Anaphylaxis registry  Food allergy is the most common cause of potentially life-threatening, anaphylaxis reactions in children and young people. There is an urgent need to learn more about the circumstances of allergic reactions in the community, to reduce the risk to individuals from anaphylaxis. However, existing NHS data does not provide sufficient information as to the cause and circumstances of reactions. The UK Anaphylaxis Registry provides a platform for clinicians to record details of all significant allergic reactions - irrespective of trigger - presenting to Emergency Departments in the UK, to help address this evidence gap. Understanding more about circumstances of allergic reactions occurring in the community will help us better inform patient care and guide public policy, for example with respect to allergen labelling. More details here or email anaphylaxis.registry@imperial.ac.uk

FIDO Febrile infants under 3 months of age are at higher risk of invasive and serious bacterial infections when compared to older children. Typically the approach to assessment and initial management of these infants involves blood testing, urinalysis, lumbar puncture and parenteral antibiotics. In the USA and Europe a number of studies have shown that a low risk cohort can be identified that are suitable for  fewer investigations and management without parenteral antibiotics. The FIDO study is a prospective observational cohort study funded by the Royal College of Emergency Medicine that aims to validate  clinical practice guidelines for the assessment and management of febrile infants. Commencing in July 2022 this NIHR portfolio study aims to recruit at least 1000 infants from PERUKI sites. For more information email fidostudy@qub.ac.uk

THE Children’s Radius Acute Fracture Fixation Trial (CRAFFT)The UK is more interventional than many countries, including the USA, in the treatment of distal radius fractures in children. Standard UK treatment is surgical correction, whilst others often follow a non-operative approach. There is low quality evidence that these fractures heal well and completely correct themselves without surgery in children under 11 years old, even if bones are initially displaced. There is a clear and pressing need to inform patients about benefits or otherwise of treatment options, and a need to inform commissioners regarding the costs to the NHS and society. CRAFFT (The Children’s Radius Acute Fracture Fixation Trial) is a multi-centre prospective randomized non-inferiority trial of surgical reduction versus non-surgical casting for severely displaced off-ended distal radius fractures (metaphyseal or Salter Harris) in children aged 4 to 10 years. In this cross-network (PERUKI & BSCOS) study the primary outcome is the Patient Reported Outcomes Measurement Information System Upper Extremity Score for Children (PROMIS UE). The trial started in 2019 and recruitment will finish in 2023. The sample size is 750 children. More details here

BRONCHSTART

Respiratory syncytial virus (RSV) causes annual winter epidemics that usually peak in December. Infants are disproportionately affected, with infection leading to lower respiratory tract disease, most commonly bronchiolitis, that often result in emergency department visits and hospitalisations. Non-pharmaceutical interventions (NPIs) introduced globally to limit the spread of SARS-CoV-2 led to disruption of the typical RSV seasonality. Studies examining the aseasonal resurgence of RSV have been limited by sample size, and lack of information on secondary care episodes and clinical features. The BronchStart study is a prospective multi-centre cohort study with the objective to monitor RSV disease in children under two years of age attending emergency departments (EDs) across the UK and Ireland and examine the impact on timing, age and severity of clinical presentations as NPI restrictions are reduced throughout the UK and Ireland in 2021. The first phase of BronchSTART (May 2021-May 2022) has been completed and is currently being written up for publication. A short summary of the outcomes for the first 10000 patients is available (https://adc.bmj.com/content/early/2022/09/01/archdischild-2022-324241). Comparing the age distribution of hospitalised infants <12 months to previous years at two large paediatric centres currently participating in the BronchStart Study , we observed a similar age distribution. Disease severe enough to require intensive care was 2.5% in our cohort (for those aged 6 weeks to one year), comparable to 4.2% reported in previous studies. We also observed a substantial number of PED visits and admissions for RSV-positive 12-23 month old children in BronchStart: 362 out of 1,468 (24.7%) admissions were in this age group. The second phase of BronchSTART started in September 2022 and will investigate admitted patients and aim to link the genomics of the RSV virus with the clinical phenotype.