The Thames Valley and Wessex Paediatric Critical Care Network have finalised a guideline pathway for the management of children with difficult IV access. This pathway offers suggestions for how to escalate issues with IV access based on the clinical need along with options for vein-finding adjuncts which may be of help. The pathway has space to be personalised for your Trust with contact numbers etc to make management of this issue easier in acute situations. This pathway will be supported by a difficult IV access practical study day which will be available later in the year. 

Find the new pathway here - www.piernetwork.org/DIVA

The Wessex genetics service have released new guidance for clinical teams to help with requesting genetic testing for acutely unwell children or children with developmental delay. These new pathways can be found at the links below or under the genetics tab on the Guidelines page:

• R14 Genome Sequencing Flowchart for Acutely Unwell Children
• Whole Genome Sequencing Flowchart for Developmental Delay

The RCEM position statement November 2021 recommended that the use of the SNAP regime to treat paracetamol toxicity should become the default standard practise in all emergency departments. Prior to this uptake of the SNAP regime had been sporadic across the UK with some early adopter sites utilising in place of the previous 21hr standard 3 bag protocol with the benefit of a reduced length of NAC treatment.
 
As per the Lancet publication 2019, The SNAP regime has been shown to be as effective as the traditional regime in preventing liver injury, with fewer adverse reactions (anaphylactoid reactions).

www.piernetwork.org/paracetamol-overdose-snap-protocol.html