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.
New & Updated Guidelines - April/May
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Current number of
​PIER Guidelines
A-Z
To search for a specific guideline:
On a computer:
  1. Click the Ctrl and F keys on your keyboard
  2. Enter your search terms in the search box​
On a phone or tablet:
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  2. Click 'Find on Page'
  3. ​Enter your search terms

A
Abdominal Pain Acute Kidney Injury - Prevention & Recognition Adrenal Crisis (new presentation or pre-existing adrenal insufficiency) Ambiguous Genitalia (Initial Management of a Baby) Anaphylaxis ​​​Antibiotic Therapy for Specific Childhood Infections Antenatally Detected Uropathy Guidelines Arrhythmia - Tachyarrhythmia with a Pulse ​​Asthma (Acute) ​​Asthma (Chronic) Autosomal Dominant Poly-cystic Kidney Disease

B
Blocked Ventricular Shunt/Hydrocephalus ​​Burns ​​Bronchiolitis

C
Ceftriaxone Administration in Children Central Venous Access Devices ​Cellulitis Chemotherapy Induced Nausea and Vomiting Chicken Pox Contacts in Immunosuppressed Children on Methotrexate, Biologics or Steroids Child Protection Policies and Procedures (Hampshire, Isle of Wight, Portsmouth and Southampton)
  • Hampshire, IoW, Portsmouth and Southampton (HIPS) Guideline
​Child Protection Companion ​​Child Death CMV (Congenital) Congenital Hypothyroidism (and raised neonatal bloodspot TSH) Conjunctivitis in Children Constipation  Coughs and Colds Croup Cyanosed Infant with Systemic to Pulmonary Shunt (Blalock-Taussig or Sano shunt)

D
​​Decreased Conscious Level RCPCH Guidelines Dermatology
  • See Dermatology section
​​Dextrocardia Diabetes Diabetic Ketoacidosis ​​Diarrhoea and Vomiting Drowning

F
Fabricated and Induced Illness
  • Hampshire, IoW, Portsmouth and Southampton (HIPS) Protocol
​​​Facial Nerve Palsy Febrile Neutropaenia ​Femoral Fracture Fever First Afebrile Seizure​​Foreign Body Ingestion

G
Gastroesophageal Reflux Gastrostomy Interactive Toolkit Gentamicin Dosing in Children ​GCSF: The Use of Haematopoietic Growth Factors in Paediatric Oncology and Haematology Patients

H
Haematuria in Children Head Injury HSP in Children HSV (Neonatal) Humidified High Flow Hydrocephalus/Blocked Ventricular Shunt Hypercyanotic Spells in Tetralogy of Fallot ​Hyperinsulinaemic Hypoglycaemia in Neonates Hypertension (Oncology) Hypertension (Non-Oncology) Hypocalcaemia Hypoglycaemia

I
Infant Feeding Guidelines​ ​​Influenza Investigation of New Oncology Patients

K
Kawasaki Disease

N
Nasal Bridle Insertion and Management Nasal Humidified Oxygen (High Flow) Nasojejunal Tube Placement and Basic Care​ ​Nausea and Vomiting Management (Oncology) Neonatal Collapse ​Neonatal Guidelines Nephrotic Syndrome Nutrition (Oncology)

P
​​​Paediatric Inflammatory Multisystem Syndrome - Temporarily Associated with SARS-CoV2 (PIMS-TS) Parent Held Oncology Records Palliative Care and Symptom Management Preorbital Cellulitis Perioperative Fasting Guidelines Pneumonia Post-exposure prophylaxis (PEP) guidelines for children and adolescents potentially exposed to blood-borne viruses ​​Pseudomonas Treatment Pyelonephritis Pyloric Stenosis

R
​​Rapid Tranquillisation & the Management of Aggressive and Violent Paediatric Patients Rash with a Fever
Return of Spontaneous Circulation (ROSC) Management in Children

S
Sedation (Procedural) in the Emergency Department Sepsis Sickle Cell Crisis Sickle Cell Disease ​​​Seizure Spinal Cord Compression ​Starting TPN (Oncology) ​​​Steroids in Surgery for Children with Adrenal Suppression Stones (Nephrolithiasis & Nephrocalcinosis) Stroke Swollen Joints in Children ​Syphilis​ (Congenital)

T
​​TB Testing in Children on Biologics Tonsillitis Neonates Born to Mothers with Thyroid Disease Transfusion and Coagulation (Oncology) Trauma Guideline Traumatic Brain Injury ​Raised TSH on Neonatal Bloodspot (and initial management of congenital hypothyroidism) Typhilitis (Oncology)

U
​Undescended Testes
  • ​Full Guideline - Temporarily Unavailable pending review
Unsettled Baby Urinary Incontinence Uropathy (Antenatally Detected) GuidelinesUTI

