Sharon O'Brien1,2, Meredith L Borland1,3, Elizabeth Cotterell4, David Armstrong5,6, Franz Babl7,8,9, Paul Bauert10, Christine Brabyn11, Lydia Garside12, Libby Haskell13, David Levitt14, Nicola McKay15, Jocelyn Neutze16, Andreas Schibler14,17,18, Kam Sinn19, Janine Spencer20, Helen Stevens21, David Thomas22, Michael Zhang23, Ed Oakley8,9,24,25, Stuart R Dalziel13,26,27. 1. Princess Margaret Hospital for Children, Perth, Western Australia, Australia. 2. School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia. 3. Divisions of Paediatric and Emergency Medicine, School of Medicine, University of Western Australia, Perth, Western Australia, Australia. 4. Department of Paediatrics, School of Rural Medicine, University of New England, Armidale, New South Wales, Australia. 5. Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia. 6. Department of Paediatrics, Monash University, Melbourne, Victoria, Australia. 7. Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia. 8. Emergency Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia. 9. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia. 10. Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia. 11. Emergency Department, Waikato District Health Board, Hamilton, New Zealand. 12. General Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia. 13. Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand. 14. University of Queensland, Brisbane, Queensland, Australia. 15. Children's Healthcare Network Western Region, Sydney, New South Wales, Australia. 16. Kidzfirst, Middlemore Hospital, Auckland, New Zealand. 17. Paediatric Intensive Care Unit, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia. 18. Paediatric Critical Care Research Group (PCCRG), Lady Cilento Children's Hospital, Brisbane, Queensland, Australia. 19. Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia. 20. Department of Paediatrics, Fiona Stanley Hospital, Perth, Western Australia, Australia. 21. Children's Healthcare Network, Sydney, New South Wales, Australia. 22. General Paediatrics, Women's and Children's Hospital, Adelaide, South Australia, Australia. 23. Emergency Department, John Hunter Hospital, Newcastle, New South Wales, Australia. 24. Emergency Department, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia. 25. Paediatric Emergency Medicine Centre of Research Excellence, Murdoch Children's Research Institute, Melbourne, Victoria, Australia. 26. Department of Surgery, University of Auckland, Auckland, New Zealand. 27. Department of Paediatrics: Youth and Child Health, University of Auckland, Auckland, New Zealand.
Abstract
AIM: Bronchiolitis is the most common lower respiratory tract disorder in infants aged less than 12 months, and research has demonstrated that there is substantial variation in practice patterns despite treatment being well defined. In order to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population. METHODS: The guideline development committee included representation from emergency and paediatric specialty medical and nursing personnel in addition to geographical representation across Australia and New Zealand - rural, remote and metropolitan. Formulation of the guideline included identification of population, intervention, comparator, outcomes and time questions and was associated with an extensive literature search from 2000 to 2015. Evidence was summarised and graded using the National Health and Medical Research Council and Grading of Recommendations Assessment, Development and Evaluation methodology, and consensus within the guideline group was sought using nominal group technique principles to formulate the clinical practice recommendations. The guideline was reviewed and endorsed by key paediatric health bodies. RESULTS: The guideline consists of a usable clinical interface for bedside functionality supported by evidence summary and tables. The Grading of Recommendations Assessment, Development and Evaluation and National Health and Medical Research Council processes provided a systematic and transparent process to review and assess the literature, resulting in a guideline that is relevant to the management of bronchiolitis in the Australasian setting. CONCLUSION: This is the first robust Australasian acute paediatric guideline and provides clear guidance for the management of the vast majority of patients seen in Australasian emergency departments and general paediatric wards with bronchiolitis.
AIM: Bronchiolitis is the most common lower respiratory tract disorder in infants aged less than 12 months, and research has demonstrated that there is substantial variation in practice patterns despite treatment being well defined. In order to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population. METHODS: The guideline development committee included representation from emergency and paediatric specialty medical and nursing personnel in addition to geographical representation across Australia and New Zealand - rural, remote and metropolitan. Formulation of the guideline included identification of population, intervention, comparator, outcomes and time questions and was associated with an extensive literature search from 2000 to 2015. Evidence was summarised and graded using the National Health and Medical Research Council and Grading of Recommendations Assessment, Development and Evaluation methodology, and consensus within the guideline group was sought using nominal group technique principles to formulate the clinical practice recommendations. The guideline was reviewed and endorsed by key paediatric health bodies. RESULTS: The guideline consists of a usable clinical interface for bedside functionality supported by evidence summary and tables. The Grading of Recommendations Assessment, Development and Evaluation and National Health and Medical Research Council processes provided a systematic and transparent process to review and assess the literature, resulting in a guideline that is relevant to the management of bronchiolitis in the Australasian setting. CONCLUSION: This is the first robust Australasian acute paediatric guideline and provides clear guidance for the management of the vast majority of patients seen in Australasian emergency departments and general paediatric wards with bronchiolitis.
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