Assessing and treating children with gastroenteritis
Every year in England, between 150,000 and 300,000 children aged under 5 have diarrhoea and vomiting which, together, are a symptom of gastroenteritis.
Deaths from gastroenteritis are now rare in this country and usually, parents simply need to make sure the child drinks a lot of fluids and, if possible, eats certain foods. If it's severe, however, it may be a sign that they are seriously ill and need hospital treatment.
The problem is, how can parents and carers know when it is serious?
“Parents I speak to every day are concerned that they are receiving mixed messages about the treatment of gastroenteritis. For example, some parents I have spoken to have heard that they should give their child flat coke - when the evidence shows that this can make the problem far worse,” explains Advanced Paediatric Nurse Practitioner Simon Minford.
Narynder Johal, a parent of three, says she has been “very concerned” when her children have had diarrhoea and vomiting and confirms, “I have not always received consistent advice on how best to manage the condition.”
Simon and Narynder were both members of a group that developed ‘Management of acute diarrhoea and vomiting due to gastroenteritis in children under 5' (clinical guideline 84).
This clinical guideline was published in April by the National Institute for Health and Care Excellence (NICE) and the National Collaborating Centre for Women's and Children's Health (NCCWCH). It makes a series of recommendations to ensure all children, wherever they live in England, are given the same treatment by the NHS - and all parents are given the same advice.
For example, it points out that once parents have taken their child to see a doctor, gastroenteritis can usually be treated at home with a certain amount of support from a healthcare professional. Examples of such support could include advice on how long the sickness and diarrhoea is likely to last - and the best fluids and foods to give.
It also stresses the need for healthcare professionals to take a parent or carer's worries seriously - something that Narynder, feels is very important.
The patient version tells parents and carers about the care their child can expect to receive within the NHS and, just as importantly, the role they can play. Narynder says this will help “parents and carers to work in partnership with healthcare professionals to look after their child”.
Dr Monica Lakhanpaul, Co-director of the NCCWCH and a Consultant Paediatrician, believes the recommendations will help all healthcare professionals to assess children with gastroenteritis “so that they can be followed up by the right people, at the right time and within the right healthcare setting”.
“This guideline,” she says, “will save children's lives.”
‘Management of acute diarrhoea and vomiting due to gastroenteritis in children under 5' NICE clinical guideline 84 is available from www.nice.org.uk/CG84
Issued: 26 May 2009
This page was last updated: 20 April 2010