scholarly journals National Survey Regarding Motivation and Conditions of Physicians Working in a Pediatric Cardiac Intensive Care Unit

2021 ◽  
Vol 69 (S 03) ◽  
pp. e61-e67
Author(s):  
Anja Hanser ◽  
Michael Hofbeck ◽  
Ralf Knies ◽  
Matthias Kumpf ◽  
Nicole Müller ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Working Conditions ◽  
Pediatric Intensive Care ◽  
Work Load ◽  
Web Based ◽  
Pediatric Hospitals ◽  
Key Issues ◽  
Study Participants ◽  
Pediatric Icu

Abstract Background The professional demands on the expertise in pediatric intensive care have continuously increased in recent years. Due to a lack of applicants, the staffing of a continuous shift service with qualified medical staff poses major challenges to the hospitals. Methods A web-based questionnaire with 27 predominantly matrix questions on working conditions and motivation for working in this area was sent to pediatric hospitals throughout Germany. Results 165 doctors responded to the survey. The average age of the participants was 35.2 years. The average weekend work load reported by 79% of the respondents was 2 weekends per month, 70% of the study participants performed five to seven night shifts per month. 92% of the respondents stated that they basically enjoyed working in the intensive care unit (ICU). When asked to prioritize the working conditions, an appreciative working atmosphere in the team was named as priority 1 by 57%, followed by good guidance in the independent performance of interventions (25%) and good working conditions (19%). Discussion The survey result shows that neither aspects of work–life balance nor payments are the key issues selecting the interesting, but physically and emotionally demanding job in pediatric ICU. Conclusion When evaluating vocational training in pediatric intensive care medicine, the immediate working atmosphere in the team with mutual respect and understanding and the guidance in training are more important than the general conditions.

Purulent Otitis Media—A “Silent” Source of Sepsis in the Pediatric Intensive Care Unit

1985 ◽  
Vol 93 (3) ◽  
pp. 330-334 ◽  
Author(s):  
Michael Persico ◽  
Geoffrey A. Barker ◽  
David P. Mitchell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Middle Ear ◽  
Nasotracheal Intubation ◽  
Pediatric Intensive Care ◽  
Nasogastric Tubes ◽  
High Incidence ◽  
Risk Patients ◽  
Pediatric Icu

Septicemia is common in patients in the pediatric intensive care unit (ICU) who have nasotracheal tubes. Although it is frequently caused by middle ear effusion (MEE), pneumatic otoscopy is not routinely performed in these patients. To demonstrate the value of this procedure, 46 pediatric ICU patients with nasotracheal tubes were followed daily with pneumatic otoscopy for 11 to 98 days and compared with 25 controls without nasotracheal tubes, 12 of whom had nasogastric tubes. Myringotomy was performed whenever blood culture became positive. MEE was significantly more frequent in patients with nasotracheal tubes (87%) than in patients with controls (23%) and occurred first on the side of intubation. Blood bacteria were identical to middle ear pathogens in 80% of patients. Nasogastric tubes were not significant in causing MEE. The high incidence of MEE resulting from nasotracheal intubation indicates the importance of including pneumatic otoscopy in the daily examination of these high-risk patients.

scholarly journals Survival among patients admitted in PICU (Pediatric Intensive Care Unit) of tertiary childcare hospital.

2021 ◽  
Vol 28 (12) ◽  
pp. 1773-1777
Author(s):  
Fatima Jabeen ◽  
Asim Khurshid ◽  
Maria Saleem
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Care Hospital ◽  
Group Iii ◽  
Group I ◽  
Male Patients ◽  
Study Participants

Objective: To determine the frequency of survival among patients admitted in Paediatric Intensive Care Unit (PICU) of tertiary care hospital according to disease severity score PRISM III. Study Design: Descriptive study. Setting: PICU of The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to April 2020. Material & Methods: A total of 205 admitted children in PICU were recruited. PRISM III forms were filled and PRISM III score was calculated for all study participants. Results: Of these 205 study cases, 124 (60.5 %) were male patients while 81 (39.5 %) were female patients. Mean age of our study cases was 3.64 ± 1.96 years. Mean duration of PICU stay was 4.52 ± 3.59 days and 139 (67.8%) patients had PICU stay for upto 5 days. Mean PRISM III score was 11.25 ± 4.69 and 69 (33.7%) had group I score, 118 (57.6%) had group II score, 14 (6.8%) had group III score and 4 (2%) had group IV score. Of these 205 study cases, mortality was noted in 31 (15.1%). Conclusion: High Frequency of mortality among children admitted to pediatric intensive care unit (PICU) was observed and mortality was found to be increasing with increasing PRISM III score.

