RT Journal Article SR Electronic T1 Outpatient respiratory management of the child with severe neurological impairment JF Archives of disease in childhood - Education & practice edition JO Arch Dis Child Educ Pract Ed FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 84 OP 91 DO 10.1136/archdischild-2012-302324 VO 98 IS 3 A1 McCrea, Nadine A1 O'Donnell, Roddy A1 Brown, Richard YR 2013 UL http://ep.bmj.com/content/98/3/84.abstract AB Most paediatricians will have faced the challenge of managing respiratory problems in the child with severe neurological impairment. These children are under-represented in clinical trials, and data is therefore often extrapolated from other groups, for example children with cystic fibrosis. This means that robust evidence for respiratory management in children with severe neurological impairment is often lacking. Here we have attempted to piece together the existing evidence to provide a rational approach to the management of respiratory problems in children with severe neurological impairment. We also hope to highlight areas of uncertainty, in order to aid honest discussions with families. The respiratory management of the child with neuromuscular disease is beyond the scope of this article.