scholarly journals 1001 Advance care plans for children with life-limiting conditions admitted to paediatric critical care

2021 ◽  
Author(s):  
Lindsey Rowley ◽  
Janet McCluskey
Keyword(s):  
Critical Care ◽  
Care Plans ◽  
Advance Care ◽  
Paediatric Critical Care

Parallel planning and the paediatric critical care patient

2019 ◽  
Vol 104 (10) ◽  
pp. 994-997 ◽  
Author(s):  
Peter Sidgwick ◽  
James Fraser ◽  
Peter-Marc Fortune ◽  
Renee McCulloch
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Critical Illness ◽  
Critical Care Patient ◽  
Care Patient ◽  
Number Of Children ◽  
Care Plans ◽  
Advance Care ◽  
Paediatric Critical Care

A growing number of children with life-limiting conditions (LLCs) are being cared for in paediatric critical care (PCC) settings. Children with LLCs admitted to PCC are at a high risk of developing complications and many die after prolonged admissions. Relatively few of these patients and their parents or carers have had documented discussions about their wishes for care in the event of a serious clinical deterioration before admission to PCC. There is a need for improved understanding of (1) how parents arrive at decisions regarding what is best for their child at times of critical illness and (2) the role of parallel planning and advance care plans in that process. This review examines the complexities of decision-making in children with LLCs who are admitted to PCC settings.

scholarly journals Healthcare Providers' Perception of Advance Care Plans for Patients with Critical Illnesses in Acute-Care Hospitals: A Cross-Sectional Study

2021 ◽  
Author(s):  
KANAKO YAMAMOTO
Keyword(s):  
Critical Care ◽  
Acute Care ◽  
Healthcare Providers ◽  
Acute Care Hospitals ◽  
Cross Sectional Study ◽  
Decision Making Process ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Plans ◽  
Advance Care

Abstract BackgroundIt is unclear how healthcare providers provide advance care plans (ACPs) support to the patients treated in ICUs. The purpose of this study is to clarify healthcare providers’ perceptions of the ACPs support provided to patients receiving critical care in acute-care hospitals.MethodsA cross-sectional study was conducted using questionnaires. In this study, 400 acute-care hospitals with ICUs in Japan were randomly selected, and 1490 subjects, including intensivists, surgeons, ICU nurses, surgical floor nurses, and surgical outpatient nurses, participated. Survey items examined whether ICU patients received ACPS support, the participants’ degree of confidence in providing ACPS support, the patients’ treatment preferences and the decision-making process, and whether there was any discussion on and succession of values.ResultsResponses were obtained from 598 participants from 157 hospitals. Sixty-five hospitals (41.4%) reportedly supported ACPs provision to ICU patients. The subjects with the highest level of ACPs understanding were surgeons, 27 out of 59 (45.8%), and differences in understanding were observed across specialties (p < 0.001). Among the respondents, physicians and nurses expressed high levels of confidence in providing ACPs support to patients requiring critical care. However, 15.2% of all the subjects mentioned that they would not attempt to resuscitate the patients. In addition, 25.7% of the participants handed over patients’ values to other departments or hospitals, whereas 25.3% handed over the decision-making process.ConclusionsAmong the participating hospitals, 40% provided ACPs support to patients receiving critical care. This is probably because support providers lack ACPs knowledge and it is sometimes too late to start providing ACPs support after ICU admission. In addition, the perception of ACPs, widely considered an ambiguous concept, differs among healthcare providers. Finally, in acute-care hospitals with different healthcare settings, it is necessary to confirm and integrate the changes in feelings and thoughts of patients’ family members and healthcare providers.

Glycaemic control in paediatric critical care

The Lancet ◽  
2009 ◽  
Vol 373 (9673) ◽  
pp. 1423 ◽  
Author(s):  
Coert J Zuurbier ◽  
Albert P Bos ◽  
Harry B van Wezel
Keyword(s):  
Critical Care ◽  
Glycaemic Control ◽  
Paediatric Critical Care

scholarly journals Paediatric admissions to a district general hospital adult intensive care unit over a six year period: A single centre retrospective case series, with review of practitioner confidence and competence in paediatric critical care

2021 ◽  
pp. 175114372110121
Author(s):  
Stephen A Spencer ◽  
Joanna S Gumley ◽  
Marcin Pachucki
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Series ◽  
Critically Ill Children ◽  
Single Centre ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Paediatric Critical Care ◽  
Doctors And Nurses

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.

Glycaemic control in paediatric critical care – Authors' reply

The Lancet ◽  
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

Cases in Paediatric Critical Care Transfer and Retrieval Medicine

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.

Time to focus on paediatric critical care survivorship

2019 ◽  
Vol 7 (2) ◽  
pp. 103-105 ◽  
Author(s):  
Jan Hau Lee ◽  
Karen Choong
Keyword(s):  
Critical Care ◽  
Paediatric Critical Care
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