Children with complex medical and developmental problems are at higher risk of unexpected deterioration and need for rapid clinical assessment or hospital admission, most often as a result of respiratory infection. This often results in frequent, prolonged admissions to an acute paediatric ward with possible exposure to pathogens, gradual deterioration of lung function and significant inconvenience to families. A number of interventions could potentially reduce admissions including appropriate positioning, management of gastro-oesophageal reflux, prophylactic antibiotics and control of secretions. However many children may not receive these interventions because clinicians may not assess for risk factors and may not have access to individual patient care plans or to potentially useful protocols.
