Critical Care Unit Organizational and Personnel Factors Impact Cardiac Arrest Prevention and Rescue in the Pediatric Cardiac Population

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Javier J. Lasa ◽  
Mousumi Banerjee ◽  
Wenying Zhang ◽  
David K. Bailly ◽  
Jun Sasaki ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Critical Care Unit

Abstract 301: Identifying Critical Care Unit Organizational Factors That Impact Cardiac Arrest Incidence and Outcomes: A Report From the Pediatric Cardiac Critical Care Consortium

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Javier J Lasa ◽  
Jeffrey A Alten ◽  
Mousumi Banerjee ◽  
Wenying Zhang ◽  
Kurt Schumacher ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Critical Care Unit ◽  
Organizational Factors ◽  
Full Time ◽  
Provider Education ◽  
Multinomial Regression ◽  
Clinical Registry ◽  
The Impact ◽  
Cardiac Critical Care

Introduction: Patient factors leading to cardiac arrest (CA) in the pediatric cardiac critical care unit (CICU) are well understood, but may be unmodifiable. Our understanding of the impact of CICU organizational factors (OFs) such as staffing models, health care provider education, and CICU bed management is limited. The association between these potentially modifiable CICU OFs on CA prevention and rescue outcomes is unknown. Hypothesis: CICU OFs associate with CA prevention and rescue. Methods: Retrospective analysis of Pediatric Cardiac Critical Care Consortium (PC4) clinical registry including data for all patients admitted to CICUs from August 2014 to March 2019. Prevention was defined as the prevalence of subjects not suffering CA. Rescue was defined as survival after CA. CICU OFs were captured via questionnaire distributed to PC4 participants in 2017 (100% response). Stratified, multivariable regression was used to evaluate associations between OFs and outcome in medical and surgical admission subgroups: competing time-to-events framework (to assess prevention) and multinomial regression (to assess rescue), accounting for clustering of patients within hospitals. Results: We analyzed 54,521 CICU admissions (59% surgical, 41% medical) from 29 hospitals with 1398 CA events (2.5%). We studied 12 OFs that varied across centers after accounting for collinearity. For both surgical and medical admissions, lower average daily occupancy (<80%) was associated with better arrest prevention for all admissions, and better rescue in the surgical cohort. Increased proportion of nurses with >2 years experience, increased proportion of nurses with critical care certification, % of full-time intensivists, % of intensivists with critical care training, dedicated respiratory therapists, quality/safety resources, and annual CICU admission volume were not associated with improved prevention or rescue. Conclusion: Our multi-institutional analysis suggests that lower average CICU occupancy was the only consistent OF evaluated that was associated with CA prevention and rescue. CICUs that have average daily occupancy >80% may need specific strategies to mitigate the risks of CA.

Post-cardiac arrest care and prognostication

2019 ◽  
pp. 87-100
Author(s):  
Justine Barnett ◽  
Jerry Nolan
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Care Unit ◽  
Daily Practice ◽  
Care Staff ◽  
Evidence Based ◽  
Standard Textbook ◽  
Learning Points

This chapter is centred on a case study on brain injury after cardiac arrest. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.

scholarly journals Successful Management of Cardiac Arrest Following Hair Dye Poisoning: A Case Report from a Rural Critical Care Unit in India

2016 ◽  
pp. 559-562
Author(s):  
Harish Handyal ◽  
Gopi Kumar ◽  
Rajesh Babu ◽  
S.M. Kannan ◽  
Chandrakiran Reddy R. N
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Case Report ◽  
Critical Care Unit ◽  
Successful Management ◽  
Hair Dye

Overdoses of tricyclic antidepressants: grandchildren and grandparents

2000 ◽  
Vol 20 (5) ◽  
pp. 69-77 ◽  
Author(s):  
K Lewis-Abney
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Drug Absorption ◽  
Cardiac Arrhythmias ◽  
Critical Care Unit ◽  
Tricyclic Antidepressants ◽  
Rapid Assessment ◽  
Specific Drug ◽  
Blood Ph ◽  
Vital Functions

TCAs are an extremely toxic source of poisoning in young children. Overdoses of TCAs can cause coma, seizures, hypotension, cardiac arrhythmias, and cardiac arrest. Treatment is directed at rapid assessment, monitoring, support of vital functions, halting drug absorption, and treating CNS and cardiac toxic effects. All children should be monitored for a minimum of 6 hours, and many require admission to a critical care unit. The mainstay of therapy is alkalinization. Intravenous administration of sodium bicarbonate is the preferred treatment for hypotension, shock, and arrhythmias. Blood pH should be monitored and should be maintained between 7.45 and 7.55. More specific drug therapy, cardioversion, or artificial pacing may be required for refractory arrhythmias. Before the child is discharged from the hospital, strategies to reduce the risk of future poisonings should be discussed with the child's family.

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mirijam Hall ◽  
David Endress ◽  
Susanne Hölbfer ◽  
Barbara Maier
Keyword(s):  
Critical Care ◽  
Pregnant Women ◽  
Critical Care Unit ◽  
Birth Rate ◽  
Total Population ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Outcome Data ◽  
High Risk Population ◽  
Retrospective Data Collection

AbstractObjectivesTo report clinical data on maternal outcome, mode of delivery and immediate neonatal outcome in women infected with COVID-19.MethodsRetrospective data collection.ResultsA total of 8.6% of the total population of hospitalised SARS-CoV-2 positive pregnant women were admitted to a critical care unit. The premature birth rate for births before 34+0 weeks of gestation among pregnant women who tested positive for SARS-CoV-2 was 7.1%. One newborn (3.6%) tested positive for SARS-CoV-2 two days after birth and showed symptoms.ConclusionsPregnant women with COVID-19 seem to be at higher risk of invasive ventilation, admission to a critical care unit and preterm birth, and should therefore be considered a high-risk-population.

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