Box 2.
Scenarios rated by panellists as appropriate to consider for home carea
| Past medical history (d) | Age | ||
|---|---|---|---|
| (a) 12–23 months | (b) 24 months–4 years and 11 months | (c) 5–12 years | |
| None (previously well aside from usual childhood illnesses) | If the child only has ear painb | ||
| No consensus/normal parental decision making requiredd | If the child only has reduced fluid intake for ≤24 hours | ||
| If the child only less socially interactive than usual | |||
| If the child has only had a high fever for ≤24 hoursc | |||
If the child only has ear painc and
| |||
| Previous admission for asthma, bronchiolitis, or other respiratory condition | No consensus/normal parental decision making requiredd | If the child only has ear painb | |
After considering the clinical stem, which states: for the parent of a child aged (a) 12–23 months/(b) 24 months–4 years and 11 months/(c) 5–12 years with ≥1 week of respiratory infection symptoms, for example, cough, sore throat, and/or runny nose, with or without eating adequately and normal conscious level, and with the (d) following past medical history and (e) combination of symptoms — what would be the most appropriate next step (f) (Rate on scale 1–9 = 1 inappropriate; 9 = appropriate) (see Box 1).
For children who have not been on a recent flight, this is nearly always due to infection and that ear pain can take ≤8 days24 for the symptom to fully resolve in the majority of children.
This guidance also applies to children who have previously been admitted for asthma, bronchiolitis, or another respiratory condition.
Where no consensus could be reached, the process was essentially unable to add anything to parents’ routine decision making, which therefore returns to being the default position.