Outcomes Following Intensive Care Unit Admission in a Pediatric Cohort in Malawi

2020 ◽  
Vol 66 (6) ◽  
pp. 621-629
Author(s):  
Laura N Purcell ◽  
Meghan Prin ◽  
John Sincavage ◽  
Clement Kadyaudzu ◽  
Michael R Phillips ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Icu Mortality ◽  
Middle Income ◽  
Icu Admission ◽  
Product Availability ◽  
Care Outcomes ◽  
Pediatric Icu

Abstract Introduction The burden of critical illness in low- and middle-income countries (LMICs) is high; however, there is a paucity of data describing pediatric critical care outcomes in this setting. Methods We performed a prospective observational study of the pediatric (≤18 years) intensive care population in Malawi, from August 2016 to May 2018. Data collected include patient demographics and clinical data, admission criteria and outcome. A multivariate Poisson regression was performed to determine risk factors for mortality. Results Over the study period, 499 patients were admitted to the intensive care unit (ICU) and 105 (21.0%) were children. The average age was 10.6 ± 5.4 years. Primary indications for ICU admission were sepsis (n = 30, 30.3%) and traumatic brain injury (TBI, n = 23, 23.2%). Of those who died, sepsis (n = 18, 32.7%), acute respiratory failure (n = 11, 20.0%) and TBI (n = 11, 20.0%) were the primary admission diagnoses. Overall, ICU mortality was 54.3% (n = 57). Multivariate regression for increased ICU mortality revealed: age ≤5 years [risk ratio (RR) 1.96, 95% CI 1.10–2.26, p < 0.001], hemoglobin < 10 g/dl (RR 1.58, 95% CI 1.08—2.01, p = 0.01) and shock requiring epinephrine support (RR 2.76, 95% CI 1.80–4.23, p < 0.001). Conclusions Pediatric ICU mortality is high. Predictors of mortality were age ≤5 years, anemia at ICU admission and the need for epinephrine support. Training of pediatric intensive care specialists and increased blood product availability may attenuate the high mortality for critically ill children in Malawi.

scholarly journals Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians

2017 ◽  
Vol 35 (3) ◽  
pp. 384-389 ◽  
Author(s):  
Anne G. Ciriello ◽  
Zoelle B. Dizon ◽  
Tessie W. October
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Medical Information ◽  
Pediatric Intensive Care ◽  
Icu Physicians ◽  
Pediatric Icu

Background: Family conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present. Aim: To compare language used by PC team and ICU physicians during family conferences. Design: A retrospective cohort review of ICU family conferences with and without the PC team. Setting: Forty-four bed pediatric ICU in a tertiary medical center. Participants: Nine ICU physicians and 4 PC providers who participated in 18 audio-recorded family conferences. Results: Of the 9 transcripts without the PC team, we identified 526 ICU physician statements, generating 10 thematic categories. The most common themes were giving medical information and discussing medical options. Themes unique to ICU physicians included statements of hopelessness, insensitivity, and “health-care provider challenges.” Among the 9 transcripts with the PC team, there were 280 statements, generating 10 thematic categories. Most commonly, the PC team offered statements of support, giving medical information, and quality of life. Both teams promoted family engagement by soliciting questions; however, the PC team was more likely to use open-ended questions, offer support, and discuss quality of life. Conclusion: Pediatric ICU physicians spend more time giving medical information, whereas the PC team more commonly offers emotional support. The addition of the PC team to ICU family conferences may provide a balanced approach to communication.

Impact of COVID-19 Pandemic on Pediatric Intensive Care Unit (PICU) Visiting Policies: A Worldwide Survey

2021 ◽  
Author(s):  
Anna Camporesi ◽  
Anna Zanin ◽  
Constantinos Kanaris ◽  
Marco Gemma ◽  
Vanessa Soares Lanziotti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Well Being ◽  
Parental Participation ◽  
South American ◽  
Web Based ◽  
Family Time ◽  
Early Mobility

AbstractThe purpose of this study was to evaluate pediatric intensive care unit (PICU) visiting policies around the world and how the coronavirus disease 2019 (COVID-19) pandemic has affected these policies, due to concerns relating to a viral transmission. A web-based international survey was designed and disseminated through social networks, emails, or direct messages. Two hundred forty-one answers were received. From these, 26 were excluded (13 due to missing location and 13 duplicated answers), resulting in a final number of 215 answers. Europe accounted for 35% of responses (n = 77), South America 22.4% (n = 49), North America 19% (n = 41), Asia 16.5% (n = 36), Central America 2.7% (n = 6), Oceania, and Africa 2.2% each (n = 5 each). Before the pandemic, reported admission/visiting policies already varied between continents. Family time schedules remained similar to the pre-pandemic period in half of European, Central, and South American units and have changed in 60% of Asian, African, North American, and Oceanian units. Access to PICUs has been granted for patients and caregivers tested negative for severe acute respiratory syndrome coronavirus 2 (SARS COV-2) in only part of studied PICUs. Isolation precautions for the visitors were intensified at the onset of the pandemic. Changes in visiting policies were observed in most PICUs worldwide during the COVID-19 pandemic, with some PICUs prohibiting any visitation by families. These changes can decrease possibilities of parental participation in emotional support and reduction of sedation needs, early mobility, and shared decision-making process and impact negatively both children and parental well-being and even patients' outcomes.

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