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Articles by Mark D Lyttle
Optimising Retraining Frequency for a Paediatric Emergency Department Admission Prediction Model: Development and Temporal Validation Using Real-World Data
1 Introduction Emergency departments (ED) globally are under escalating pressure from rising patient volumes and disease complexity, negatively impacting the quality, safety and efficiency of patient care [1, 2]. Delays to care in ED are associated with longer inpatient stays and increased 30-day mortality [3].
Perceptions and knowledge of machine learning for paediatric related decision support in emergency care - A UK and Ireland network survey study of clinician leaders | PLOS Digital Health
Loading metrics Open Access Peer-reviewed Research Article Citation: Leonard F, Lyttle MD, O’Sullivan D, Gilligan J, Roland D, Barrett M, et al. (2026) Perceptions and knowledge of machine learning for paediatric related decision support in emergency care – A UK and Ireland network survey study of clinician leaders. PLOS Digit Health 5(2): e0001213.
Machine Learning for Paediatric Related Decision Support in Emergency Care - A UK and Ireland Network Survey Study
The authors have declared no competing interest. The support of the Technological University Dublin Scholarship Programme is gratefully acknowledged. The funders did not have a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Disposable female urinal bottle (the UniWee) improves patient experience for immobile women with lower limb fractures
Handling editor Mary Dawood X @mdlyttle Contributors ST is the guarantor. ST designed the study, is fully responsible for the conduct of the study, had access to the data, analysed the data, is responsible for drafting this manuscript and controlled the decision to publish. SB, PE, SL, JP and ST lead the recruitment of participants and management of data in their respective departments.
ILCAs at the Queen Mary Summer Series Week 2
ILCAs at the Queen Mary Summer Series Week 2 by Mark Lyttle & Tony Woods 10 Jun 14:23 BST Race 1 (by Mark Lyttle) Doing a couple of half windward legs before the start, I felt there were frequent large shifts and gusts meaning the sides would be dangerous and the right side approaching the windward mark may have less wind in general.
The ILCA 4 - The single hander you've been looking for?
Please select your home edition Edition The ILCA 4 - The single hander you've been looking for? by Mark Lyttle 20 May 04:01 PDT UKLA are working hard on behalf of the wider ILCA/Laser sailing community. They are always looking at ways to include sailors of every age, weight and ability so they can race. Mark Lyttle, the current UKLA chair, writes a weekly blog (anyone can subscribe to this) in which he talks directly to us all.
What does SARS‐CoV‐2 tell us about the aetiology of environmental triggers for diabetes in children and young people?
Corresponding Author Ruud G.
International practice patterns of IV magnesium in paediatric acute asthma
asthma pediatric emergency medicine respiratory acute care Guideline recommendations about discharge of children with acute asthma treated with IV magnesium (IV-Mg) are disparate and inconclusive (see online supplemental material).
International practice patterns of IV magnesium in paediatric acute asthma
asthma pediatric emergency medicine respiratory acute care Guideline recommendations about discharge of children with acute asthma treated with IV magnesium (IV-Mg) are disparate and inconclusive (see online supplemental material).
International practice patterns of IV magnesium in paediatric acute asthma
http://orcid.org/0000-0002-2225-3215Laura Simone1, Roger Zemek2, http://orcid.org/0000-0001-9334-5144Damian Roland3,4, http://orcid.org/0000-0002-8634-7210Mark D Lyttle5, Simon Craig6, Stuart R Dalziel7, http://orcid.org/0000-0001-5901-4990Jocelyn Gravel8, http://orcid.org/0000-0002-0947-3571Yaron Finkelstein9, Sarah Curtis10, Stephen B Freedman11, Amy C Plint12, Suzanne Schuh13 on behalf of the Pediatric Emergency Research Network Group 1Emergency Medicine, Hospital for Sick Children,...
