Αλγόριθμοι διαχείρισης ασθενών στο ΤΕΠ
Στις παρακάτω θεματικές ενότητες μπορείτε να βρείτε έντυπο υλικό της Α’ Πανεπιστημιακής Παιδιατρικής Κλινικής που περιλαμβάνει αλγορίθμους διαχείρισης περιστατικών βασισμένους στη διεθνή βιβλιογραφία και προσαρμοσμένους στον τρόπο λειτουργίας του ΤΕΠ του Γ.Ν. Παίδων «Η Αγία Σοφία».
Συντονιστές:
Χριστίνα Κανακά-Gantenbein, Καθηγήτρια, Διευθύντρια Α’ Παιδιατρικής Κλινικής
Ευανθία Μπότσα, Παιδίατρος-Λοιμωξιολόγος, Επιμελήτρια Α’ Παιδιατρικής Κλινικής
Συγγραφική ομάδα Α’ Παιδιατρικής Κλινικής:
Επιμελητές Παιδιατρικής: Χάρης Καπόγιαννης, Μαρία Μπίνου, Μαριλύν Μπόμπου
Ειδικευόμενοι Παιδιατρικής: Βαγγέλης Γιαμούρης, Μιχαέλα Νικολάου, Νατάσα Σαλίχου, Ελένη Ατματζίδου, Θεσσαλία Καμηλάρη, Σπύρος Καραγεώργος, Δημήτρης Κουντούρης, Βάσω Κυμιωνή, Έλενα Μακρίδη, Ιφιγένεια Ματαρά, Λιάνα Μαρκάκη, Αφροδίτη Μπαρμπάκου, Δώρα Παππά, Κέλλυ Ροδολάκη, Τάσος Χαντζαράς
Επιβλέποντες ειδικοί: Αθ. Καδίτης-Πνευμονολόγος, R. Pons-Νευρολόγος, A. Παπαδοπούλου-Γαστρεντερολόγος
Επιμέλεια και τελική μορφοποίηση: Ευανθία Μπότσα, Δημήτρης Κουντούρης
Αναπνευστικό σύστημα
Αλγόριθμος βρογχιολίτιδας
Βιβλιογραφία
1. Clinical Practice Guidelines: Bronchiolitis. (Reviewed: May 2020). The Royal Children’s Hospital Melbourne.
2. Kids Health Information: Bronchiolitis. (Reviewed: Feb 2018). The Royal Children’s Hospital Melbourne.
3. Australasian Bronchiolitis Guideline. Paediatric Research in Emergency Departments International Collaborative.
4. Bronchiolitis in children: Diagnosis and management. (Published: June 2015, Revised: Aug 2021). National Institute for Health and Care Excellence (NICE).
5. Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Bronchiolitis. (Posted: Sep 2005, Revised: May 2022). Children’s Hospital of Philadelphia.
6. Bronchiolitis Pathway. (v13.0, Revised: Mar 2022). Seattle Children’s Hospital.
Αλγόριθμος ασθματικού παροξυσμού
Βιβλιογραφία
1. Clinical Practice Guidelines: Acute asthma. (Reviewed: Dec 2020). The Royal Children’s Hospital Melbourne.
2. Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Asthma. (Posted: Oct 2005, Revised: Dec 2020). Children’s Hospital of Philadelphia.
3. Asthma Pathway. (v9.0, Revised: Oct 2019). Seattle Children’s Hospital.
4. Pediatric Emergency Medicine Clinical Pathways/Asthma exacerbations. (Posted: Dec 2016, Revised: Dec 2019). Benioff Children’s Hospital.
Αλγόριθμος πνευμονίας
Βιβλιογραφία
1. Clinical Practice Guidelines: Community acquired pneumonia. (Reviewed: Feb 2020). The Royal Children’s Hospital Melbourne.
2. Kids Health Information: Pneumonia. (Reviewed: Feb 2018). The Royal Children’s Hospital Melbourne.
3. Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Community-Acquired Pneumonia. (Posted: Sep 2012, Revised: July 2022). Children’s Hospital of Philadelphia.
4. Community-Acquired Pneumonia Pathway. (v.6.1, Revised: Aug 2021). Seattle Children’s Hospital.
5. Paediatric Community Acquired Pneumonia. (Posted: Sep 2019). British Thoracic Society.
6. Bradley, J. S., Byington, C. L., Shah, S. S., et al. (2011). The management of community-acquired pneumonia in infants and children older than 3 months of age: Clinical practice guidelines by the pediatric infectious diseases society and the infectious diseases society of america. Clinical Infectious Diseases, 53(7), e25–e76.
Αλγόριθμος croup
Βιβλιογραφία
1. Clinical Practice Guidelines: Croup (Laryngotracheobronchitis). (Reviewed: May 2020). The Royal Children’s Hospital Melbourne.
