Care-Entrusting

Save My Kid ◽  
2020 ◽  
pp. 77-104
Author(s):  
Amanda M. Gengler
Keyword(s):  
Medical Care ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Health Capital ◽  
Critically Ill Child

Chapter 4 profiles families of critically ill children who primarily care-entrusted. The author lays out the very different philosophies that several families applied to managing their children’s medical care and shows the various ways that they channelled their advocacy efforts. These families missed out on some of the medical advantages care-captaining could produce, and, with fewer resources, often struggled to negotiate the logistical demands of caring for a critically ill child. Yet care-entrusting often makes more emotional sense for families with little cultural health capital, and as such can provide them some important nonmedical benefits.

Pediatric Obesity in Acute and Critical Care

2008 ◽  
Vol 19 (1) ◽  
pp. 38-46
Author(s):  
Andrea M. Kline
Keyword(s):  
United States ◽  
Critical Care ◽  
Critically Ill ◽  
Pediatric Obesity ◽  
The United States ◽  
Critically Ill Children ◽  
Surgical Strategies ◽  
Specific Effects ◽  
Critically Ill Child

Pediatric obesity has reached epidemic proportions in the United States. Significant obesity-related comorbidities are being noted at earlier ages and often have implications for the acute and critically ill child. This article will review the latest in epidemiologic trends of pediatric obesity and examine how it affects multisystem body organs. The latest data evaluating the specific effects of obesity on acute and critically ill children will be reviewed. Available nonpharmacologic, pharmacologic, and surgical strategies to combat pediatric obesity will be discussed.

scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background: Critically ill children require optimum feeding in the intensive care for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units.Methods: A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N=42).Results: The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children.Conclusions: Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU is recommended to reduce possible infant and child mortality resulting from feeding.

scholarly journals Medical Tourism and the Best Interests of the Critically ill Child in the Era of Healthcare Globalisation

2020 ◽  
Vol 28 (4) ◽  
pp. 696-730
Author(s):  
Neera Bhatia ◽  
Giles Birchley
Keyword(s):  
Critically Ill ◽  
Healthcare Professionals ◽  
Medical Tourism ◽  
Case Law ◽  
Best Interests ◽  
Critically Ill Children ◽  
Medical Law ◽  
Novel Treatments ◽  
Critically Ill Child ◽  
The Law

Abstract In this article, we examine emerging challenges to medical law arising from healthcare globalisation concerning disputes between parents and healthcare professionals in the care and treatment of critically ill children. We explore a series of issues emerging in English case law concerning children’s medical treatment that are signs of increasing globalisation. We argue that these interrelated issues present distinct challenges to healthcare economics, clinical practice, and the operation of the law. First, social media leverages the emotive aspects of cases; secondly, the Internet provides unfiltered information about novel treatments and access to crowdfunding to pay for them. Finally, the removal of barriers to global trade and travel allows child medical tourism to emerge as the nexus of these issues. These aspects of globalisation have implications for medicine and the law, yet child medical tourism has been little examined. We argue that it affects a range of interests, including children’s rights, parents’ rights as consumers, and the interests of society in communalised healthcare. Identifying putative solutions and a research agenda around these issues is important. While cases involving critically ill children are complex and emotionally fraught, the interconnectedness of these issues requires the law to engage and respond coherently to the impacts of healthcare globalisation.

Blending and Switching Care Strategies

Save My Kid ◽  
2020 ◽  
pp. 105-126
Author(s):  
Amanda M. Gengler
Keyword(s):  
Critically Ill ◽  
Management Strategies ◽  
Illness Experience ◽  
Critically Ill Children ◽  
Illness Management ◽  
Health Capital ◽  
Emotional Dynamics

Chapter 5 analyzes the emotional dynamics of families with critically ill children, detailing the cases and moments in which families blended or switched illness management strategies. For families with enough cultural health capital to care-captain at strategic moments, stepping back and care-entrusting at other times could facilitate a less harried illness experience. These cases, along with instances in which other families switched strategies, illuminate the powerful emotional forces driving families’ decisions about how to manage their child’s illness.