Features of the transposed seasonality of the 2021 RSV epidemic in the UK and Ireland: analysis of the first 10 000 patients
http://orcid.org/0000-0001-9334-5144Damian Roland1,2, Thomas Williams3, http://orcid.org/0000-0002-8634-7210Mark D Lyttle4,5, Robin Marlow4, http://orcid.org/0000-0002-0154-1306Pia Hardelid6, Ian Sinha7,8, http://orcid.org/0000-0001-7386-2849Olivia Swann3,9, Abigail Maxwell-Hodkinson8, http://orcid.org/0000-0001-7342-251XSteve Cunningham10,11 1 Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Royal Infirmary, Leicester, UK 2 SAPPHIRE Group, Health Sciences, University...
Features of the transposed seasonality of the 2021 RSV epidemic in the UK and Ireland: analysis of the first 10 000 patients
http://orcid.org/0000-0001-9334-5144Damian Roland1,2, Thomas Williams3, http://orcid.org/0000-0002-8634-7210Mark D Lyttle4,5, Robin Marlow4, http://orcid.org/0000-0002-0154-1306Pia Hardelid6, Ian Sinha7,8, http://orcid.org/0000-0001-7386-2849Olivia Swann3,9, Abigail Maxwell-Hodkinson8, http://orcid.org/0000-0001-7342-251XSteve Cunningham10,11 1Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Royal Infirmary, Leicester, UK 2SAPPHIRE Group, Health Sciences, University...
Pediatric Emergency Research in the UK and Ireland (PERUKI): developing a collaborative for multicentre research
Mark D Lyttle1,2, Ronan O'Sullivan3,4, Stuart Hartshorn5, Catherine Bevan6, Francesca Cleugh7, Ian Maconochie8, on behalf of PERUKI 1Department of Paediatric Emergency Medicine, Bristol Royal Hospital for Children, Bristol, UK 2University of the West of England, Bristol 3Department of Emergency Medicine, Cork University Hospital, Cork, Ireland 4Paediatric Emergency Research Unit (PERU), National Children's Research Centre, Dublin, Ireland 5Department of Paediatric Emergency Medicine,...
Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland
Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland http://orcid.org/0000-0001-9452-7716Thomas Waterfield1, Mark D Lyttle2,3, Charlotte Munday2, Steven Foster4, Marc McNulty4, Rebecca Platt5, Michael Barrett6,7, Emma Rogers6, http://orcid.org/0000-0002-5109-3417Sheena Durnin8,9, Nida Jameel10, Julie-Ann Maney11, Claire McGinn11, Lisa McFetridge12, Hannah Mitchell12, Deepika Puthucode13,...
Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland
Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland http://orcid.org/0000-0001-9452-7716Thomas Waterfield1, Mark D Lyttle2,3, Charlotte Munday2, Steven Foster4, Marc McNulty4, Rebecca Platt5, Michael Barrett6,7, Emma Rogers6, http://orcid.org/0000-0002-5109-3417Sheena Durnin8,9, Nida Jameel10, Julie-Ann Maney11, Claire McGinn11, Lisa McFetridge12, Hannah Mitchell12, Deepika Puthucode13,...
ILCA Spring Series at Queen Mary Sailing Club - Day 2
ILCA Spring Series at Queen Mary Sailing Club - Day 2 by Mark Lyttle 14 Apr 03:44 PDT 11 April 2021 ILCA Spring Series at Queen Mary © Simon Winkley 34 ILCAs lined up on the second Sunday of the Spring Series at Queen Mary Sailing Club after a very tedious lockdown. It is the tradition at QM that the first to round the windward mark of the first race writes the race report - this week that honour comes to Mark Lyttle.
