Are we following the guiding SIGN when managing paediatric XXXX ?

@entity1 @entity542
BACKGROUND AND AIMS: The Scottish Intercollegiate Guidelines Network (SIGN) has published guidelines for the management of @entity1 with @entity542 . The management of @entity1 with @entity542 admitted to our local unit under the Paediatric Surgeons has been audited to determine whether or not current practice follows SIGN recommendations. METHODS: Data were collected retrospectively from the case records of @entity1 admitted between January and December 2007. The SIGN guideline 'Early Management of @entity1 with a @entity542 ' (Guideline 46) was published in 2000 and updated in 2009 (Guideline 110). @entity542 admission practices were audited against both guidelines. RESULTS: The case records of 200 @entity1 were analysed. According to SIGN Guideline 46 (2000), 146 Computed Tomography (CT) scans were indicated but only 24 were performed (16%). The updated Guideline 110 (2009) suggests a CT scan was indicated in 24 @entity1 and should have been considered in a further 87. However, only 12 (50%) and 18 (21%) @entity1 were imaged in these respective groups. Both guidelines indicated neurosurgical review in 13 @entity1 but sought in only 4 (31%). 50 @entity1 were deemed to have suffered a significant @entity542 warranting follow-up, but this was arranged in only 14 (28%). CONCLUSIONS: Our study has identified that management of paediatric @entity542 in our unit is reliant on clinical acumen rather than the SIGN guidelines when making decisions regarding the need for imaging, neurosurgical review and follow-up. We suggest further investigation is required to determine whether greater awareness and closer adherence with the guidelines would alter clinical outcomes.