2. Kids Health Information: Croup. (Reviewed: Aug 2020). The Royal Children’s Hospital Melbourne.
3. Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Croup. (Posted: Sep 2014, Revised: Dec 2020). Children’s Hospital of Philadelphia.
4. Croup Pathway. (v.4.0, Revised: Sep 2020). Seattle Children’s Hospital.
5. Asmundsson, A. S., Arms, J., Kaila, R., Roback, M. G., Theiler, C., Davey, C. S., & Louie, J. P. (2019). Hospital course of croup after emergency department management. Hospital Pediatrics, 9(5), 326–332. https://doi.org/10.1542/hpeds.2018-0066
6. Bjornson, C., Russell, K., Vandermeer, B., Klassen, T. P., & Johnson, D. W. (2013). Nebulized epinephrine for croup in children. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD006619.pub3
7. Gates, A., Gates, M., Vandermeer, B., Johnson, C., Hartling, L., Johnson, D. W., & Klassen, T. P. (2018). Glucocorticoids for croup in children. Cochrane Database of Systematic Reviews, 2018(8). https://doi.org/10.1002/14651858.CD001955.pub4
8. Ortiz-Alvarez, O. (2017). Acute management of croup in the emergency department. Paediatrics & Child Health, 22(3), 166–169. https://doi.org/10.1093/pch/pxx019
9. Petrocheilou, A., Tanou, K., Kalampouka, E., Malakasioti, G., Giannios, C., & Kaditis, A. G. (2014). Viral croup: Diagnosis and a treatment algorithm: croup, diagnosis and management. Pediatric Pulmonology, 49(5), 421–429. https://doi.org/10.1002/ppul.22993
Αλγόριθμος ωτίτιδας
Βιβλιογραφία
1. Clinical Pathway for Evaluation/Treatment of Suspected Acute Otitis Media in Children 2 Months to 12 Years. (Posted: 2008, Revised: 2023). Children’s Hospital of Philadelphia (CHOP).
2. Clinical Practice Guidelines – Acute otitis media. (Revised: June 2021). The Royal Children’s Hospital Melbourne.
3. Evidence Based Practice – Acute Otitis Media. (Posted: Oct 2022). Children’s Mercy Kansas City.
Γαστρεντερικό σύστημα
Αλγόριθμος γαστρεντερίτιδας
Βιβλιογραφία
1. Clinical Practice Guidelines: Croup (Dehydration). (Reviewed: Sep 2020). The Royal Children’s Hospital Melbourne.
2. Diarrhoea and vomiting caused by gastroenteritis in under 5s: Diagnosis and management. (Published: April 2009). National Institute for Health and Care Excellence (NICE).
3. Intravenous fluid therapy in children and young people in hospital. (Published: Dec 2015, Revised: June 2020). National Institute for Health and Care Excellence (NICE).
4. Hartman, S., Brown, E., Loomis, E., & Russell, H. A. (2019). Gastroenteritis in children. American Family Physician, 99(3), 159–165.
5. Emergency Department Clinical Pathway for Healthy Children with Gastroenteritis/ Dehydration. (Posted: Aug 2007, Revised: June 2022). Children’s Hospital of Philadelphia. https://www.chop.edu/clinical-pathway/gastroenteritis-and-dehydration-clinical-pathway
Αλγόριθμος αφυδάτωσης
Βιβλιογραφία
1. Clinical Practice Guidelines: Croup (Dehydration). (Reviewed: Sep 2020). The Royal Children’s Hospital Melbourne.
2. Diarrhoea and vomiting caused by gastroenteritis in under 5s: Diagnosis and management. (Published: April 2009). National Institute for Health and Care Excellence (NICE).
3. Intravenous fluid therapy in children and young people in hospital. (Published: Dec 2015, Revised: June 2020). National Institute for Health and Care Excellence (NICE).
4. Hartman, S., Brown, E., Loomis, E., & Russell, H. A. (2019). Gastroenteritis in children. American Family Physician, 99(3), 159–165.
5. Emergency Department Clinical Pathway for Healthy Children with Gastroenteritis/ Dehydration. (Posted: Aug 2007, Revised: June 2022). Children’s Hospital of Philadelphia. https://www.chop.edu/clinical-pathway/gastroenteritis-and-dehydration-clinical-pathway
Αλγόριθμοι δυσκοιλιότητας
Βιβλιογραφία
1. 2018 exceptional surveillance of constipation in children: Diagnosis and management (NICE guideline CG99). (2018). National Institute for Health and Care Excellence (NICE).
2. Tabbers, M. M., DiLorenzo, C., Berger, et al., European Society for Pediatric Gastroenterology, Hepatology, and Nutrition, & North American Society for Pediatric Gastroenterology. (2014). Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition, 58(2), 258–274.
