Adaptation of Evidence-based Clinical Practice Guidelines for Management of Altered Level of Consciousness in Children: An Emergency Guide

Document Type : Original Article

Authors

1 Pediatrics Department, Faculty of Medicine, Alexandria University Alexandria, Egypt.

2 Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt.

3 Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia

Abstract

Background: We recently adapted the published Royal College of Pediatrics and Child Health (RCPCH) clinical practice guideline (CPG) for the management of children with an altered level of consciousness (ALOC) to the Alexandria University Children’s Hospital (AUCH) context. It is hypothesized that adapting clinical practice guidelines (CPGs) to the local healthcare situation, rather than developing them, will increase their acceptance without putting a large strain on the resources. Aim: To present the adaptation pathway that was used to create the first local CPG in AUCH for the management of children with ALOC. Methods: For CPG adaption, we utilized the 'Adapted ADAPTE' approach. We went over the entire process in depth, including the setup, adaptation, and finalization phases. Results: Eight major recommendations were adopted by the panel from one source (RCPCH) guideline. The recommendations included: (i) service organization and training, (ii) recognition of the health problem and referral, (iii) diagnostic approach (iv) providing support (v) management of ALOC, and (vi) indication to PICU admission (vii) recommended medications (viii)monitoring and follow up. Conclusions: The finalized CPG provides evidence-based guidelines to healthcare providers for the management of children with ALOC in AUCH. The initiative also established the efficacy of the 'Adapted ADAPTE,' as well as the importance of clinical and methodology expert panel collaboration for local CPG adaptation.
 

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