V
Vaccinations For Paediatric Patients Treated With Standard-Dose Chemotherapy And Haemopoietic Stem Cell Transplantation RecipientsRe-Vaccination Schedule for Patients After Completion of Standard Dose ChemotherapyVancomycin Dosing in ChildrenVeno-Occlusive Disease (Oncology) Ventricular Shunt Problems Viral Infections, Viral Prophylaxis and Vaccinations (Oncology) Vitamin D

W
Viral Induced Wheeze and Acute Asthma Treatment ​Recurrent Wheeze in <5 year old
Child Death
Emergency Medicine
​Burns ​Drowning Extravasation ​Foreign Body Ingestion Head Injury Humidified High Flow in Children Procedural SedationReturn of Spontaneous Circulation (ROSC) Management in Children Traumatic Brain Injury Wessex Children's Major Trauma GuidelineNational Links
Endocrinology
Steroids in Surgery for Children with Adrenal Suppression Adrenal Crisis (new presentation or pre-existing adrenal insufficiency) Acute Hypocalcaemia Atypical or Ambiguous Genitalia Congenital Hypothyroidism (and raised neonatal bloodspot TSH) Diabetes Diabetic Ketoacidosis​
​ ​Electrolyte Replacement
  • SORT Guideline
  • ​Also see Electrolyte Replacement section of Oncology Guidelines
Hypoglycaemia ​Hyperinsulinaemic Hypoglycaemia in Neonates Low Vitamin D Obesity in Children and Young People Sick Day Telephone Advice for Children Taking Regular Oral Steroids ​​Management of Neonates Born to Mothers with Thyroid Disease
​National Links
Gastroenterology
Constipation  ​​​Diarrhoea and Vomiting Gastroesophageal Reflux Gastrostomy Interactive Toolkit Nasal Bridle Insertion and Management Nasojejunal Tube Placement and Basic Care​​National Links
Infectious Disease
Antibiotic Therapy for Specific Childhood Infections Ceftriaxone Administration in Children Management of Congenital CMV Chicken Pox Contacts in Immunosuppressed Children on Methotrexate, Biologics or SteroidsGentamicin Dosing in Children Kawasaki Disease ​​​Management of Neonatal HSV Management of Paediatric Influenza Malaria in Children ​Management of Suspected Meningitis ​Management of Infants at Risk of Congenital Syphilis​ Management of Sepsis ​​​Paediatric Inflammatory Multisystem Syndrome - Temporarily Associated with SARS-CoV2 (PIMS-TS) Post-exposure prophylaxis (PEP) guidelines for children and adolescents potentially exposed to blood-borne viruses TB Testing in Children on Biologics Vancomycin Dosing in Children
British Society for Antimicrobial Chemotherapy (BSAC) Paediatric Pathways
​​National Links​
LTV
Guides to LTV Ventilators
Nippy 4
Trilogy
Mental Health
Rapid Tranquillisation & the Management of Aggressive and Violent Paediatric Patients​​​
​National Links
Metabolic Disorders
Electrolyte Replacement
  • SORT Guideline
  • ​Also see Electrolyte Replacement section of Oncology Guidelines
Metabolic Emergencies ​
​National Links
Neonatology
Neonatal Collapse ​Nursing Guidelines (from Neonatal ODN website)
​​Clinical Guidelines (from Neonatal ODN website)
​Congenital Hypothyroidism (and raised neonatal bloodspot TSH) ​Initial Management of a Baby with Atypical or Ambiguous Genitalia ​Management of Congenital CMV
  • See Infectious Disease
Nephrology
Acute Kidney Injury - Prevention & Recognition ​​Antenatally Detected Uropathy GuidelinesAutosomal Dominant Poly Cystic Kidney Disease Electrolyte Replacement
  • SORT Guideline
  • ​Also see Electrolyte Replacement section of Oncology Guidelines
Haematuria in ChildrenManagement of HSP in Children Nephrotic Syndrome ​Pharmacological Management of Non-Neuropathic Overactive BladderPyelonephritisRecognition & Follow up of Hypertension Stones (Nephrolithiasis & Nephrocalcinosis) ​Assessment of Daytime Urinary IncontinenceUTI
​National Links
Oncology
COVID-19 Specialty Information
​Care and Management of Central Venous Access Devices ​Chemotherapy Induced Nausea and Vomiting Electrolyte Replacement Extravasation of Chemotherapy Febrile Neutropaenia ​GCSF: The Use of Haematopoietic Growth Factors in Paediatric Oncology and Haematology Patients Hypertension Investigation of New Patients Mucositis Nausea and Vomiting Management Nutrition Off Treatment Surveillance Oncology Emergencies Parent Held Oncology Records Palliative Care and Symptom Management ​Spinal Cord Compression ​Starting TPN Transfusion and Coagulation  Typhilitis Vaccinations For Paediatric Patients Treated With Standard-Dose Chemotherapy And Haemopoietic Stem Cell Transplantation Recipients Viral Infections, Viral Prophylaxis and Vaccinations ​Veno-Occlusive Disease ​
​National Links