🇹🇹👩🏽‍⚕️| Paediatric Emergency Medicine Consultant | Interests 🗺global health🏏west indies🥭julie mango https://xitter.cf/t.co/Xo1UpxC4Xp

Birmingham
Joined October 2019
My latest paper on Paediatric Early Warning Systems Paediatric Early Warning Systems: prediction without proof? My central argument is PEWS have been evaluated as scores but implemented as systems. #PEWS #earlywarning authors.elsevier.com/a/1nk90… (open access for 60 days)
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If you have a baby who struggles with a completely normal physiological consequence of growing please don’t stick a plastic tube up their bum… MHRA formally advise to stop using these over the counter treatments gov.uk/drug-device-alerts/al… HT @NCMD_England
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My fantastic colleague Dr Charlotte Durand has worked collaboratively with @RCollEM to produce a position statement on e-scooter use in children. Please have a read and share widely. rcem.ac.uk/wp-content/upload…
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🚨 Hot off the press! 🚨 Introducing the PRoMPT BOLUS study results — a landmark trial evaluating the safety & efficacy of normal saline vs. balanced fluids in suspected pediatric septic shock 🌍 9,000+ children 🏥 47 sites 🌎 5 countries And the winner is… 👇 nejm.org/doi/full/10.1056/NE… @nkuppermann @franbalamuth
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…both! PRoMPT BOLUS found: • 0.9% saline AND balanced fluids are safe & effective in suspected pediatric septic shock • Fluid type does NOT impact major outcomes (mortality, kidney injury) • Biochemical differences ≠ differences in patient-centered outcomes @PERC_network @PREDICT_network nejm.org/doi/full/10.1056/NE…
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🚨Great news for children! 🚨 In 2012 we knew we could treat significant forearm fractures in children without surgery ovid.com/jnls/jbjsjournal/ab… It's only taken another 14 years to demonstrate this in a RCT... crafft.digitrial.com/results Well done @MrDanPerry and team!
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Anandi retweeted
Medicines update - Use of tranexamic acid in children with major haemorrhage Good trial evidence of effectiveness in adults, but lacking in children. Good safety profile, so may be useful to use ep.bmj.com/content/early/202…
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You’re a little slow to the party.
Idk who needs to hear this, but you’re beautiful.
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"Your roots are your strength, giving you a unique lens through which to care, lead and innovate" - Dr Shivan Pancham, NHS consultant haematologist. Celebrating all our South Asian NHS staff - past & present 💙 #RootstoRoutes #SouthAsianHeritageMonth
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🚨Adverse events from procedural #sedation are rare - occurring <1% of the time High-quality care can mitigate the risk of adverse outcomes Review these resources from @EMSCImprovement Pediatric Education and Advocacy Kit (PEAK): Procedural Sedation bit.ly/4hBpjo2
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Hello my name is…. Time to include full name, title & role Patients need to know who is treating them. Colleagues need to know who they’re talking to. This is increasingly so as workforce changes mean roles may be opaque! Equally important in ‘flash teams’ in acute care situations. bmj.com/content/388/bmj.r607
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Anandi retweeted
QI report - Improving communication with social work after child protection medical assessment with a new template ep.bmj.com/content/early/202…
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Severe accidental poisonings in children: a British Paediatric Surveillance Unit study. 116 cases in one year. Prescription meds left unattended most common. adc.bmj.com/content/early/20…
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Seven elements in tackling complex problems in a work context (not necessarily in a linear order: all these elements are interconnected): 1. Step back to see the wider picture: we need to pull ourselves out of the details/specifics because of the interdependencies in big, complex problems: systems thinking, system mapping, soft systems &/or network analysis can help. 2. Get input from people with a wide range of experiences & expertise. 3. invest time & energy in external research: lessons learned in other organisations & the expertise of researchers, thought leaders & regulators. 4. Revisit our principles & values to help guide our approach as to how we are going to implement change. 5. Build our tolerance for uncertainty & risk: how can we learn, grow & more effectively navigate the increasing complexity of our world? 6. Create small scale tests of change to understand what might work. 7. Continuously learn, adapt & improve. plan.io/blog/solving-complex…. By @planio.
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New paper out today in @ArchivesEandP 15 minute consultation: Intubation of the critically ill child presenting to the ED 👀👇 bit.ly/2Uymv5p 🔸Drug Doses 🔸Minimising Risk 🔸Checklists 🔸Human Factors Special thanks to @NicholasChrimes & @kjpNWTS #PedsICU #PedsAnes
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