Regional Guidelines
The PIER tools and guidelines have been created to reduce the variation of care for paediatric conditions throughout the region. They have been created by multidisciplinary clinicians from throughout the region, with input from tertiary consultants, regional speciality networks and accepted national guidance. Our resources also include useful signposting websites for children and young people with chronic health conditions.
Search all the PIER, SORT and Healthier Together Guidelines
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New & Updated Guidelines - September 2025
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Guidelines Coming Soon
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Allergy
Anaphylaxis Management IgE Home Milk Introduction Paediatric Allergic Rhinitis Paediatric Egg Allergy Urticaria Cardiology
Acute Management of a Cyanosed Infant with Systemic to Pulmonary Shunt (Black-Taussig or Sano Shunt) Dextrocardia Hyper-cyanotic spells in Tetralogy of Fallots Perinatal Ectopic Beats Child Death
Hampshire and Isle of Wight Child Death Overview Panel Notification Form (CEDOP Form) Diabetes
Diabetic Ketoacidosis (DKA) Treatment of Children with Diabetes Undergoing Surgery Eating Disorders
Emergency Medicine & Acute Paediatrics
Brief Resolved Unexplained Event (BRUE) Debrief Tools for After a Difficult Event Difficult Intravenous Access Pathway Lower Motor Neurone Facial Nerve Palsy Fever in babies less than 90 days old (the 'hot baby' pathway) First Afebrile Seizure Paracetamol Overdose - 12hr SNAP Protocol Henoch-Scholein Purpura (HSP) Swollen Joints in Children Foreign Body Ingestion Procedural Sedation in the Emergency Department Use of Inhaled Methoxyflurane (Penthrox) as an Analgesic Agent for Acute Traumatic Pain and Painful Procedures Trauma
Toxic Shock Syndrome in Paediatric Burns Endocrine
Adrenal Crisis (New Presentation or Pre-existing adrenal insufficiency) Ambiguous Genitalia (Initial Management of a Baby) Congenital Hyperinsulinism in Neonates Hyperthyroidism and Thyrotoxicosis Acute Hypocalcaemia Investigations and Initial Management of Hypoglycaemia Management of Neonates Born to Mothers with Thyroid Disease Management of Raised Neonatal Bloodspot TSH and Initial Management of Congenital Hypothyroidism Sick Day Steroids Guideline Peri-operative Steroid Management Obesity Genetics
Choosing and Ordering Whole Genome Sequencing for Children with Developmental Delay How to Request Urgent Whole Genome Sequencing for Acutely Unwell Children Gastroenterology
Bedside Placement and Care of a Nasojejunal Tube Gastrostomy Toolkit Nasal Bridle in Children Prescribing and Monitoring of Biologics in IBD Management of Significant Upper GI Bleed Haematology
Assessment and Management of Idiopathic Thrombocytopaenic Purpura (ITP) Management of Newborn infant where a parent has Hereditary Spherocytosis Sickle Cell
Infectious Diseases
Gentamicin Dosing in Children Kawasaki Disease Lyme Disease Congenital Cytomegalovirus (CMV) Chicken Pox Contacts in Immunosuppressed Children on Methotrexate, Biologics or Steroids Management of Infants at Risk of Congenital Syphilis Malaria Suspected Meningitis Neonatal HSV Paediatric Inflammatory Multisystem Syndrome - Temporarily Associated with SARS-CoV2 (PIMS-TS) Paediatric Influenza TB Testing in Children on Biologics Vancomycin Guideline Non-Tuberculous Myobacterial Cervical Lymphadenitis Acute Management of Pertussis Position Statement on Respiratory PCR Testing in Children |
Infant Feeding
IgE Home Milk Introduction Mental Health & Eating Disorders
Medical Assessment in Eating Disorders Management of a Ward Admission in Eating Disorders Rapid Tranquilisation Policy Mental Health Act Frameworks Explainer Neonatal Guidelines
Thames Valley and Wessex Neonatal Network Congenital Hyperinsulinism in Neonates Ambiguous Genitalia (Initial Management of a Baby) Congenital Cytomegalovirus (CMV) Neonatal HSV Management of Infants at Risk of Congenital Syphilis Management of Neonates Born to Mothers with Thyroid Disease Antenatally Detected Uropathy - Investigations and Management Nephrology & Urology
Acute Kidney Injury Prevention and Recognition Antenatally Detected Uropathy - Investigations and Management Haematuria in Children Assessment of Childhood Daytime Urinary Incontinence Micturating Cystograms in Children Nephrolithiasis and Nephrocalcinosis (Stones) Nephrotic Syndrome Pharmacological Management of Non-Neuropathic Overactive Bladder (Wetting) Recognition and Follow up of Hypertension in Children Neurology & Neurosurgery
Anticonvulsant Medications when the Oral Route is Unavailable Assessment of Childhood Daytime Urinary Incontinence Care for Children with Hydrocephalus or a Blocked Ventricular Shunt Encephalitis First Afebrile Seizure Idiopathic Intracranial Hypertension in Children aged 1-18 years Lower Motor Neurone Facial Nerve Palsy Management of Children and Young People with Acute Decrease in Conscious Level (RCPCH DeCon Guidelines) Pineal Cyst Pathway Oncology
