Use of a physiologic scoring system during interhospital transport of pediatric patients

2001 ◽  
Vol 20 (4) ◽  
pp. 0023-0026
Author(s):  
Bj[ouml ]rn Gunnarsson ◽  
Christopher M.B. Heard ◽  
Alexandre T. Rotta ◽  
Andrew M.B. Heard ◽  
Barbara H. Kourkounis ◽  
...  
2001 ◽  
Vol 20 (4) ◽  
pp. 23-26 ◽  
Author(s):  
Björn Gunnarsson ◽  
Christopher M.B. Heard ◽  
Alexandre T. Rotta ◽  
Andrew M.B. Heard ◽  
Barbara H. Kourkounis ◽  
...  

Author(s):  
Graziella Di Grezia ◽  
Saverio Pignata ◽  
Gianvito Pace ◽  
Diana Donatiello ◽  
Nicola Serra ◽  
...  

PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 893-898 ◽  
Author(s):  
Robert K. Kanter ◽  
Nancy M. Boeing ◽  
William P. Hannan ◽  
Deborah L. Kanter

A prospective study was performed to determine whether excess morbidity occurred in critically ill and injured pediatric patients during interhospital transport compared with morbidity in a control group. Control observations were made during the first 2 hours of pediatric intensive care unit (PICU) care of patients emergently admitted from within the same institution and not requiring interhospital transport. The first 2 PICU hours of control patients corresponded to the interval of transport in those who required interhospital transfer. Transport care was provided by nonspecialized teams from referring hospitals. Morbidity occurred in 20.9% of 177 transported patients, exceeding the morbidity rate of 11.3% in 195 control patients (P < .05). The difference in morbidity was due to intensive care-related adverse events (eg, plugged or dislodged endotracheal tubes, loss of intravenous access) in 15.3% and 3.6% of transported and control patients, respectively (P < .05). Physiologic deterioration occurred at similar rates of 7.9% and 8.7% in transported and control patients, respectively (P > .05). Slightly greater pre-ICU severity of illness in transported than control patients (median Pediatric Risk of Mortality Score = 10 and 7, respectively, P < .05) and greater pre-ICU therapy relative to severity (P < .05) in control patients are potential confounding sources of the morbidity differences. If patients are stratified into subgroups of similar pre-ICU severity, an excess of intensive care-related adverse events in transported patients remains evident in the severe subgroup (P < .05). Further investigation is warranted to determine whether specialized transport teams can reduce the excess morbidity associated with interhospital transport of critically ill and injured pediatric patients.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Karen Ka Yan Leung ◽  
Shu Wing Ku ◽  
Kam Lun Hon ◽  
Linda Chigaru ◽  
Alan K. S. Chiang ◽  
...  

2021 ◽  
Vol 9 (T3) ◽  
pp. 244-248
Author(s):  
Linda Wati ◽  
Ririe Fachrina Malisie ◽  
Juliandi Harahap

Background: Doctors must be able to quickly and accurately assess clinical condition of patients, especially in the emergency rooms. An easy scoring system but producing meaningful clinical conclusions is the reason for creating various scoring systems. Includes a scoring system for predicting the admission status of patients. Aim: To determine the diagnostic value of POPS and EWSS to predicting admission status of pediatric patients in the emergency department. Methods: Diagnostic tests for POPS and EWSS were done to predict the admission status of pediatric patients in the emergency department of Haji Adam Malik general hospital from May to October 2020. Subjects aged 1 month to 18 years were excluded if they left the emergency department prior to assessment, had trauma cases, died, inpatients due to social indications, and patients who came only to continue therapy were also excluded. POPS and EWSS assessments were carried out by the researcher and the admission status of the patients were determined by the doctor in charge in the emergency department. Results: There were 119 children meeting the inclusion and exclusion criteria. POPS score ≥3 had sensitivity 82.65%, specificity 85.71%, and AUC 0.88 (p <0.001). EWSS score ≥2 had sensitivity 83.67%, specificity 71.43%, and AUC 0.83 (p <0.001). Conclusion: POPS and EWSS had good diagnostic values in predicting the admission status of pediatric patients in the emergency department. POPS has a slightly higher diagnostic value than EWSS.


