Welcoming expertise: Bereaved parents’ perceptions of the parent–healthcare provider relationship when a critically ill child is admitted to the paediatric intensive care unit

2019 ◽  
Vol 32 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Ashleigh E. Butler ◽  
Beverley Copnell ◽  
Helen Hall
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Provider ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Bereaved Parents ◽  
Critically Ill Child

DOES CHLORHEXIDINE WIPE HELP IN REDUCING HOSPITAL ACQUIRED INFECTIONS (HAIS) AMONG CRITICALLY ILL CHILDREN ADMITTED TO A PAEDIATRIC INTENSIVE CARE UNIT?

2021 ◽  
pp. 35-37
Author(s):  
Madhan Kumar ◽  
Jolly Chandran ◽  
Pragathesh Pragathesh ◽  
Ebor Jacob Gnananayagam ◽  
Hema Paul ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Critically Ill Children ◽  
Intervention Period ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
Historical Controls

OBJECTIVE: To determine the effect of chlorhexidine wipes in reducing the incidence of hospital acquired infections (HAIs) among critically ill children admitted in Paediatric Intensive Care Unit (PICU). METHODS: An interventional study, wherein enrolled children were wiped with chlorhexidine after routine bath. The incidence of HAIs were noted and compared with data from historical controls of previous year during the same period (pre-intervention). RESULTS: One hundred and ninety nine children in the intervention period were compared with 271 children from pre-intervention period. The numbers of ventilator-days were 777 and 696 respectively for the intervention period and pre-intervention periods. Incidence of ventilator associated pneumonia (VAP) reduced from 12.9/1000 ventilator-days in the pre-intervention period to 6.4/1000 ventilator-days in the intervention period (p=0.1). VAP prevalence was 3.3% in the pre-intervention period as compared to 2.5% in the intervention period (p=0.6). The incidence of CLABSI was 3.6/1000 catheter-days (catheter days: 1377) with prevalence of 2.5% in the intervention period, whereas among the historic controls of the previous year it was 4.2/1000 days (catheter days 1432) with a prevalence of 2.2% (p= 0.8). No untoward effect was reported. CONCLUSION: The use of chlorhexidine wipes in ICU was feasible but did not signicantly decrease HAIs.

scholarly journals Stress hyperglycemia: clinical profile and outcome in critically ill children

2017 ◽  
Vol 4 (6) ◽  
pp. 2175
Author(s):  
Diana Grace R. ◽  
Poovazhagi V.
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Study Group ◽  
Stress Hyperglycemia ◽  
The Common ◽  
Overall Mortality

Background: Stress hyperglycemia (SH) occurs commonly during critical illness in children with previously normal glucose homeostasis. Objective of present study was to study the clinical presentation, underlying illness and the outcome of stress hyperglycemia among critically ill children.Methods:Children attending the outpatient department and the casualty were admitted to Emergency department based on the triage guidelines. Children with blood glucose above 200 mg/dl on admission to the emergency department were considered to have hyperglycemia and were shifted to the Paediatric intensive care unit or the paediatric wards for further management. Data was collected as per the proforma. The blood sugar values were followed up in these children until restoration of normoglycemia. All the children were followed up till discharge or death in case of mortality. Associated risk factors were analysed between the survivors and nonsurvivors.Results: Among 102 children included in the study group from1 month to 12 yrs, 55 were infants, 37 in the age group of 1-5 yrs and 10 were more than 5 yrs. 60 were males and 42 were females. Family history of diabetes was encountered in 10 children. Out of 102 children, 60 recovered to hospital discharge. Sepsis, seizures, bronchopneumonia and CNS infections were the common illness among children with stress hyperglycemia. Age less than 1year, breathlessness, fever, shock, seizures and altered sensorium were identified to be significantly associated with mortality in children with stress hyperglycemia by univariate analysis in this study. Regression analysis revealed age less than one year, presence of lung infiltrates, longer duration of hyperglycemia, and need for Paediatric Intensive Care Unit (PICU) admission to be significantly associated with mortality. Non survivors had persistent hyperglycemia up to 48 hours in comparison to survivors. Overall mortality in the study group was 41%.Conclusions:Incidence of stress hyperglycemia is high in infants. Infections were the common underlying diagnosis in stress hyperglycemia. Being an infant, prolonged hyperglycemia for 48 hrs and need for PICU care were significantly associated with mortality. Overall mortality in children with stress hyperglycemia is 41%. 