Management of Chemotherapy Induced Nausea and Vomiting (CCLG Guideline) Electrolyte Management Guidelines for the Prophylaxis of Pneumocystis Jirovecii Pneumonia (PJP) in Children with Solid Tumours Hypoalbuminaemia in Paediatric Oncology Investigation of New Patients in Oncology Blocked Central Venous Devices and Lines Hyperleucocytosis Hypertension in Oncology Ifosfamide Induced Encephalopathy Varicella Contact in Oncology Veno-occlusive Disease in Paediatric Oncology Patients Viral Infections, Viral Prophylaxis and Vaccination Guidance Off Treatment Follow Up for Acute Lymphoblastic Leukaemia (ALL) Systemic Anti Cancer Therapy Extravasation Guideline Children’s Cancer Referral Pathway into Southampton Principle Treatment Centre (PTC) V1.0 Re-Vaccination Schedule for Patients Beginning 3 months After Completion of Standard Dose Chemotherapy Recognition and Management of Tumour Lysis Spinal Cord Compression (SCC) Starting Parenteral Nutrition (PN) in Paediatric Oncology Symptom Management and Palliative Care in Oncology The Use of Haemopoietic Growth Factors in Paediatric Oncology and Haematology Patients Transfusion and Coagulation in Paediatric Oncology Typhilitis Vaccinations For Paediatric Patients Treated With Standard-Dose Chemotherapy and Haemopoietic Stem Cell transplantation Recipients Supportive Care Guidelines: Management of Nutrition Steroid, Chemotherapy or Transplant Induced Hyperglycaemia Recommendations for the Prevention and Management of Oral Complications in Children and Young People with Cancer (CCLG) List of Approved Chemotherapy Regimes Parent Held Oncology Records Orthopaedics
Femoral Fracture Transfer Guideline Respiratory
Eradication Protocol for Initial Isolates of Pan Sensitive Pseudomonas Aeruginosa Asthma
Use of Heated, Humidified High Flow for Children and Young People Long Term Ventilation Quick Links Chest Drain Insertion in a DGH Rheumatology
Chicken Pox Contacts in Immunosuppressed Children on Methotrexate, Biologics or Steroids Swollen Joints in Children Surgery
Perioperative Fasting Guidelines Pre-Operative Care of Infants with Pyloric Stenosis |
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Disclaimer
The PIER guidelines have been created collaboratively with ratification through the relevant regional speciality clinical network. They represent the views of the relevant speciality clinical network and have been produced after consideration of the available evidence in conjunction with local expertise.
Guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the individual circumstances of their patients.
Governance and ratification of the PIER Guidelines is kindly performed by the Child Health Governance group at University Hospital Southampton. Overall management of the guidelines is performed by the PIER team.
PIER guidelines are subject to a 3 year review process which takes into account any changes in management or new research. Some guidelines may have reached or passed this review date. These guidelines are still available for use in clinical practice but should be used at the clinicians discretion with appropriate review of any new national guidelines that may be available. PIER does not hold any responsibility for the outcomes of the use for guidelines used outside of their review process.
Resources contained within the Resource Hub as provided from Trusts within the Wessex and Thames Valley region for free use within the Network's Trusts. These resources are available for local adaptation and are not checked of ratified using the Guidelines governance procedures. Please use these resources at your discretion and with local governance protocols.
Guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the individual circumstances of their patients.
Governance and ratification of the PIER Guidelines is kindly performed by the Child Health Governance group at University Hospital Southampton. Overall management of the guidelines is performed by the PIER team.
PIER guidelines are subject to a 3 year review process which takes into account any changes in management or new research. Some guidelines may have reached or passed this review date. These guidelines are still available for use in clinical practice but should be used at the clinicians discretion with appropriate review of any new national guidelines that may be available. PIER does not hold any responsibility for the outcomes of the use for guidelines used outside of their review process.
Resources contained within the Resource Hub as provided from Trusts within the Wessex and Thames Valley region for free use within the Network's Trusts. These resources are available for local adaptation and are not checked of ratified using the Guidelines governance procedures. Please use these resources at your discretion and with local governance protocols.
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