Planning for success: overcoming challenges to recruitment and conduct of an open-label emergency department-led paediatric trial
Planning for success: overcoming challenges to recruitment and conduct of an open-label emergency department–led paediatric trial Louise Roper1, Mark D Lyttle2,3, Carrol Gamble4, Amy Humphreys4, Shrouk Messahel5, Elizabeth D Lee5, Joanne Noblet5, Helen Hickey4, Naomi Rainford4, Anand Iyer6, Richard Appleton6, http://orcid.org/0000-0002-5726-5304Kerry Woolfall1 1 Institute of Population Health & Society, University of Liverpool, Liverpool, UK 2 Emergency Department, Bristol Royal Children's...
Loop-mediated isothermal amplification for the early diagnosis of invasive meningococcal disease in children
Paediatric emergency medicine Loop-mediated isothermal amplification for the early diagnosis of invasive meningococcal disease in children Free http://orcid.org/0000-0001-9452-7716Thomas Waterfield1,2, Mark D Lyttle3,4, James McKenna5, Julie-Ann Maney6, http://orcid.org/0000-0001-9334-5144Damian Roland7,8, http://orcid.org/0000-0001-9272-2323Michael Corr9, Kerry Woolfall10, Bethany Patenall11, Michael Shields1,12, Derek Fairley12 on behalf of Paediatric Emergency Research in the UK and...
Validating clinical practice guidelines for the management of children with non-blanching rashes in the UK (PiC): a prospective, multicentre cohort study
Summary Background No previous studies have validated current clinical practice guidelines for the management of non-blanching rashes in children who have received meningococcal B and C vaccinations. The aim of this study was to evaluate the performance of existing clinical practice guidelines in the diagnosis of invasive meningococcal disease in children presenting with a fever and non-blanching rash in the UK.
UKLA Noble Marine ILCA7 Autumn Qualifier at Weymouth & Portland Sailing Academy
UKLA Noble Marine ILCA7 Autumn Qualifier at Weymouth & Portland Sailing Academy by Ben Flower and Mark Lyttle 21 Oct 09:28 PDT 17-18 October 2020 It was a rather cold affair with the first and only autumn qualifier getting under way at WPNSA. The racing was once again in the harbour and on the Saturday there was 10-12 knots of breeze coming from the East.
Planning for success: overcoming challenges to recruitment and conduct of an open-label emergency department-led paediatric trial
Planning for success: overcoming challenges to recruitment and conduct of an open-label emergency department–led paediatric trial Louise Roper1, Mark D Lyttle2,3, Carrol Gamble4, Amy Humphreys4, Shrouk Messahel5, Elizabeth D Lee5, Joanne Noblet5, Helen Hickey4, Naomi Rainford4, Anand Iyer6, Richard Appleton6, http://orcid.org/0000-0002-5726-5304Kerry Woolfall1 1Institute of Population Health & Society, University of Liverpool, Liverpool, UK 2Emergency Department, Bristol Royal Children's...
Seven-step framework to enhance practitioner explanations and parental understandings of research without prior consent in paediatric emergency and critical care trials
Seven-step framework to enhance practitioner explanations and parental understandings of research without prior consent in paediatric emergency and critical care trials Louise Roper1, Mark D Lyttle2,3, Carrol Gamble4, Amy Humphreys4, Shrouk Messahel5, Elizabeth D Lee5, Joanne Noblet5, Helen Hickey4, Naomi Rainford4, Anand Iyer6, Richard Appleton6, http://orcid.org/0000-0002-5726-5304Kerry Woolfall1 1Institute of Population Health, University of Liverpool, Liverpool, UK 2Emergency Department,...
Loop-mediated isothermal amplification for the early diagnosis of invasive meningococcal disease in children
Loop-mediated isothermal amplification for the early diagnosis of invasive meningococcal disease in children http://orcid.org/0000-0001-9452-7716Thomas Waterfield1,2, Mark D Lyttle3,4, James McKenna5, Julie-Ann Maney6, http://orcid.org/0000-0001-9334-5144Damian Roland7,8, http://orcid.org/0000-0001-9272-2323Michael Corr9, Kerry Woolfall10, Bethany Patenall11, Michael Shields1,12, Derek Fairley12 on behalf of Paediatric Emergency Research in the UK and Ireland (PERUKI) 1Wellcome-Wolfson...