scholarly journals Clinico-etiological profile of acute kidney injury in children admitted to paediatric intensive care unit of a tertiary care centre

2017 ◽  
Vol 5 (11) ◽  
pp. 4959
Author(s):  
Jakanattane V. ◽  
Mathivanan M.
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Kidney Injury ◽  
Paediatric Intensive Care ◽  
Renal Recovery ◽  
Research Centre ◽  
Critically Ill Children

Background: Acute Kidney Injury (AKI) refers to a reversible accumulation of urea, creatinine and nitrogenous waste products and disturbances in maintenance of fluid and electrolyte homeostasis. The incidence of AKI continues to increase in the Paediatric age group particularly in critically ill children with the etiology shifting from primary renal disorders to multifactorial cause. The objective of the study to determine the incidence, clinical profile and outcome of AKI in critically ill children using p-RIFLE criteria.Methods: A prospective observational study was done with 342 children aged between 1-12 years, admitted in Paediatric Intensive Care Unit (PICU) of Institute of Child Health and Research Centre, Madurai Medical College, Madurai during July 2015 to June 2016.Results: The overall incidence of AKI among critically ill children was 30.1%. The mortality rate was 43.7% and 20.7% patients with AKI had partial renal recovery at the time of discharge. 27.2% patients required renal replacement therapy (RRT). Infectious causes 57.3% (Sepsis, Meningoencephalitis, Bronchopneumonia) dominated the etiological profile.Conclusions: Incidence of AKI is high in critically-ill children. AKI continues to be associated with adverse outcomes, including high mortality and partial renal recovery.

scholarly journals Study of morbidity pattern and outcome of patients admitted in paediatric intensive care unit in a tertiary care rural teaching hospital

2019 ◽  
Vol 6 (5) ◽  
pp. 2064
Author(s):  
Vijay L. Bhavari ◽  
Deepali A. Ambike ◽  
Neil D. Pawar
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Medical Record ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Critically Ill Children ◽  
Rural Teaching

Background: The care of the critically ill children remains one of the most demanding and challenging aspects in the field of paediatrics. The main purpose of Paediatric Intensive care unit is to prevent mortality by intensively monitoring and treating critically ill children who are considered at high risk of mortality. In the developing countries, there is a scarce data on paediatric critical care. Evaluation of the outcome of medical interventions can assess the efficacy of treatment. This helps in better decision making, improving the quality of care and modifying the future of management if required. This study will also help to study the causes of morbidity and mortality among paediatric age group in our hospital. Aims and Objectives of the study is to evaluate the morbidity pattern and outcome of admissions in the PICU of a rural teaching hospital, and to take measures to prevent morbidity and mortality by improving critical care facilities.Methods: This was a retrospective study, the cases admitted in paediatric ICU in our teaching hospital in last two and a half considering the estimated sample size. Data will be collected from PICU and Medical record Department. Details will be studied with the help of medical record and will be analysed and interpreted according to the medical record details.Results: During a period of 30 months of the study, total of 417 patients were admitted in our PICU. Of the total cases studied, Maximum i.e. 180(43.2%) had age below 1 year. The minimum – maximum range of age was between 1 day to 18 years. About 228(54.7%) cases were males and 189(45.3%) were females. The most common diagnosis was LRTI which was observed in 61(14.7%) of cases. The most common system involved was respiratory system which was observed in 101(21.8%) cases. Of total cases studied, 357(85.6%) were discharged, 36(8.6%) had DAMA (discharge against medical advice) and 24(5.8%) expired.Conclusions: Mortality was low in our PICU. We conclude based on the present study that in our rural set up PICU, with better treatment protocols, skilled expertise/ Paediatric Intensivist we have chances to facilitate the care of critically ill patients giving desirable outcome.

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