acquired brain injury in childhood – back to the beginning
DESCRIPTION
Acquired Brain Injury in Childhood – Back to the beginning. Anna Maw Consultant Paediatric Neurologist CUH/CPFT. Overview. Acquired brain injury in childhood Background to this project (what I thought I was going to learn) Project method Findings and thoughts Where next ?. - PowerPoint PPT PresentationTRANSCRIPT
Acquired Brain Injury in Childhood ndash Back to the beginning
Anna MawConsultant Paediatric Neurologist
CUHCPFT
Overview
bull Acquired brain injury in childhood bull Background to this project (what I thought I
was going to learn)bull Project methodbull Findings and thoughtsbull Where next
Acquired Brain Injury in childhood ndash Background
bull Lifelong condition with lifelong implicationsbull Recovery and rehabilitation have different
aims in childhood ndash ldquoback to normalrdquo is never enough
bull Many consequences remain hidden or unrecognised for many years ndashsilent disability
DEVELOPMENT
ImpairmentPhysical disabilityMoodCognitionBehaviour
BehaviourImpulsivityPoor concentrationSocial judgementPlanning and organisation
ConsequencesLoss of social participationFamily strainSchool failureOffending behaviour
Acquired Brain Injury ndash Complex needs in a complex system
Increased contact with services
Youth Justice
EducationSocial Care
Health
Third Sector
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What is their service user journeybull What service needs do they havebull What is the best configuration of services to meet those
needs
wwwinclusivedesigntoolkitcom
wwwinclusivedesigntoolkitcom
Paediatric Intensive Care Unit (PICU) Data
bull Aim to identify ndash children with first presentation of a condition which carries a
significant risk of acquired brain injuryndash PICU admission as a proxy marker of severity
bull Admission data from 2007-2011bull 2723 admissionsbull Phase 1 ndash exclude all children with clearly unrelated conditionsbull Phase 2 ndash exclude re-admissions elective admissions children who died on PICU
and children with primary oncology diagnosisbull Phase 3 ndash group children into broad diagnostic categoriesbull Phase 4 ndash review electronic medical records lab results imaging ndash CT MRI of each
case to ensure correct diagnosis Further exclusionsbull Final cohort 253 children age 0-16bull 154 boys 99 girls
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Overview
bull Acquired brain injury in childhood bull Background to this project (what I thought I
was going to learn)bull Project methodbull Findings and thoughtsbull Where next
Acquired Brain Injury in childhood ndash Background
bull Lifelong condition with lifelong implicationsbull Recovery and rehabilitation have different
aims in childhood ndash ldquoback to normalrdquo is never enough
bull Many consequences remain hidden or unrecognised for many years ndashsilent disability
DEVELOPMENT
ImpairmentPhysical disabilityMoodCognitionBehaviour
BehaviourImpulsivityPoor concentrationSocial judgementPlanning and organisation
ConsequencesLoss of social participationFamily strainSchool failureOffending behaviour
Acquired Brain Injury ndash Complex needs in a complex system
Increased contact with services
Youth Justice
EducationSocial Care
Health
Third Sector
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What is their service user journeybull What service needs do they havebull What is the best configuration of services to meet those
needs
wwwinclusivedesigntoolkitcom
wwwinclusivedesigntoolkitcom
Paediatric Intensive Care Unit (PICU) Data
bull Aim to identify ndash children with first presentation of a condition which carries a
significant risk of acquired brain injuryndash PICU admission as a proxy marker of severity
bull Admission data from 2007-2011bull 2723 admissionsbull Phase 1 ndash exclude all children with clearly unrelated conditionsbull Phase 2 ndash exclude re-admissions elective admissions children who died on PICU
and children with primary oncology diagnosisbull Phase 3 ndash group children into broad diagnostic categoriesbull Phase 4 ndash review electronic medical records lab results imaging ndash CT MRI of each
case to ensure correct diagnosis Further exclusionsbull Final cohort 253 children age 0-16bull 154 boys 99 girls
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Acquired Brain Injury in childhood ndash Background
bull Lifelong condition with lifelong implicationsbull Recovery and rehabilitation have different
aims in childhood ndash ldquoback to normalrdquo is never enough
bull Many consequences remain hidden or unrecognised for many years ndashsilent disability
DEVELOPMENT
ImpairmentPhysical disabilityMoodCognitionBehaviour
BehaviourImpulsivityPoor concentrationSocial judgementPlanning and organisation
ConsequencesLoss of social participationFamily strainSchool failureOffending behaviour
Acquired Brain Injury ndash Complex needs in a complex system
Increased contact with services
Youth Justice
EducationSocial Care
Health
Third Sector
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What is their service user journeybull What service needs do they havebull What is the best configuration of services to meet those
needs
wwwinclusivedesigntoolkitcom
wwwinclusivedesigntoolkitcom
Paediatric Intensive Care Unit (PICU) Data
bull Aim to identify ndash children with first presentation of a condition which carries a
significant risk of acquired brain injuryndash PICU admission as a proxy marker of severity
bull Admission data from 2007-2011bull 2723 admissionsbull Phase 1 ndash exclude all children with clearly unrelated conditionsbull Phase 2 ndash exclude re-admissions elective admissions children who died on PICU
and children with primary oncology diagnosisbull Phase 3 ndash group children into broad diagnostic categoriesbull Phase 4 ndash review electronic medical records lab results imaging ndash CT MRI of each
case to ensure correct diagnosis Further exclusionsbull Final cohort 253 children age 0-16bull 154 boys 99 girls
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
DEVELOPMENT
ImpairmentPhysical disabilityMoodCognitionBehaviour
BehaviourImpulsivityPoor concentrationSocial judgementPlanning and organisation