Ουροποιητικό σύστημα
Αλγόριθμος ουρολοίμωξης
Βιβλιογραφία
1. Urinary tract infection in under 16s: Diagnosis and management. (Published: Aug 2007, Revised: Oct 2018). National Institute for Health and Care Excellence (NICE).
2. Urinary tract infection (lower): antimicrobial prescribing. (Published: Oct 2018). National Institute for Health and Care Excellence (NICE).
3. Pyelonephritis (acute): antimicrobial prescribing. (Published: Oct 2018). National Institute for Health and Care Excellence (NICE).
4. Urinary Tract Infection (v11.0, Revised: Oct 2020). Seattle Children’s Hospital.
5. Urinary tract infections in infants older than one month and young children: Acute management, imaging, and prognosis. UpToDate.
6. Stein, R., Dogan, H. S., Hoebeke, et al. (2015). Urinary tract infections in children: Eau/espu guidelines. European Urology, 67(3), 546–558.
7. Helen K. Hughes, Lauren K. Kahl, The Harriet Lane Handbook, (21nd edition), The Johns Hopkins Hospital, Elsevier
Αλγόριθμος αιματουρίας
Βιβλιογραφία
1. Rovin, B. H., Adler, S. G., Barratt, J., et al. (2021). Kdigo 2021 clinical practice guideline for the management of glomerular diseases. Kidney International, 100(4), S1–S276.
2. Bignall, O. N. R., & Dixon, B. P. (2018). Management of hematuria in children. Current Treatment Options in Pediatrics, 4(3), 333–349.
3. Patel, H. P., & Bissler, J. J. (2001). Hematuria in children. Pediatric Clinics of North America, 48(6), 1519–1537.
4. Youn, T., Trachtman, H., & Gauthier, B. (2006). Clinical spectrum of gross hematuria in pediatric patients. Clinical Pediatrics, 45(2), 135–141.
5. Greenfield, S. P., Williot, P., & Kaplan, D. (2007). Gross hematuria in children: A ten-year review. Urology, 69(1), 166–169.
Αλγόριθμος ουρολιθίασης
Βιβλιογραφία
1. Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Suspected Nephrolithiasis. (Posted: Oct 2009, Revised: July 2020). Children’s Hospital of Philadelphia.
2. Kidney stones in children: Acute management. UpToDate.
3. Kidney stones in children: Clinical features and diagnosis. UpToDate.
4. Treatment & Prevention for Kidney Stones in Children. National Institute of Diabetes and Digestive and Kidney Diseases (NIH).
Ενδοκρινολογικό σύστημα
Αλγόριθμος Υπογλυκαιμίας
Βιβλιογραφία
1. Clinical Practice Guidelines – Hypoglycaemia. (Reviewed: Nov 2019). The Royal Children’s Hospital Melbourne
2. Hypoglycaemia in children (<16 years) - Investigation and Management of. (Posted: April 2008). Leeds Health Pathways.
3. Hypoglycemia in children and adolescents with type 1 diabetes mellitus (Updated: Dec 2022). UpToDate.
4. Hypoglycemia Guideline (Reviewed: May 2020). Dell Children’s Ascension - Medical Center for Central Texas.
Αλγόριθμος Υπογλυκαιμίας με ΣΔ1
Βιβλιογραφία
1. Clinical Practice Guidelines – Hypoglycaemia. (Reviewed: Nov 2019). The Royal Children’s Hospital Melbourne
2. Hypoglycaemia in children (<16 years) - Investigation and Management of. (Posted: April 2008). Leeds Health Pathways.
3. Hypoglycemia in children and adolescents with type 1 diabetes mellitus (Updated: Dec 2022). UpToDate.
4. Hypoglycemia Guideline (Reviewed: May 2020). Dell Children’s Ascension - Medical Center for Central Texas.
Αλγόριθμος Επινεφριδιακής κρίσης
Βιβλιογραφία
1. Furtado, N. (2019). Adrenal insufficiency. M. Tenenbein, C. G. Macias, G. Q. Sharieff, et al. Strange and Schafermeyer’s Pediatric Emergency Medicine (5th edition). McGraw-Hill Education.
2. Speiser PW, Arlt W, Auchus RJ, et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018 Nov 1;103(11):4043-4088.
3.Adrenal Crisis Information. Society of Endocrinology.
