Safety Snippets

Here you will find recent alerts and developments in paediatric patient safety

The FSA has issued new voluntary industry guidance on glycerol in slush-ice drinks, advising that they should not be sold to children four years of age and under.

At very high levels of exposure – typically when several of these products are drunk by a child in a short space of time – glycerol intoxication could cause shock, hypoglycaemia and loss of consciousness.

See the FSA for further details


  1. Is glycerol exposure in healthcare professionals differential diagnoses when reviewing a hypoglycaemic child?
  2. Do hospital shops sell slushies? Are parents aware of the risks?

As of 27/5/24: NHSE has reported that 143 sites trialling Martha’s rule: See here for further details 

Related to the Martha’s Rule Programme: ‘Prevention Identification, Escalation, Response’ (PIER) toolkit to be produced in Summer 2024 including a range of resources to support integrated care boards (ICBs) to introduce the PIER approach across their local systems. The toolkit will support and guide ICBs with pathway/system thinking for deterioration management that is system led. This suite of resources will help ICBs to use an improvement approach to design and implement a deterioration improvement plan.

Healthcare professionals prescribing montelukast should be alert to the risk of neuropsychiatric reactions in all patients including children and adolescents. Reported neuropsychiatric reactions include sleep disorders, hallucinations, anxiety and depression, as well as changes in behaviour and mood. Healthcare professionals should advise patients and their caregivers to be alert to these risks and seek medical advice as soon as possible if neuropsychiatric reactions occur.

Follow the link for full details: MHRA

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