Research without prior consent in paediatric emergency and critical care medicine
To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect. Abstract Children and young peoples' healthcare should be evidence-based yet many treatments are unlicensed or prescribed off-label. Research is needed, but prospective informed consent for many emergency and critical care trials is neither feasible nor ethical – treatments are time critical, and delays for research discussions may cause harm.
045 We’re going to need a bigger boat! Evening opening of mothballed outpatient areas to reduce crowding in a children’s emergency department
045 We’re going to need a bigger boat! Evening opening of mothballed outpatient areas to reduce crowding in a children’s emergency department Katherine Hance1,2, Mark Lyttle1,2, Sue Humphreys1,2 1Emergency Department, Bristol Royal Hospital for Children, Bristol, UK 2Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK Abstract Background EDs are increasingly crowded, with negative impact on care quality. This is multifactorial, but tends to peak during evenings.
007 Variability in point of care ultrasound (POCUS) practices in paediatric emergency departments in the UK & ireland; a PERUKI study
Abstracts APEM Elizabeth Molyneux Prize 007 Variability in point of care ultrasound (POCUS) practices in paediatric emergency departments in the UK & ireland; a PERUKI study Mark Lyttle1, Dan Magnus2, Anand Kanani3, Lisa Kehler4, Niccolo Parri5, Sarah Jones6 1Bristol Royal Hospital for Children 2Uni 3Birmingham Women’s and Children’s Hospital 4Royal Wolverhampton NHS Trust 5Meyer University Children’s Hospital 6Alder Hey Children’s Hospital NHS Foundation Trust Abstract Background Point Of...
Parents’ and clinicians’ views on conducting paediatric diagnostic test accuracy studies without prior informed consent: qualitative insight from the Petechiae in Children study (PiC)
Parents’ and clinicians’ views on conducting paediatric diagnostic test accuracy studies without prior informed consent: qualitative insight from the Petechiae in Children study (PiC) Thomas Waterfield1, Mark D Lyttle2,3, Michael Shields1, Derek Fairley4, Damian Roland5, James McKenna4, Kerry Woolfall6 On behalf of Paediatric Emergency Research in the UK and Ireland (PERUKI) 1 Centre for Experimental Medicine, Wellcome Wolfson Institute of Experimental Medicine, Queen’s University Belfast,...
Parents’ and clinicians’ views on conducting paediatric diagnostic test accuracy studies without prior informed consent: qualitative insight from the Petechiae in Children study (PiC)
Parents’ and clinicians’ views on conducting paediatric diagnostic test accuracy studies without prior informed consent: qualitative insight from the Petechiae in Children study (PiC) Thomas Waterfield1, Mark D Lyttle2,3, Michael Shields1, Derek Fairley4, Damian Roland5, James McKenna4, Kerry Woolfall6 On behalf of Paediatric Emergency Research in the UK and Ireland (PERUKI) 1 Centre for Experimental Medicine, Wellcome Wolfson Institute of Experimental Medicine, Queen’s University Belfast,...
Epidemiology and aetiology of paediatric traumatic cardiac arrest in England and Wales
Epidemiology and aetiology of paediatric traumatic cardiac arrest in England and Wales James Vassallo1,2,3, Melanie Webster4, Edward B G Barnard3, Mark D Lyttle4,5, Jason E Smith3 On behalf of PERUKI (Paediatric Emergency Research in the UK and Ireland) 1 Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa 2 Institute of Naval Medicine, Gosport, UK 3 Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia),...
Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial
Summary Background Phenytoin is the recommended second-line intravenous anticonvulsant for treatment of paediatric convulsive status epilepticus in the UK; however, some evidence suggests that levetiracetam could be an effective and safer alternative. This trial compared the efficacy and safety of phenytoin and levetiracetam for second-line management of paediatric convulsive status epilepticus.
