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Treatment for acute middle ear infections

Children who have an acute middle ear infection (acute otitis media) usually have earache and a fever. They sleep badly, are restless and cry a lot. As a result, parents often have sleepless nights too. But the infection usually clears up on its own within two to three days. What are the treatment options and when is it important to seek medical advice?Middle ear infections usually clear up after a few days. Complications are very rare. The earache often already goes away again after one day. Until that happens, children can use medication to relieve pain and reduce fever, such as ibuprofen and acetaminophen (paracetamol). A lot of care and attention can also help, and some people feel that certain home remedies have a soothing effect too.Antibiotics often do not work and can have side effects. So there is usually a good reason to wait two or three days at first, to see whether a middle ear infection clears up on its own. If the symptoms do not get better, the child can still take antibiotics then. Antibiotics also help in children who are leaking pus from their ear, and in children who are under two years old and have an infection in both ears.If a child is unwell it can be important to seek medical advice early on. The doctor can judge whether it is a middle ear infection and how severe it is. You can then discuss the most appropriate treatment approach together. If the symptoms do not get better despite treatment, or if the child has problems such as hearing loss, it is advisable to see the doctor again.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 1, 2016

What does blood do?

Blood is a vitally important fluid in the body. One of the things it does is transport oxygen from the lungs to the cells of the body, where it is needed for metabolism.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 7, 2015

Bronchiolitis: Diagnosis and Management of Bronchiolitis in Children

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This guideline has been developed with the aim of providing guidance on the care of children with bronchiolitis.

NICE Guideline - National Collaborating Centre for Women's and Children's Health (UK).

Version: June 2015

Head Injury: Triage, Assessment, Investigation and Early Management of Head Injury in Children, Young People and Adults

For the purposes of this guideline, head injury is defined as any trauma to the head other than superficial injuries to the face. Head injury is the commonest cause of death and disability in people aged 1–40 years in the UK. Data for head injury are recorded in the Hospital Episode Statistics (http://www.hscic.gov.uk/hes). Each year, 1.4 million people attend emergency departments in England and Wales with a recent head injury. Between 33% and 50% of these are children aged under 15 years. Annually, about 200,000 people are admitted to hospital with head injury. Of these, one-fifth have features suggesting skull fracture or have evidence of brain damage. Most patients recover without specific or specialist intervention, but others experience long-term disability or even die from the effects of complications that could potentially be minimised or avoided with early detection and appropriate treatment.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: January 2014

Sedation in Children and Young People: Sedation for Diagnostic and Therapeutic Procedures in Children and Young People [Internet]

Many children present to hospitals and dental clinics needing effective sedation or anaesthesia for painful or distressing diagnostic or therapeutic procedures. There are many sedation techniques available but there is insufficient guidance on which techniques are effective and what resources are required to deliver them safely. Sedation is not always effective enough and will occasionally require the procedure to be delayed until the child can be anaesthetised perhaps in another healthcare setting or on another day. Consequently sedation failure is both distressing for the child and has major NHS cost implications. Excessive doses of sedation can cause unintended loss of consciousness and dangerous hypoxia. In comparison, planned anaesthesia is effective, but may have resource implications. The need for sedation or anaesthesia will depend upon the type of procedure. Some types of procedures are very common and healthcare providers and practitioners need to understand whether sedation or anaesthesia is the most cost effective method of managing them

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: December 2010

When To Suspect Child Maltreatment

This guidance provides a summary of the clinical features associated with maltreatment (alerting features) that may be observed when a child presents to healthcare professionals. Its purpose is to raise awareness and help healthcare professionals who are not specialists in child protection to identify children who may be being maltreated. It does not give healthcare professionals recommendations on how to diagnose, confirm or disprove child maltreatment.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: July 2009
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Sepsis: Recognition, Assessment and Early Management

Sepsis is a clinical syndrome caused by the body's immune and coagulation systems being switched on by an infection. Sepsis with shock is a life-threatening condition that is characterised by low blood pressure despite adequate fluid replacement, and organ dysfunction or failure. Sepsis is an important cause of death in people of all ages. Both a UK Parliamentary and Health Service Ombudsman enquiry (2013) and UK National Confidential Enquiry into Patient Outcome and Death (NCEPOD, 2015) have recently highlighted sepsis as being a leading cause of avoidable death that kills more people than breast, bowel and prostate cancer combined.

NICE Guideline - National Guideline Centre (UK).

