68 Paediatric critical care transport; electronic patient observations with automated transmitting of data for clinical application and research

Background Critically ill children presenting to district general hospitals (DGH) are admitted to adult intensive care units (AICUs) for stabilisation prior to transfer to paediatric intensive care units (PICUs). Current training in PICU for adult intensive care physicians is only three months. This single centre retrospective case series examines the case mix of children presenting to a DGH AICU and a multidisciplinary survey assesses confidence and previous experience, highlighting continued training needs for DGH AICU staff. Methods all paediatric admissions to AICU and paediatric retrievals were reviewed over a 6-year period (2014-2019). Cases were identified from the Electronic Patient Record (EPR) and from data provided by the regional paediatric retrieval service. A questionnaire survey was sent to AICU doctors and nurses to assess confidence and competence in paediatric critical care. Results Between 2014-2019, 284 children were managed by AICU. In total 35% of cases were <1 y, 48% of cases were <2 y and 64% of cases were <5 y, and 166/284 (58%) children were retrieved. Retrieval reduced with increasing age (OR 0.49 [0.40-0.60], p < 0.0001). The survey had an 82% response rate, and highlighted that only 13% of AICU nurses and 50% of doctors had received prior PICU training. Conclusion At least one critically unwell child presents to the AICU each week. Assessment, stabilisation and management of critically unwell children are vital skills for DGH AICU staff, but confidence and competence are lacking. Formalised strategies are required to develop and maintain paediatric competencies for AICU doctors and nurses.

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Glycaemic control in paediatric critical care – Authors' reply

The Lancet ◽

10.1016/s0140-6736(09)60815-1 ◽

2009 ◽

Vol 373 (9673) ◽

pp. 1424

Author(s):

G Van den Berghe ◽

D Vlasselaers ◽

L Desmet ◽

I Vanhorebeek ◽

D Mesotten

Keyword(s):

Critical Care ◽

Glycaemic Control ◽

Paediatric Critical Care

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Thinking about thinking in paediatric critical care

Paediatrics and Child Health ◽

10.1016/j.paed.2021.03.003 ◽

2021 ◽

Author(s):

Hiren Mehta ◽

Adrian Plunkett

Keyword(s):

Critical Care ◽

Paediatric Critical Care

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Cases in Paediatric Critical Care Transfer and Retrieval Medicine

10.1017/9781108946438 ◽

2021 ◽

Keyword(s):

Emergency Medicine ◽

Critical Care ◽

Intensive Care ◽

Critically Ill ◽

Transfer Process ◽

The Past ◽

Clinical Presentations ◽

Paediatric Critical Care ◽

Care Transfer ◽

Case Based

Critically ill paediatric transfers have expanded rapidly over the past ten years and, as such, the need for transfer teams to recognise, understand and treat the various illnesses that they encounter is greater than ever. This highly illustrated book covers a multitude of clinical presentations in a case-based format to allow an authentic feel to the transfer process. Written by clinicians with experience in thousands of transfers, it brings together many years of experience from a world-renowned hospital. Following the case from initial presentation, to resuscitation and referral and finally with the transfer itself; the book explores the clinical stabilisation, human factors decisions and logistical challenges that are encountered every day by these teams. Following the entire journey, this is an ideal resource for all professionals who may be involved in critical care transfer and retrieval medicine, particularly those working in paediatrics, emergency medicine, anaesthesiology, intensive care, or pre-hospital settings.

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