Canadian and UK/Ireland practice patterns in lumbar puncture performance in febrile neonates with bronchiolitis
Canadian and UK/Ireland practice patterns in lumbar puncture performance in febrile neonates with bronchiolitis Laura Simone1,2, Mark D Lyttle3, Damian Roland4,5, Derek Stephens6,7, Suzanne Schuh1,6,8 for the Pediatric Emergency Research Canada (PERC) and the Pediatric Emergency Research United Kingdom and Ireland (PERUKI) networks 1 Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada 2 Department of Pediatrics, University of Toronto, Toronto, ON,...
Canadian and UK/Ireland practice patterns in lumbar puncture performance in febrile neonates with bronchiolitis
Canadian and UK/Ireland practice patterns in lumbar puncture performance in febrile neonates with bronchiolitis Laura Simone1,2, Mark D Lyttle3, Damian Roland4,5, Derek Stephens6,7, Suzanne Schuh1,6,8 for the Pediatric Emergency Research Canada (PERC) and the Pediatric Emergency Research United Kingdom and Ireland (PERUKI) networks 1Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada 2Department of Pediatrics, University of Toronto, Toronto, ON,...
Comparing the usability of paediatric weight estimation methods: a simulation study
Comparing the usability of paediatric weight estimation methods: a simulation study Robin D Marlow1,2, Dora L B Wood3, Mark D Lyttle2,4 1 Population Health Sciences, University of Bristol, Bristol, UK 2 Paediatric Emergency Department, Bristol Royal Children’s Hospital, Bristol, UK 3 Paediatric Intensive Care, Bristol Royal Children’s Hospital, Bristol, UK 4 Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK Correspondence to Dr Robin D Marlow, Bristol...
Authors’ response to letter entitled ‘During a paediatric traumatic cardiac arrest, is ventricular fibrillation a reversible cause like any other?’
Authors’ response to letter entitled ‘During a paediatric traumatic cardiac arrest, is ventricular fibrillation a reversible cause like any other?’ Jason Smith1,2, James Vassallo1, Mark D Lyttle3 1 Emergency Department, Derriford Hospital, Plymouth, UK 2 Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK 3 Emergency Department, Bristol Royal Children’s Hospital, Bristol, UK Correspondence to Professor Jason Smith,...
Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion
Background Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist.
Paediatric traumatic cardiac arrest: the development of an algorithm to guide recognition, management and decisions to terminate resuscitation
In total, 41 individuals from a variety of backgrounds attended the consensus development meeting (table 1). The overwhelming majority of participants were consultants, mostly from paediatric emergency medicine. Responses to questions are shown in table 2, along with the number of participants responding for each statement. Of the 19 statements, 13 reached positive consensus and were included in the paediatric TCA algorithm (figure 1).
Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion
Background Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist.
Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion
Background Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist.
Epidemiology and aetiology of paediatric traumatic cardiac arrest in England and Wales
Patients and setting All paediatric and adolescent patients with TCA recorded on the TARN database for a 10-year period (2006–2015). Results 21 710 paediatric patients were included in the database; 129 (0.6%) sustained TCA meeting study inclusion criteria. The majority, 103 (79.8%), had a prehospital TCA. 62.8% were male, with a median age of 11.7 (3.4–16.6) years, and a median ISS of 34 (25–45). 110 (85.3%) had blunt injuries, with road-traffic collision the most common mechanism (n=73, 56.6%).
Paediatric traumatic cardiac arrest: the development of an algorithm to guide recognition, management and decisions to terminate resuscitation
Introduction Paediatric traumatic cardiac arrest (TCA) is a high acuity, low frequency event. Traditionally, survival from TCA has been reported as low, with some believing resuscitation is futile. Within the adult population, there is growing evidence to suggest that with early and aggressive correction of reversible causes, survival from TCA may be comparable with that seen from medical out-of-hospital cardiac arrests.
