New recommendations for Child and Adolescent Care
It has been a busy week for the Child and Adolescent Care Panel with two new consensus recommendations for:
A new information box and an updated table of PIMS-TS definitions has also been added for ease of reading (further details below).
Update from the Care of Older People and Palliative Care Panel
The Care of Older People and Palliative Care Panel have reviewed each of the Taskforce’s existing recommendations to ensure specific considerations for the clinical care of COVID-19 in these patient populations have been discussed and captured, including for disease-modifying treatments (see the ‘key info’ section within each of the recommendations in MAGICapp).
The panel is currently developing new flowcharts for the management of people with COVID-19 who are older and living with frailty or cognitive impairment, and the management of people with COVID-19 receiving palliative care.
Participation in NHMRC/AHEC workshops on ethics framework for COVID-19
This week the NHMRC’s Australian Health Ethics Committee (AHEC) invited health consumers to participate in the next phase of the development of national framework for ethical decision-making when establishing health policies and practices to address pandemics such as COVID-19.
Our community partner, the Consumers Health Forum of Australia submitted Consumer Position Statement: Ethical Issues Arising from the COVID-19 Pandemic. One of the key ethical issues particularly relevant to the ongoing work off the Taskforce that was highlighted by CHF is that ‘Inaccurate information and misleading statements about treatments for COVID-19 should be widely corrected and rebutted to protect consumers.’
Several of our Taskforce Consumer Panel members attend workshops to develop case studies in public health ethics, clinical ethics and research ethics to illustrate the draft framework. The NHMRC will use these case studies in a broader online consultation to inform the next phase of framework development.
Thank you for your insights
The Taskforce is grateful to all clinicians who completed our recent survey to help improve and shape our clinical guideline recommendations and flowcharts. We look forward to sharing the results shortly.
Respiratory management of the deteriorating child
New consensus recommendation
Consider endotracheal intubation and mechanical ventilation in children and adolescents with COVID-19 who are deteriorating despite optimised, non-invasive respiratory support.
Extracorporeal membrane oxygenation for children
New consensus recommendation
Consider early referral to an ECMO centre for venovenous or venoarterial ECMO in mechanically ventilated children and adolescents with COVID-19 with refractory respiratory or cardiovascular failure despite optimising other critical care interventions.
Therapies for pre-existing conditions in patients with COVID-19
A new section has been added to house the existing recommendations on therapies for pre-existing conditions in patients with COVID-19.
Delayed umbilical cord clamping
New consensus recommendation
Delayed umbilical cord clamping is supported as part of standard care, independent of the presence of COVID-19.
Child and adolescent care
The Taskforce is continually monitoring research to update recommendations weekly as new evidence accumulates.
Five clinical flowcharts have been developed by the Taskforce to cover:
There are no changes to flowcharts this week.
We are currently reviewing evidence to develop recommendations and flowcharts to guide practice in areas including:
Cochrane
A Cochrane Rapid Review on the effectiveness of digital contact tracing technologies was published in the Cochrane Library this week. The authors investigated whether digital contact tracing, compared to manual contact tracing, is effective in reducing the spread of infection, as measured by secondary infections, identifying close contacts, tracing a complete set of contacts, and identifying the context of infection. Read here
It is a core mission of the Taskforce to engage with frontline clinicians to rapidly identify and address priority clinical questions.
Each week we collect suggestions for new clinical questions or topics for consideration by the Taskforce. A document that lists all of the suggested questions, topics and new patient groups that we have received to date is available here.
Please encourage your clinical colleagues to provide their insights via the website.