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Parental Intuition Outperforms Vital Signs in Predicting Pediatric ICU Admission

NHS hospitals are piloting ‘Martha’s Rule’, which grants families the right to a second medical opinion after parents express worry about a child’s condition.

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Merope Mills with her daughter, Martha. Her concerns about Martha’s condition were dismissed

Overview

  • Monash University researchers reviewed nearly 190,000 emergency visits in Melbourne and found children were four times more likely to need ICU care when parents raised deterioration concerns.
  • Parental worry showed a stronger link to intensive care admission than any abnormal vital sign, including heart rate, breathing or blood pressure.
  • In 19.3% of documented cases, parents voiced concerns before clinical measurements detected a decline, indicating potential for earlier intervention.
  • Martha’s Rule has been introduced across NHS trusts to formalise family requests for second opinions based on parental intuition.
  • Thousands of patients or families have invoked the initiative since March, with over 100 children subsequently admitted to intensive care under the new protocol.