4. Adrenal Insufficiency, Adrenal Crisis – Pathway of events. Great Ormond Street Hospital for Children.
5. Ματσανιώτης Ν., Καρπάθιος Θ., Νικολαϊδου-Καρπαθίου Π., Επίτομη Παιδιατρική, p: 519-524
Αλλαγή επιπέδου συνείδησης
Αλγόριθμος πυρετικών σπασμών
Βιβλιογραφία
1. Management of Febrile Convulsion in Children. (Published: Nov 2019). University Hospitals of Leicester (NHS).
2. Clinical features and evaluation of febrile seizures. UpToDate.
Αλγόριθμος status epilepticus
Βιβλιογραφία
1. Management of Status Epilepticus. (Published: March 2022). Leicester Children’s Hospital. (NHS).
2. Clinical Pathway for Evaluation/Treatment of Infants and Children > 2 months with Status Epilepticus. (Posted: Nov 2008, Revised: Sep 2021). Children’s Hospital of Philadelphia.
3. Febrile Seizure Pathway. (v2.0, Revised: June 2019). Seattle Children’s Hospital.
4. Approach to treatment of convulsive status epilepticus in children and adolescents. UpToDate.
5. Advanced Life Support Group (ALSG). Advanced Paediatric Life Support (APLS, 2016): A Practical Approach to Emergencies. 6th Wiley Blackwell
6. Thomas, S., & Cherian, A. (2009). Status epilepticus. Annals of Indian Academy of Neurology, 12(3), 140.
7. Wylie, T., Sandhu, D. S., & Murr, N. (2022). Status epilepticus. StatPearls.
Αλγόριθμος συγκοπής
Βιβλιογραφία
1. Clinical Practice Guidelines: Syncope. (Reviewed: Aug 2018). The Royal Children’s Hospital Melbourne.
2. Emergency evaluation of syncope in children and adolescents. UpToDate.
3. Cannon, B., & Wackel, P. (2016). Syncope. Pediatrics In Review, 37(4), 159–168.
Αλγόριθμος BRUE
Βιβλιογραφία
1. Emergency Department and Inpatient Pathway for Evaluation of Infants with a Brief, Resolved, Unexplained Event (BRUE). (Posted: March 2017, Revised: May 2021). Children’s Hospital of Philadelphia.
2. Diagnosis and Initial Management of Brief Resolved Unexplained Event. (Posted: Feb 2019). Texas Children’s Hospital.
Λοιπά συστήματα
Αλγόριθμος θωρακαλγίας
Βιβλιογραφία
1. Clinical Practice Guidelines: Chest Pain. (Reviewed: Aug 2018). The Royal Children’s Hospital Melbourne.
2. Emergency Department Clinical Pathway for Evaluation/Treatment of Children with Chest Pain without Known Cardiac Disease. (Posted: Jan 2014, Revised: Oct 2021). Children’s Hospital of Philadelphia.
3. Paediatric Clinical Practice Guideline/Chest Pain. The alex Emergency Department. Brighton and Sussex University Hospitals (NHS).
4. Approach to pediatric nontraumatic chest pain. UpToDate.
Αλγόριθμος κνίδωσης
Βιβλιογραφία
1. Hives. (Posted: March 2014). Children’s Hospital of Philadelphia.
2. Clinical Practice Guidelines – Urticaria. (Reviewed: March 2023). The Royal Children’s Hospital Melbourne.
3. Urticaria pathway. (Revised: June, 2020). Seattle Children’s Hospital.
4. Zuberbier, T., Aberer, W., Asero, et al. (2018). The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy, 73(7), 1393–1414.
Αλγόριθμος αναφυλαξίας
Βιβλιογραφία
1. Anaphylaxis: assessment and referral after emergency treatment. (Posted: Dec 2011, Revised: Aug 2020). NICE Guidance. Clinical guideline [CG134].
2. Emergency treatment of anaphylaxis: Guidelines for healthcare providers. Resuscitation Council UK Guidelines 2021.
3. Antonella Muraro, Margitta Worm et al. EAACI guidelines: Anaphylaxis (2021 update). Practice Guideline Allergy 2022 Feb;77(2):357-377.
4. Anaphylaxis Pathway. (v6.2, Revised: Aug 2022). Seattle Children’s Hospital.
Αλγόριθμος σήψης
Βιβλιογραφία
1. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. (2020). Society of Critical Care Medicine, European Society of Intensive Care Medicine.
2. Sepsis – Emergency management in children. Children’s Health Queensland Hospital and Health Service.
3. Septic shock in children: Rapid recognition and initial resuscitation (first hour). UpToDate.
4. Pediatric Sepsis. (Revised: April 2021). Medscape.
5. Cruz, A. T., Lane, R. D., Balamuth, F., et al. (2020). Updates on pediatric sepsis. Journal of the American College of Emergency Physicians Open, 1(5), 981–993.
ΔΕΛΤΙΟ Α’ ΠΑΙΔΙΑΤΡΙΚΗΣ ΚΛΙΝΙΚΗΣ
