Children and young people can have a wide range of life limiting conditions and may sometimes live with such conditions for many years. This guideline recommends that end of life care be managed as a long term process that begins at the time of diagnosis of a life limiting condition and entails planning for the future. Sometimes it may begin before the child’s birth. It is part of the overall care of the child or young person and runs in parallel with other active treatments for the underlying condition itself. Finally, it includes those aspects related to the care of the dying.
“Think sepsis” in any person with suspected infection
Sepsis may present with non-specific symptoms and signs and without fever
Have a high index of suspicion of sepsis in those who are aged <1 year or >75 years, pregnant, or immunocompromised, and those who have a device or line in situ or have had recent surgery
Use risk factors and any indicators of clinical concern to decide if full assessment is required
Offer people at high risk of sepsis broad spectrum antibiotics and intravenous fluids in hospital
Most home care visits should be at least half an hour long to enable carers to provide the personalised and dignified care that elderly patients need when being supported to stay in their own home, says a guideline on social care services from the National Institute for Health and Care Excellence (NICE).
Shorter visits would be appropriate only rarely, said the finalised guideline on home care, published on 23 September. This might be when the visit is part of a wider package of support, made by a carer who is known to the patient, or made to complete a specific time limited task, such as checking that a medicine has been taken or that a person is safe and well.
Coeliac disease is a common autoimmune condition, in which the ingestion of gluten (present in wheat, barley, and rye) activates an abnormal immune response, leading to chronic inflammation of the small intestine and malabsorption of nutrients. It affects about 1% of the UK population.
NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness.
The National Institute for Health and Care Excellence (NICE) has recommended tighter blood sugar control for patients with diabetes, to minimise the risk of long term vascular complications, according to the BMJ.
An updated NICE guideline on diagnosing and managing type 1 diabetes in adults is now available.
The Royal College of Obstetricians and Gynaecologists has revised its guideline on female genital mutilation to clarify healthcare professionals’ legal responsibilities, the requirements to notify cases, and the management of women who have undergone mutilation who are pregnant or giving birth.
People whose jobs are predominantly desk based should be encouraged to stand up and walk about for at least two hours during each working day, says the first UK guidance developed to reduce the health risks of prolonged sitting at work.
Growing evidence has shown links between a sedentary lifestyle and an increased risk of cardiovascular disease, diabetes, and some cancers. To help reduce this risk Public Health England and a UK community interest company, Active Working, asked an international group of experts in the field to review the available evidence and develop guidelines for employers to promote avoidance of prolonged periods of sedentary work