Neurosurgery ◽  
2007 ◽  
Vol 61 (5) ◽  
pp. 987-994 ◽  
Author(s):  
Raj Kumar ◽  
Samir K. Kalra ◽  
Ashok K. Mahapatra

Abstract OBJECTIVE The assessment of response to treatment in pediatric patients with congenital atlantoaxial dislocation (AAD) is performed using a disability grading system but may be better determined by a score based on clinical parameters. This study proposes a scoring system based on a comprehensive neurological examination to assess surgical outcome in these patients. METHODS Sixty-seven patients with congenital AAD aged 14 years or younger were included and analyzed prospectively. A scoring system based on six factors (motor power, gait, sensory involvement, sphincteric involvement, spasticity, and respiratory difficulty) was designed at the beginning of the study and all patients were assessed using this score as well as the Di Lorenzo's grade preoperatively, postoperatively, and at the time of each follow-up visit. RESULTS There was a very high incidence of occipitalized arch of atlas and fusion of the second and third cervical vertebrae in the irreducible variety. Most patients were classified in poor grades preoperatively; however, the changes in score were seen more often when using the scoring system we developed compared with the Di Lorenzo's grade. Our score also corroborated better with the clinical improvement. CONCLUSION The clinical profiles of pediatric patients with AAD are similar with a higher incidence of atlas arch anomalies in patients with irreducible AAD. A scoring system based on clinical parameters is proposed for clinical evaluation of such patients. This system is easy to use and interpret and is more sensitive to the changes in the neurological status of patients.


2012 ◽  
Vol 6 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Kristin M. Kim ◽  
Sandro Cinti ◽  
Steven Gay ◽  
Susan Goold ◽  
Andrew Barnosky ◽  
...  

ABSTRACTObjective: The novel H1N1 influenza pandemic renewed the concern that during a severe pandemic illness, critical care and mechanical ventilation resources will be inadequate to meet the needs of patients. Several published protocols address the need to triage patients for access to ventilator resources. However, to our knowledge, none of these has addressed the pediatric populations.Methods: We used a systematic review of the pediatric critical care literature to evaluate pediatric critical care prognosis and multisystem organ failure scoring systems. We used multiple search engines, including MEDLINE and EMBASE, using a search for terms and key words including including multiple organ failure, multiple organ dysfunction, PELOD, PRISM III, pediatric risk of mortality score, pediatric logistic organ dysfunction, pediatric index of mortality pediatric multiple organ dysfunction score, “child+multiple organ failure + scoring system. ” Searches were conducted in the period January 2010-February 2010.Results: Of the 69 papers reviewed, 22 were used. Five independently derived scoring systems were evaluated for use in a respiratory pandemic ventilator triage protocol. The Pediatric Logistic Organ Dysfunction (PELOD) scoring system was the most appropriate for use in such a triage protocol.Conclusions: We present a pediatric-specific ventilator triage protocol using the PELOD scoring system to complement the NY State adult triage protocol. Further evaluation of pediatric scoring systems is imperative to ensure appropriate triage of pediatric patients.(Disaster Med Public Health Preparedness. 2012;6:131–137)


Author(s):  
Duantida Songdej ◽  
Manunya Tandhansakul ◽  
Ampaiwan Chuansumrit ◽  
Nongnuch Sirachainan ◽  
Pimlak Charoenkwan ◽  
...  

Background: Hemoglobin H (HbH) is usually recognized as mild thalassemia. However, a wide range of clinical manifestations, from fatal hydrops fetalis to asymptomatic mild anemia, is observed. A severity scoring system to guide the management of patients with HbH is needed. Objective: To develop a scoring system to predict the necessity of regular transfusion among patients with HbH. Methods: Patients were classified into 2 groups according to transfusion requirement: severe among transfusion-dependent thalassemia (TDT) and nonsevere among nontransfusion-dependent thalassemia (NTDT). Clinical and hematological parameters associated with transfusion dependency were identified and β-coefficients of significant parameters from multiple logistic regression analysis were used to develop a scoring system. Results: A total of 247 pediatric patients (24 severe, 223 nonsevere) with a median age of 14.3 (IQR 9.9-18.4) years were included. Multiple logistic regression analysis revealed 3 significant parameters associated with regular transfusion requirement including 1) age at diagnosis <2 years, 2) spleen size ≥3 cm and 3) Hb at steady-state <8 g/dL. Coefficients of the respective parameters were used to define the scores as 1, 2 and 2, respectively. A total score of ≥3 was associated with regular transfusion requirement among severe HbH (sensitivity 88%, specificity 83%). The newly developed scoring system was validated in the second cohort of 134 pediatric patients with HbH treated at another center. The cut-off score ≥3 yielded comparable sensitivity and specificity for the prediction.


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