Bedside Clinical Guidelines Partnership
in association with
partnersinpaediatrics
Paediatric
Guidelines
2025‒28
, This copy belongs to:
Name: ___________________________________________________
Further copies can be obtained from Partners in Paediatrics via
http://www.partnersinpaediatrics.org
Published by the Bedside Clinical Guidelines Partnership and Partners in Paediatrics
NOT TO BE REPRODUCED WITHOUT PERMISSION
Partners in Paediatrics
NHS Birmingham and Solihull Integrated Care Board
Birmingham Community Healthcare NHS Foundation Trust
Birmingham Women’s and Children’s NHS Foundation Trust
Coventry and Warwickshire Partnership NHS Trust
Dudley Group NHS Foundation Trust
East Cheshire NHS Trust
George Eliot Hospital NHS Trust
Midlands Partnership NHS Foundation Trust
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Sandwell and West Birmingham Hospitals NHS Trust
Shropshire Community Health NHS Trust
South Warwickshire NHS Foundation Trust
The Royal Orthopaedic Hospital NHS Foundation Trust
The Royal Wolverhampton NHS Trust
The Shrewsbury and Telford Hospital NHS Trust
University Hospitals Birmingham NHS Foundation Trust
University Hospitals Coventry and Warwickshire NHS Trust
University Hospitals of North Midlands NHS Trust
Walsall Healthcare NHS Trust
West Midlands Ambulance Service NHS Foundation Trust
Worcestershire Acute Hospitals NHS Trust
Herefordshire and Worcestershire Health and Care NHS Trust
Wye Valley NHS Trust
The Bedside Clinical Guidelines Partnership
County Durham and Darlington NHS Foundation Trust
The Dudley Group NHS Foundation Trust
Manchester University NHS Foundation Trust
Mid and South Essex University Hospitals Group
North Cumbria Integrated Care NHS Foundation Trust
Northern Care Alliance Group
Shrewsbury and Telford Hospital NHS Trust
Surrey and Sussex Healthcare NHS Trust
The Royal Wolverhampton Hospitals NHS Trust
University Hospitals Birmingham NHS Foundation Trust
University Hospitals of Morecambe Bay NHS Trust
University Hospitals North Midlands NHS Trust
Walsall Healthcare NHS Trust
, CONTENTS
Preface 4
Acknowledgements 6
ANAESTHETICS AND CRITICAL CARE
Analgesia 25
Anaphylaxis 29
APLS – Cardiorespiratory arrest 34
APLS – Recognition and assessment of the sick child 37
Brief resolved unexplained episode (BRUE) 56
Extravasation injuries 151
Intraosseous infusion 232
Intravenous fluid therapy 235
Long line insertion 257
Monitoring ex-prem infants and neonates aged <1 month post general
anaesthetic 271
Pain assessment and management 297
Post-operative nausea and vomiting aged >2 yr 318
Pre-operative fasting 319
Sedation 329
Tracheostomy 348
BREATHING (RESPIRATORY DISEASE)
Asthma – acute management 44
Bronchiolitis 58
Croup 87
Cystic fibrosis – Admission 66
Cystic fibrosis – Distal intestinal obstruction syndrome (DIOS) 68
Cystic fibrosis – Exacerbation 69
Cystic fibrosis – Microbiology 71
Pleural effusion 303
Pneumonia 306
Pneumothorax 309
CARDIOVASCULAR DISEASE
Cardiac arrhythmias 61
Chest pain 73
Cyanotic congenital heart disease – see Neonatal guidelines 96
ECG interpretation 131
Endocarditis prophylaxis 143
Heart failure 186
Heart murmur 188
Palpitations 299
Syncope 344
DERMATOLOGY
Eczema ‒ inpatient treatment 137
Eczema wet wrap dressings 139
DRUGS AND POISONING
Poisoning and drug overdose 312
ENDOCRINE/METABOLISM
Congenital hypothyroidism 222
Diabetes and fasting for surgery 100
Diabetes new (non-ketotic) 105
Diabetic ketoacidosis 107
Hypoglycaemia 215
, Ketone monitoring 250
Adrenal insufficiency (previously Steroid dependence) 19
GASTROENTEROLOGY
Abdominal pain 7
Coeliac disease 80
Constipation 82
Diarrhoea and vomiting 116
Eating disorders 123
Faltering growth 156
Gastro-oesophogeal reflux 172
Jaundice in neonates 242
Nutritional first line advice 282
Overweight and obesity (previously Obesity) 294
Pyloric stenosis 320
Vitamin D deficiency 367
HAEMATOLOGY
Bleeding disorders in children 50
Blood and platelet transfusions 54
Febrile neutropenia 163
Henoch-Schönlein purpura 189
Immune thrombocytopenic purpura (ITP) 224
INFECTION
Antibiotics 33
Cervical lymphadenopathy 92
Cuts and bites 89
Encephalitis 140
Febrile illness 159
Fever of unknown origin 166
Hepatitis B and C 191
HIV and hepatitis B post-exposure prophylaxis (PEP) 193
HIV testing 197
Immunodeficiency 226
Travel (previously Infection in the returning traveller) 352
Infection prevention 228
Kawasaki disease 245
Lyme disease 261
Malaria 264
Meningitis 267
Migrant 270
Needle stick injuries 272
Notifiable infectious diseases and food poisoning 280
Orbital cellulitis and sinusitis 287
Osteomyelitis and septic arthritis 290
Petechial/purpuric rashes 301
Scabies 328
Sepsis (including meningococcal) 334
Tuberculosis 356
Vancomycin 365
NEUROLOGY
Acute psychosis 16
Epilepsy 144
Facial palsy 155
Glasgow coma score 169
Headache 181
Head injury 177
