Trends in road transport collision deaths in the Irish paediatric population: a retrospective review of mortality data, 1991–2015

Objective: To establish the incidence of road transport collision (RTC) fatalities in the Irish paediatric population, examining trends in fatality rates over a period of 25 years, during which several national road safety interventions were implemented.Study design: Retrospective review of death registration details of children 0-19 years in Ireland between January 1991 and December 2015. Trends in mortality rates were investigated using average annual per cent change and Poisson regression analysis.Results: Proportionate RTC mortality, the majority of which occurred on public roads (94.1%, n=1432) increased with age; Conclusion: Child and adolescent mortality from RTCs has declined dramatically in Ireland, in excess of reductions in overall paediatric mortality. However, rates remain higher than in other EU countries and further effort is required to reduce the number of deaths further, particularly among adolescent males.</div

National paediatric diabetes audit feasibility study report

Ireland has a high incidence of type 1 diabetes mellitus (T1DM), a chronic condition that places huge demands on affected individuals, their families, and the health service. Continuous and integrated multidisciplinary patient support is required to empower patients and caregivers to maximise self-management skills in order to achieve optimal diabetes control, which has been definitively shown to reduce the risk of acute and long-term diabetes-related complications. Paediatric T1DM care requires prioritisation because of its high incidence and the significant long-term sequelae of suboptimal care. No national paediatric diabetes audit (NPDA) exists in Ireland, and available data originate from single-centre, stand-alone, or retrospective studies. The lack of reliable data precludes healthcare professionals from making informed decisions about how to improve services, and means that disparities in paediatric diabetes care are neither identified nor prospectively addressed. A national audit of paediatric T1DM will highlight areas of good practice, identify deficits, and promote improvement in the quality of care delivery and data-driven resource allocation. The need for an NPDA was specifically emphasised in the Model of Care for All Children and Young People with Type 1 Diabetes.</div

Brain magnetic resonance imaging and outcome after hypoxic ischaemic encephalopathy

<div><p></p><p><i>Objective</i>: To correlate pattern of injury on neonatal brain magnetic resonance imaging (MRI) with outcome in infants ≥36 + 0 weeks gestation with hypoxic ischaemic encephalopathy.</p><p><i>Methods</i>: Prospective cohort study. Images were blindly reviewed. Children were assessed using a variety of standardised assessments.</p><p><i>Results</i>: MRI brain was performed on 88 infants. Follow up was available in 73(83%) infants. Eight of 25(32%) children with normal imaging had below normal assessment scores. Eight infants (12%) had isolated punctate white matter lesions and five of these had abnormal assessment scores. Death and cerebral palsy were seen only in children with imaging scores ≥3 on basal ganglia/thalami (BGT) score or ≥4 on watershed score. No developmental concerns were raised in 3/7(43%) infants with isolated watershed injury. Ten of 13(77%) infants with isolated BGT injury died or developed cerebral palsy. All 23 children with posterior limb of the internal capsule (PLIC) injury displayed developmental difficulties.</p><p><i>Conclusions</i>: Almost one-third of infants with a normal MRI brain may be at risk of developmental problems. Punctate foci of white matter injury are common and not always benign. PLIC involvement is usually associated with neurological sequelae including isolated cognitive deficits<i>.</i> Worst outcomes are associated with basal ganglia injury.</p></div

Irish Paediatric Critical Care Audit National Report 2017-2019

The Paediatric Intensive Care Audit Network (PICANet) collects information on all patients admitted to paediatric critical care units in the United Kingdom (UK) and the Republic of Ireland (ROI). The objective of this data collection is to measure the quality of care in Paediatric Critical Care Units (PCCUs) and benchmark this against other PCCUs across the UK. Since 2009, reports for the ROI have been produced within PICANet UK in conjunction with the ROI PCCU clinical leads. In 2015, the audit of paediatric critical care was incorporated into the National Office of Clinical Audit (NOCA), which provides support through a clinical audit team and an independent voluntary governance structure.</p