Version: July 2016

Using clinical practice variations as a method for commissioners and clinicians to identify and prioritise opportunities for disinvestment in health care: a cross-sectional study, systematic reviews and qualitative study

This study found large variability in the use of some common procedures that cannot be explained by differences in local need and may reflect uncertainty about appropriate use. This may help identify procedures that could be reassessed for disinvestment.

Health Services and Delivery Research - NIHR Journals Library.

Version: April 2015

Fractures (Non-Complex): Assessment and Management

Two of the five guidelines in the NICE trauma suite relate to fractures. These are titled non-complex and complex fractures. In broad terms, non-complex fractures are those likely to be treated at the receiving hospital, whereas complex fractures require transfer or the consideration of transfer of the injured person to a specialist.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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The Diagnosis and Treatment of Lung Cancer (Update)

This guidance updates and replaces NICE clinical guideline 24 (published February 2005).

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: April 2011

The Prevention and Management of Pressure Ulcers in Primary and Secondary Care

Prevention of pressure ulcers usually involves an assessment to identify people most at risk of pressure ulcers, such as elderly, immobile people or those with spinal cord injury. Assessments are most commonly carried out using specific pressure area risk scores (for example, the Braden or Waterlow scales for predicting pressure sore risk or the, Glamorgan scale for paediatric pressure ulcers).

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: April 2014

End of Life Care for Infants, Children and Young People with Life-Limiting Conditions: Planning and Management

This guideline covers the physical, emotional, social and spiritual elements of end of life care, and focuses on improving the child or young person’s quality of life and supporting their family and carers. There are, for instance, recommendations on managing distressing symptoms and providing care and bereavement support after death. Recommendations have also been made about how services should be delivered. The guideline is aimed at all providers of paediatric end of life care, whatever their level of practise, and also for children and young people with life-limiting conditions and their parents or carers.

NICE Guideline - National Guideline Alliance (UK).

Version: December 2016
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Autism: The Management and Support of Children and Young People on the Autism Spectrum

This guideline has been developed to advise on the management and support of children and young people on the autism spectrum. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, children and young people with autism, their carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high-quality care for children and young people with autism while also emphasising the importance of the experience of care for children and young people with autism and their carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: August 2013

Type 1 Diabetes in Adults: Diagnosis and Management

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

Major Trauma: Service Delivery

A trauma service provides care for people who have sustained physical injuries. These injuries are often the result of an accident but can be sustained in other circumstances. Injuries range from minor to serious life-threatening trauma. The scope of this guidance is the delivery of services for people with major trauma in the initial phase of care, exploring areas of uncertainty and variation.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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Drug Allergy: Diagnosis and Management of Drug Allergy in Adults, Children and Young People

All drugs have the potential to cause side effects, also known as ‘adverse drug reactions’, but not all of these are allergic in nature. Other reactions are idiosyncratic, pseudo-allergic or caused by drug intolerance. The British Society for Allergy and Clinical Immunology (BSACI) defines drug allergy as an adverse drug reaction with an established immunological mechanism. The mechanism at presentation may not be apparent from the clinical history and it cannot always be established whether a drug reaction is allergic or non-allergic without investigation. Therefore, this guideline has defined drug allergy as any reaction caused by a drug with clinical features compatible with an immunological mechanism.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: September 2014
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Spinal Injury: Assessment and Initial Management

The scope of this guideline is the assessment, imaging and early management of spinal injury and does not address rehabilitation. It is important to recognise that early management is intrinsically connected to rehabilitation and some later complications may be avoided with changes in early care. Early and ongoing collaborative multidisciplinary care across a trauma network is vital in ensuring that the patient with a spinal injury receives the best possible care.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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Motor Neurone Disease: Assessment and Management

Motor neurone disease (MND) is a neurodegenerative condition that affects the brain and spinal cord. MND is characterised by the degeneration of primarily motor neurones, leading to muscle weakness.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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Fractures (Complex): Assessment and Management

Two of the five guidelines in the NICE Trauma Suite relate to fractures. These are titled non-complex and complex fractures. In broad terms the non-complex fractures are those likely to be treated at the receiving hospital, whereas the complex fractures require transfer or the consideration of transfer of the injured person to a specialist centre.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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Major Trauma: Assessment and Initial Management

This guideline provides guidance on the assessment and management of major trauma, including resuscitation following major blood loss associated with trauma. For the purposes of this guideline, major trauma is defined as an injury or a combination of injuries that are life-threatening and could be life changing because it may result in long-term disability. This guideline covers both the pre-hospital and immediate hospital care of major trauma patients but does not include any management after definitive lifesaving intervention. It has been developed for health practitioners and professionals, patients and carers and commissioners of health services.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: February 2016
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