both peer reviewers agreed on the balance of probability in 2 cases; • one agreed on balance of probability, the other did not feel able to tell, in 2 cases. 21
The Diagnosis of Salt Poisoning Leading to Hypematraemia in Children – September 2009 The Cardiff ranking system could not be applied to the cases where child abuse was not considered by the authors to be the cause of the hypernatraemia. The peer reviewed findings of each individual case are reported in sections 4.2 and 4.4. Where the peer reviewer’s opinions differ, this is made clear in the text. Consultation A draft of the guideline was circulated to the organisations and individuals listed at the beginning of the document. Their responses were incorporated into the guideline where appropriate. Updating It is hoped that the document will be updated in approximately 2-3 years time from date of publication by the College’s Science and Research Department. In the meantime, the College would welcome feedback from users of the guideline as to how useful it was. Comments can be submitted to clinical.effectiveness@rcpch.ac.uk. 22
Page 1 and 2: The Differential Diagnosis of Hyper
Page 3 and 4: The Diagnosis of Salt Poisoning Lea
Page 27: The Diagnosis of Salt Poisoning Lea
Page 79 and 80:
The Diagnosis of Salt Poisoning Lea
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
show all

The differential diagnosis of hypernatraemia in children, with ...

Create successful ePaper yourself

Delete template?

Save as template?