Group A Streptococcus bacteria can cause various pyogenic infections such as tonsillitis, pharyngitis, scarlet fever, impetigo, erysipelas, cellulitis and pneumonia. Most group A Streptococcus infections in children are mild and respond positively to treatment with antibiotics. However, some children develop severe infection accompanied by complications such as sepsis and will require urgent treatment, which may include non-invasive or invasive ventilation and the administration of fluids and vasoactive agents. In some instances, for example if there are no beds available in the paediatric intensive care unit, these interventions may be undertaken in a ward setting. This article gives an overview of group A Streptococcus infection, including two rare but severe complications, streptococcal toxic shock syndrome and necrotising fasciitis. It uses a fictionalised case study to examine the management of the deteriorating child with suspected group A Streptococcus infection, including respiratory support, haemodynamic support and symptom management.
Food allergy is a common allergic disease and often coexists with other allergic diseases such as asthma, allergic rhinitis and eczema. Parents of children and young people with food allergy commonly experience stress and anxiety and this can significantly affect their child's mental health. Interventions that incorporate approaches from cognitive behavioural therapy (CBT) can reduce stress and anxiety in parents of children and young people with food allergy and support healthy adjustment and psychological well-being in their children. However, access to psychological services is limited. This article uses reflection on a case study to illustrate the value of taking a CBT-informed intervention approach and to outline the potential role for nurses in its delivery. Research suggests that talking therapies may improve mental health and parenting behaviours in the parents of children and young people with a range of long-term conditions, so this article is also relevant to their care.
Atopic eczema is a chronic, non-contagious, relapsing inflammatory skin condition commonly seen in children and adults. Children with atopic eczema often endure complex skincare regimens that can keep the condition under control when managed effectively. Nonadherence, particularly to topical treatments, is one of the most common causes of treatment failure in atopic eczema. This literature review aimed to explore the barriers that influence treatment adherence in children and young people with atopic eczema and identify recommendations for practice. Six studies were included in the literature review and three themes were identified: relationships, medicines concerns and information deficits. Healthcare professionals should strive to develop trusting relationships with parents and understand the barriers to treatment adherence. Individualised conversations and education about medicines concerns, understanding the psychosocial effects of atopic eczema on children and families, and providing clear, consistent advice can be beneficial.
Children with complex care needs are at an increased risk of developing serious illness which could lead to sepsis. Many children receiving palliative care do not have a completed advance care plan identifying their wishes for ongoing care, which means they would require active intervention if they were to become acutely unwell. Sepsis is the immune system's overreaction to an infection or injury and about 25,000 children are admitted to hospital with sepsis in the UK each year. Early recognition of the acutely unwell child and escalation of concerns from the community to an acute care setting is required to manage and treat a child who is deteriorating. This article describes a project of three phases which aimed to explore the assessment tools available to support recognition and screening of children who became acutely unwell while accessing community palliative care services. It also identifies the importance of working together in partnership with external organisations and acknowledges the achievements of all of the partners involved.