Neuromuscular disorders 277
in association with
partnersinpaediatrics
Paediatric
Guidelines
2025‒28
, This copy belongs to:
Name: ___________________________________________________
Further copies can be obtained from Partners in Paediatrics via
http://www.partnersinpaediatrics.org
Published by the Bedside Clinical Guidelines Partnership and Partners in Paediatrics
NOT TO BE REPRODUCED WITHOUT PERMISSION
Partners in Paediatrics
NHS Birmingham and Solihull Integrated Care Board
Birmingham Community Healthcare NHS Foundation Trust
Birmingham Women’s and Children’s NHS Foundation Trust
Coventry and Warwickshire Partnership NHS Trust
Dudley Group NHS Foundation Trust
East Cheshire NHS Trust
George Eliot Hospital NHS Trust
Midlands Partnership NHS Foundation Trust
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Sandwell and West Birmingham Hospitals NHS Trust
Shropshire Community Health NHS Trust
South Warwickshire NHS Foundation Trust
The Royal Orthopaedic Hospital NHS Foundation Trust
The Royal Wolverhampton NHS Trust
The Shrewsbury and Telford Hospital NHS Trust
University Hospitals Birmingham NHS Foundation Trust
University Hospitals Coventry and Warwickshire NHS Trust
University Hospitals of North Midlands NHS Trust
Walsall Healthcare NHS Trust
West Midlands Ambulance Service NHS Foundation Trust
Worcestershire Acute Hospitals NHS Trust
Herefordshire and Worcestershire Health and Care NHS Trust
Wye Valley NHS Trust
The Bedside Clinical Guidelines Partnership
County Durham and Darlington NHS Foundation Trust
The Dudley Group NHS Foundation Trust
Manchester University NHS Foundation Trust
Mid and South Essex University Hospitals Group
North Cumbria Integrated Care NHS Foundation Trust
Northern Care Alliance Group
Shrewsbury and Telford Hospital NHS Trust
Surrey and Sussex Healthcare NHS Trust
The Royal Wolverhampton Hospitals NHS Trust
University Hospitals Birmingham NHS Foundation Trust
University Hospitals of Morecambe Bay NHS Trust
University Hospitals North Midlands NHS Trust
Walsall Healthcare NHS Trust
, CONTENTS
Preface 4
Acknowledgements 6
ANAESTHETICS AND CRITICAL CARE
Analgesia 25
Anaphylaxis 29
APLS – Cardiorespiratory arrest 34
APLS – Recognition and assessment of the sick child 37
Brief resolved unexplained episode (BRUE) 56
Extravasation injuries 151
Intraosseous infusion 232
Intravenous fluid therapy 235
Long line insertion 257
Monitoring ex-prem infants and neonates aged <1 month post general
anaesthetic 271
Pain assessment and management 297
Post-operative nausea and vomiting aged >2 yr 318
Pre-operative fasting 319
Sedation 329
Tracheostomy 348
BREATHING (RESPIRATORY DISEASE)
Asthma – acute management 44
Bronchiolitis 58
Croup 87
Cystic fibrosis – Admission 66
Cystic fibrosis – Distal intestinal obstruction syndrome (DIOS) 68
Cystic fibrosis – Exacerbation 69
Cystic fibrosis – Microbiology 71
Pleural effusion 303
Pneumonia 306
Pneumothorax 309
CARDIOVASCULAR DISEASE
Cardiac arrhythmias 61
Chest pain 73
Cyanotic congenital heart disease – see Neonatal guidelines 96
ECG interpretation 131
Endocarditis prophylaxis 143
Heart failure 186
Heart murmur 188
Palpitations 299
Syncope 344
DERMATOLOGY
Eczema ‒ inpatient treatment 137
Eczema wet wrap dressings 139
DRUGS AND POISONING
Poisoning and drug overdose 312
ENDOCRINE/METABOLISM
Congenital hypothyroidism 222
Diabetes and fasting for surgery 100
Diabetes new (non-ketotic) 105
Diabetic ketoacidosis 107
Hypoglycaemia 215
, Ketone monitoring 250
Adrenal insufficiency (previously Steroid dependence) 19
GASTROENTEROLOGY
Abdominal pain 7
Coeliac disease 80
Constipation 82
Diarrhoea and vomiting 116
Eating disorders 123
Faltering growth 156
Gastro-oesophogeal reflux 172
Jaundice in neonates 242
Nutritional first line advice 282
Overweight and obesity (previously Obesity) 294
Pyloric stenosis 320
Vitamin D deficiency 367
HAEMATOLOGY
Bleeding disorders in children 50
Blood and platelet transfusions 54
Febrile neutropenia 163
Henoch-Schönlein purpura 189
Immune thrombocytopenic purpura (ITP) 224
INFECTION
Antibiotics 33
Cervical lymphadenopathy 92
Cuts and bites 89
Encephalitis 140
Febrile illness 159
Fever of unknown origin 166
Hepatitis B and C 191
HIV and hepatitis B post-exposure prophylaxis (PEP) 193
HIV testing 197
Immunodeficiency 226
Travel (previously Infection in the returning traveller) 352
Infection prevention 228
Kawasaki disease 245
Lyme disease 261
Malaria 264
Meningitis 267
Migrant 270
Needle stick injuries 272
Notifiable infectious diseases and food poisoning 280
Orbital cellulitis and sinusitis 287
Osteomyelitis and septic arthritis 290
Petechial/purpuric rashes 301
Scabies 328
Sepsis (including meningococcal) 334
Tuberculosis 356
Vancomycin 365
NEUROLOGY
Acute psychosis 16
Epilepsy 144
Facial palsy 155
Glasgow coma score 169
Headache 181
Head injury 177
Neuromuscular disorders 277