ConsequencesLoss of social participationFamily strainSchool failureOffending behaviour
Acquired Brain Injury ndash Complex needs in a complex system
Increased contact with services
Youth Justice
EducationSocial Care
Health
Third Sector
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What is their service user journeybull What service needs do they havebull What is the best configuration of services to meet those
needs
wwwinclusivedesigntoolkitcom
wwwinclusivedesigntoolkitcom
Paediatric Intensive Care Unit (PICU) Data
bull Aim to identify ndash children with first presentation of a condition which carries a
significant risk of acquired brain injuryndash PICU admission as a proxy marker of severity
bull Admission data from 2007-2011bull 2723 admissionsbull Phase 1 ndash exclude all children with clearly unrelated conditionsbull Phase 2 ndash exclude re-admissions elective admissions children who died on PICU
and children with primary oncology diagnosisbull Phase 3 ndash group children into broad diagnostic categoriesbull Phase 4 ndash review electronic medical records lab results imaging ndash CT MRI of each
case to ensure correct diagnosis Further exclusionsbull Final cohort 253 children age 0-16bull 154 boys 99 girls
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What is their service user journeybull What service needs do they havebull What is the best configuration of services to meet those
needs
wwwinclusivedesigntoolkitcom
wwwinclusivedesigntoolkitcom
Paediatric Intensive Care Unit (PICU) Data
bull Aim to identify ndash children with first presentation of a condition which carries a
significant risk of acquired brain injuryndash PICU admission as a proxy marker of severity
bull Admission data from 2007-2011bull 2723 admissionsbull Phase 1 ndash exclude all children with clearly unrelated conditionsbull Phase 2 ndash exclude re-admissions elective admissions children who died on PICU
and children with primary oncology diagnosisbull Phase 3 ndash group children into broad diagnostic categoriesbull Phase 4 ndash review electronic medical records lab results imaging ndash CT MRI of each
case to ensure correct diagnosis Further exclusionsbull Final cohort 253 children age 0-16bull 154 boys 99 girls
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Paediatric Intensive Care Unit (PICU) Data
bull Aim to identify ndash children with first presentation of a condition which carries a
significant risk of acquired brain injuryndash PICU admission as a proxy marker of severity
bull Admission data from 2007-2011bull 2723 admissionsbull Phase 1 ndash exclude all children with clearly unrelated conditionsbull Phase 2 ndash exclude re-admissions elective admissions children who died on PICU
and children with primary oncology diagnosisbull Phase 3 ndash group children into broad diagnostic categoriesbull Phase 4 ndash review electronic medical records lab results imaging ndash CT MRI of each
case to ensure correct diagnosis Further exclusionsbull Final cohort 253 children age 0-16bull 154 boys 99 girls
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Acquired Brain Injury by diagnosis
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
bull Young patientsbull Very severely injuredbull High mortality ndash 10
diedbull Global brain injurybull High level of physical
needbull 13 of 19 patients are
aged 2 or under
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Lancet Neurol 2012 Sep11(9)774-83 Epub 2012 Aug 3
Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC) a case-control studyViner RM Booy R Johnson H Edmunds WJ Hudson L Bedford H Kaczmarski E Rajput K Ramsay M Christie D
bullabout a tenth have major disabling deficitsbullmore than a third have one or more deficits in physical cognitive and psychological functioning with the additional burden of memory deficits and executive function problems
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Traumatic Brain Injury - 130 cases
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
bull 30 are under 1 yearbull 46 are age 4 or underbull What do we tell them about
the lifetime risk of problems
bull How do we keep track of them over time
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
bull Who gets severe acquired brain injurybull How do they injure their brainsbull What problems and deficits are they left withbull What service needs do they havebull What is their service user journeybull What is the best configuration of services to
meet those needs
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Many thanks toAndrew BatemanTony HollandFergus GraceyTerry DickersonCecily Morrison
EASTERN CHILDRENS HEAD INJURY NETWORK
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
Acquired Brain Injury Pathway for Children
Discuss with local team - named contact for each locality
bull Initial high intensity nursing care
bull Ongoing specialist therapy input
bull Discuss with commissioners
ABI Passport
bullCommunity PaediatricsbullNeurologybullEndocrinebullCCPNRbullThird sectorbullAdult services
bullAssessment and Discharge Planning tool ndash Pilot bullMDT with 2-3 weeks notice involving local team bullCBIT child and family worker
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
bull Usually focal brain injurybull May make a good early physical
recoverybull Risk of significant cognitive
difficultiesbull Lots of research data on strokebull No reports in the literature
relating to outcome following
abscesses in children
Persona samples
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-
CLAHRC
bull NIHR Projectbull 9 collaborations around the
countrybull research focused on the
needs of patients and service users
bull to support the translation of research evidence into practice in the NHS
bull Emphasis on Mental Health
- Acquired Brain Injury in Childhood ndash Back to the beginning
- Overview
- Acquired Brain Injury in childhood ndash Background
- Acquired Brain Injury ndash Complex needs in a complex system
- PowerPoint Presentation
- Paediatric Intensive Care Unit (PICU) Data
- Acquired Brain Injury by diagnosis
- Slide 8
- Slide 9
- Traumatic Brain Injury - 130 cases
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Acquired Brain Injury Pathway for Children
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- CLAHRC
-