PT  - JOURNAL ARTICLE
AU  - Joana Freitas
AU  - Julia Sanpera
AU  - Tareq Dessouki
AU  - Victoria Rainsley
AU  - Maggie Nyirenda
AU  - Anna Canet Tarrés
AU  - Jessica Thomas
TI  - Fifteen-minute consultation: An approach to the management of PIMS-TS in a district general hospital
AID  - 10.1136/archdischild-2021-321921
DP  - 2021 Oct 22
TA  - Archives of disease in childhood - Education & practice edition
PG  - edpract-2021-321921
4099  - http://ep.bmj.com/content/early/2021/10/24/archdischild-2021-321921.short
4100  - http://ep.bmj.com/content/early/2021/10/24/archdischild-2021-321921.full
AB  - The COVID-19 pandemic has caused significant disease across the globe but children seem to be much less affected than adults. Coincidentally with the first wave of the pandemic, a cluster of children with fever, hyperinflammation and shock were identified, and this was first described as paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) by the Royal College of Paediatrics and Child Health. Patients with this novel condition were transferred to tertiary centres for management, increasing the pressure in these hospitals that were already extremely busy. There are multiple challenges related to the identification of patients presenting with PIMS-TS given that they mimic multiple other well-known paediatric conditions, like Kawasaki disease and toxic shock syndrome. Investigations and admission criteria to a district general hospital (DGH) need to be well established, and clear guidance should be available for easy decision making in a busy paediatric emergency department. Furthermore, these children can deteriorate suddenly and rapidly; close monitoring is vital, and any deterioration must be taken seriously and addressed immediately. All children who present severely ill, with shock and multiorgan failure, should be retrieved to a paediatric intensive care unit. As our knowledge of the condition has developed, more patients are now managed in a DGH, with virtual multidisciplinary team involvement. This paper outlines a structured approach to management of children presenting with suspected PIMS-TS in a DGH.