Improved diagnosis of serious infection in children
We have extensive experience examining how use vital signs to identify serious illness in children.
Vital signs are clinical measurements which assess a child’s basic body functions. The main vital signs measured are body temperature, heart rate, breathing rate, and oxygen saturation. Healthcare professionals often measure vital signs in children – but need more accurate ways of measuring vital signs and interpreting how normal or abnormal they are when caring for an individual child in primary care and emergency department settings.
We are involved in a stream of work which aims to find out how we can use vital signs to identify serious illness in children. We have produced new charts so that doctors and nurses can determine whether a child’s heart rate and breathing rates are normal or abnormal. These centile charts are being used around the world. We are now identifying more accurate ways of measuring breathing rates and oxygen levels in children, as these can be difficult to measure accurately. We are also identifying the best combination of vital signs that can be used in primary care and emergency departments to identify children with serious illnesses.
- ERNIE (European Recognition of serious iNfection collaboration). This group is co-ordinated by Matthew Thompson, and includes members from the Universities of Leuven (Belgium), Masstricht, and Rotterdam (NL), University College London, Northampton. The ERNIE group has published key research using data from primary care and emergency departments across Europe and is now investigating more effective ways to use vital signs and other clinical features to recognise serious illness earlier, in children visiting primary care and emergency departments.
- We are assessing more accurate methods to measure respiratory rate in children. In collaboration with Professor Lionel Tarrasenko and colleagues in the University of Oxford department of Biomedical Engineering, we have conducted several studies using a new method to measure breathing rate electronically in children. This new technology should be simple, rapid and not invasive, and may be able to improve the diagnostic tools that GPs and ED clinicians use to measure breathing rate.
- We are also researching the best way for GPs and other health care professionals to use vital signs in assessing children with acute illnesses. This includes determining the predictive value of abnormal levels of heart rate and breathing rate for identifying children with serious infection, using centile charts of heart rates expected in children of various age groups presenting with fever,
- C-Reactive Protein. Testing for levels of C-reactive protein in the blood helps GPs to assess the level of inflammation in patients, and to identify serious infection. These tests are not used routinely in GP settings. We will carry out research to assess the impact of using these tests on children attending primary care.