Comparing the usability of paediatric weight estimation methods: a simulation study
Objective Estimating weight is essential in order to prepare appropriate sized equipment and doses of resuscitation drugs in cases where children are critically ill or injured. Many methods exist with varying degrees of complexity and accuracy. The most recent version of the Advanced Paediatric Life Support (APLS) course has changed their teaching from an age-based calculation method to the use of a reference table. We aimed to evaluate the potential implications of this change.
Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management
Aims Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients.
Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management
Aims Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients.
49 Paediatric traumatic cardiac arrest - the development of a treatment algorithm
Introduction Paediatric Traumatic Cardiac Arrest (TCA) is a high acuity, low frequency event with fewer than 15 cases reported per year to the Trauma Audit Research Network (TARN). Traditionally survival from TCA has been reported as low, with some believing resuscitation is futile.
51 Paediatric emergency clinicians are rarely exposed to non-airway critical procedures: a predict/PERN study
Background Recent studies suggest that approximately one per thousand paediatric ED attendances may require some sort of critical procedure, with intubation being by far the most common. It is unknown how often critical non-airway procedures such as chest decompression, CPR, ED thoracotomy, defibrillation, pacing, and advanced vascular access techniques are performed by paediatric emergency clinicians.
The transition to clinical expert: enhanced decision making for children aged less than 5 years attending the paediatric ED with acute respiratory conditions
The supplementary skills of observation, risk management and intuition develop over the course of training and are used to good effect by experienced clinicians to arrive at rapid treatment decisions. Decision making in the paediatric ED (PED) for children attending with episodes of acute respiratory illness remains unexplored. Greater understanding of issues from urgent care settings could provide a platform for successful management of many conditions in the community.
The transition to clinical expert: enhanced decision making for children aged less than 5 years attending the paediatric ED with acute respiratory conditions -- Bowen et al. -- Emergency Medicine Journal
Background Rates of unplanned paediatric admissions are persistently high. Many admissions are short-stay events, lasting less than 48 hours. Objective This qualitative research explores factors that influence clinical decision making in the paediatric ED (PED) for children under 5 attending with acute respiratory conditions, focusing on how management decisions adapt with increasing experience.
The transition to clinical expert: enhanced decision making for children aged less than 5 years attending the paediatric ED with acute respiratory conditions -- Bowen et al. 34 (2): 76 -- Emergency Medicine Journal
Background Rates of unplanned paediatric admissions are persistently high. Many admissions are short-stay events, lasting less than 48 hours. Objective This qualitative research explores factors that influence clinical decision making in the paediatric ED (PED) for children under 5 attending with acute respiratory conditions, focusing on how management decisions adapt with increasing experience.
The transition to clinical expert: enhanced decision making for children aged less than 5 years attending the paediatric ED with acute respiratory conditions -- Bowen et al. 34 (2): 76 -- Emergency Medicine Journal
Conclusions The emergence of intuition entwined with approaches to risk management and the role of these skills in clinical decision making, carry implications for the development of training programmes for clinicians working in PEM. Enhanced training for such groups to permit development of the supplementary skills described in this study could have the ability to improve care delivery and even reduce paediatric admissions.
Kohler's disease: an unusual cause for a limping child
Kohler's disease: an unusual cause for a limping child Jemma Shanley1, David R James2, Mark D Lyttle2,3, Savvas Andronikou1,4, Dominique M A Knight5 1Faculty of Health Sciences, University of Bristol, Bristol, UK 2Emergency Department, Bristol Royal Hospital for Children, Bristol, UK 3Academic Department of Emergency Care, University of the West of England, Bristol, UK 4Department of Paediatric Radiology, Bristol Royal Hospital for Children, Bristol, UK 5Department of Orthopaedics, Bristol...
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