Table 2

Current PERUKI research priorities (top 20 highest ranking questions)

RankQuestionMean score
1In paediatric patients with a fever, are any biomarkers helpful in predicting presence or absence of serious bacterial illness?5.62
2In children with possible major trauma, which predictor variables identify serious injury requiring direct transport to a major trauma centre?5.60
3In children with septic shock, does aggressive fluid management, as opposed to judicious fluid management, improve mortality? ‘That is, a response to FEAST study results in a UK population’5.57
4In children with acute severe asthma requiring intravenous therapy, is salbutamol, aminophylline, magnesium or a combination of these superior in safety, and clinical and cost effectiveness?5.53
5=In paediatric major trauma patients with major haemorrhage, does intravenous tranexamic acid compared with no treatment reduce mortality and morbidity?5.50
5=In children with c-spine injury, does currently available guidance provide satisfactory performance accuracy in identifying significant injuries?5.50
7In children with atraumatic limp (or possible orthopaedic sepsis), what is the best clinical decision rule for observation/investigation/management?5.34
8In children with petechiae, can a clinical decision rule be derived to determine which predictor variables necessitate investigation?5.33
9Are observation wards/clinical decisions units within EDs cost effective?5.28
10In children with head injury, does the updated NICE guidance compared with other clinical decision rules provide an acceptable management strategy in terms of performance accuracy and economic considerations?5.26
11=What are current procedural sedation practices within EDs in the UK and Ireland?5.24
11=In children with massive haemorrhage, does treatment with tranexamic acid compared with no tranexamic acid increase the rate of thromboembolic events?5.24
13=What are the top 10 most commonly occurring patient safety issues occurring in PERUKI EDs?5.22
13=In children with sepsis, does the use of paediatric sepsis bundles compared with standard treatment improve clinical outcomes?5.22
15What are the current practices for pain control for children within EDs in the UK and Ireland?5.19
16Has the introduction of paediatric trauma networks and major trauma centres altered the patterns of major injury that affect mortality?5.17
17=In children with petechiae, what is a safe minimum period of observation to ensure no clinical deterioration?5.16
17=In paediatric patients presenting to ED, can the use of the Paediatric Observation Priority Score compared with the ManChEWS or PEWS more accurately predict severity of illness and hence the need for admission or discharge from ED?5.16
17=In children presenting with an acute moderate exacerbation of wheeze aged 1–16 years, does intensive early treatment in the first hour compared with standard treatment reduce subsequent need for hospital admission?5.16
20In children with abdominal trauma, does the model provided by the PECARN network accurately identify which patients do not need abdominal imaging?5.12
  • ED, emergency department; ManChEWS, Manchester Children's Early Warning System; NICE, National Institute for Health and Care Excellence; PECARN, Pediatric Emergency Care Applied Research Network; PERUKI, Paediatric Emergency Research in the UK and Ireland; PEWS, Pediatric Early Warning System.