Shrouk Messahel

Alder Hey Children's NHS Foundation Trust · Emergency Department

Objective To assess paediatric emergency department (PED) health professionals’ confidence, experience and awareness in managing traumatic dental injuries (TDIs). Design A cross-sectional online survey. Setting PED at Alder Hey Children’s Hospital and Birmingham Children’s Hospital. Results 94 ED health professionals responded. One-third of resp...

Shrouk Messahel,1 Louise Bracken,2 Richard Appleton3 1NIHR NWC Speciality Research Lead for Trauma and Emergency Care, The Emergency Department, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK; 2Paediatric Medicines Research Unit, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK; 3Faculty of Health and Life Scienc...

Background During the initial phase of the Coronavirus Disease 2019 (COVID-19) pandemic, reduced numbers of acutely ill or injured children presented to emergency departments (EDs). Concerns were raised about the potential for delayed and more severe presentations and an increase in diagnoses such as diabetic ketoacidosis and mental health issues....

Aims Electric (e-)scooters are increasingly popular in the UK and there is a paucity of published evidence regarding the injury patterns in children. Such vehicles can travel at speeds of up to 68 mph, in lanes of traffic and can present as major trauma or serious injuries as well as minor injuries. Rental e-scooters are illegal in under 16s and pr...

Background: The most common fractures in children are torus (buckle) fractures of the wrist. Controversy exists over treatment, which ranges from splint immobilisation and discharge to cast immobilisation, follow-up, and repeat imaging. This study compared pain and function in affected children offered a soft bandage and immediate discharge with t...

Background Torus (buckle) fractures of the wrist are the most common fractures in children involving the distal radius and/or ulna. It is unclear if children require rigid immobilisation and follow-up or would recover equally as well by being discharged without any immobilisation or a bandage. Given the large number of these injuries, identifying t...

Study objective Approximately 250,000 children undergo pediatric procedural sedation (PPS) in UK & Irish emergency departments (ED) annually. PPS practice in our setting has not been described as fully as in other high income countries. We aimed to evaluate PPS in UK and Irish EDs. Methods Online survey distributed through Pediatric Emergency Rese...

Background To investigate the impact of the COVID-19 pandemic and infection prevention measures on children visiting emergency departments across Europe. Methods Routine health data were extracted retrospectively from electronic patient records of children aged <16 years, presenting to 38 emergency departments (ED) in 16 European countries for the...

Aims/Objectives/Background Approximately 250,000 children undergo paediatric procedural sedation (PPS) in UK and Irish emergency departments (ED) annually. In comparison to other countries, PPS practice in our setting has not been described. We therefore aimed to evaluate PPS practice in UK and Irish EDs. Methods/Design Online survey distributed t...

Background Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation. Methods A cross-sectional online survey study of POCT use was conducte...

Background Music is known to have therapeutic benefits and is frequently used in healthcare. For children in emergency settings, it may reduce stress and pain. There is little evidence evaluating the effect of live music in an emergency setting. This innovative study explores the effect of live music on children undergoing a painful procedure in a...

Background With increasing wait times seen across Emergency Departments in recent years, it is vital to have a reliable triage system in place. Newborns represent a particularly high-risk group. They often have nonspecific presentations for serious underlying illness and a tendency toward rapid clinical deterioration. A range of benign clinical fin...

Background Convulsive status epilepticus is the most common neurological emergency in children. Its management is important to avoid or minimise neurological morbidity and death. The current first-choice second-line drug is phenytoin (Epanutin, Pfizer Inc., New York, NY, USA), for which there is no robust scientific evidence. Objective To determin...

Background Key challenges to the successful conduct of The Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children (EcLiPSE) trial were identified at the pre-trial stage. These included practitioner anxieties about conducting research without prior consent (RWPC), inexperience in conducting an ED-led trial and use of a...

Background Alternatives to prospective informed consent enable the conduct of paediatric emergency and critical care trials. Research without prior consent (RWPC) involves practitioners approaching parents after an intervention has been given and seeking consent for their child to continue in the trial. As part of an embedded study in the ‘Emergenc...

Background Acute exacerbations of asthma are common in children. Multiple asthma severity scores exist, but current emergency department (ED) use of severity scores is not known. Methods A systematic review was undertaken to identify the parameters collected in pediatric asthma severity scores. A survey of Paediatric Emergency Research in the Unit...

Aims Challenges to the success of ‘The Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children (EcLiPSE)’ trial included: practitioner anxieties about research without prior consent (‘deferred consent’), including how parents would react to being informed their child had already been randomised into the trial; inexperi...

Aim Phenytoin is the recommended second-line intravenous anticonvulsant in the management of paediatric convulsive status epilepticus (CSE). Anecdotal data suggest levetiracetam may be as effective as, and safer than phenytoin. The aim of this trial was to compare the effectiveness and safety of both drugs in CSE. Methods A superiority and open-la...

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...

Abstract Background EcLiPSE (Emergency treatment with Levetiracetam or Phenytoin in Status Epilepticus in children) is a randomised controlled trial (RCT) in the United Kingdom. Challenges to success include the need to immediately administer an intervention without informed consent and changes in staffing during trial conduct, mainly due to physic...

Background: Convulsive status epilepticus (CSE) is the most common life-threatening neurological emergency in childhood. These children are also at risk of significant morbidity, with acute and chronic impact on the family and the health and social care systems. The current recommended first-choice, second-line treatment in children aged 6 months a...

To evaluate the effectiveness of site initiation visit (SIV) training on healthcare practitioners’ (HCP) confidence in the recruitment of patients to EcLiPSE.

To inform the design of a randomised controlled trial (called EcLiPSE) to improve the treatment of children with convulsive status epilepticus (CSE). EcLiPSE requires the use of a controversial deferred consent process. Qualitative interview and focus group study. 8 UK support groups for parents of children who have chronic or acute health conditio...