Hope Is a Thing with Feathers

Save My Kid ◽  
2020 ◽  
pp. 3-23
Author(s):  
Amanda M. Gengler
Keyword(s):  
Critically Ill ◽  
Family Life ◽  
Healthcare Providers ◽  
Critically Ill Children ◽  
Health Capital ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Basic Concepts ◽  
Reproduction Of Inequality

Since families with critically ill children have different resources available to them, they take different approaches to managing their child’s life-threatening illness. The author introduces basic concepts that are analyzed over the course of the book, including care-captaining, which involves working hard to influence the course of their child’s treatment, and care-entrusting, which involves deferring to the judgement of their child’s healthcare providers. Additionally, the chapter covers the topic of healthcare inequality and cultural health capital, emotions and the reproduction of inequality in family life, and more.

Looking after critically ill children

2019 ◽  
pp. 645-651
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Child Abuse ◽  
Critically Ill ◽  
Medical Practitioner ◽  
Self Report ◽  
Critically Ill Children ◽  
Vulnerable Children ◽  
Injured Child ◽  
Number Of Children ◽  
Critically Ill Child ◽  
The Uk

This chapter discusses paediatrics in critical care and includes discussion on both paediatric transfers for the adult intensivist and looking after a vulnerable child (safeguarding children for the adult practitioner). With the centralization of specialist services into a limited number of hospitals across the UK, an increasing number of children require an interhospital transfer. These include but are not limited to the transfer of the critically ill child. Between 2012 and 2014, 18 500 transfers of critically ill or injured children were undertaken across the UK, of which 2400 were undertaken by non-specialist teams. These patients are some of the sickest children. It is while in transit that these patients are most at risk and the transferring team is most exposed. To minimize risks it is important that the team holds the relevant skills to stabilize and transfer children. A systematic approach is vital. The patient’s condition should be optimized before transfer and any likely difficulties anticipated and a plan to tackle any complications swiftly and effectively is agreed prior to the transfer. In this chapter we offer our approach to the safe transfer of the critically ill child. The second part of this chapter offers an introduction into the safeguarding of vulnerable children. A 2009 survey conducted by the National Society for the Prevention of Cruelty to Children asking children to self-report abuse and neglect found that 18.6% of 11–17-year-olds said they had experienced some type of severe maltreatment. The high prevalence of child abuse makes it likely for the medical practitioner who is mostly caring for adult patients to encounter vulnerable children in clinical practice. This will often happen when participating in the resuscitation of a critically ill or injured child, when anaesthetizing a child, or when looking after a caregiver of such a child. The aim of this chapter is to provide these practitioners with the information that will help them to identify possible child abuse and make them aware of their responsibilities towards these children and their options for action.

Intravenous sotalol use in a complex critically ill child: balancing the systems in choosing antiarrhythmic medication

2017 ◽  
Vol 27 (9) ◽  
pp. 1857-1860 ◽  
Author(s):  
Michele M. Pasierb ◽  
Stephen P. Seslar
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Organ System ◽  
Critically Ill Children ◽  
Intravenous Therapy ◽  
System Disease ◽  
Antiarrhythmic Medication ◽  
Critically Ill Child ◽  
Effective Use ◽  
Paediatric Critical Care

AbstractIn critically ill children, multi-organ-system disease can influence the choice of antiarrhythmic medication. Intravenous therapy is often necessary. There is a scarcity of paediatric critical-care cases demonstrating the dosing, monitoring, and efficacy of intravenous sotalol. This case demonstrates the effective use of intravenous sotalol in an adolescent with renal, hepatic, and haematological dysfunctions.

Fifteen-minute consultation: Intubation of the critically ill child presenting to the emergency department

2021 ◽  
pp. edpract-2021-322520
Author(s):  
Constantinos Kanaris ◽  
Peter Croston Murphy
Keyword(s):  
Emergency Department ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Successful Intubation ◽  
Patient Harm ◽  
Failed Intubation ◽  
Drug Choice ◽  
Critically Ill Child ◽  
Adequate Oxygenation ◽  
Selection Of

Intubation of critically ill children presenting to the emergency department is a high-risk procedure. Our article aims to offer a step-by-step guide as to how to plan and execute a rapid, successful intubation in a way that minimises risk of adverse events and patient harm. We address considerations such as the need for adequate resuscitation before intubation and selection of equipment and personnel. We also discuss drug choice for induction and peri-intubation instability, difficult airway considerations as well as postintubation care. Focus is also given on the value of preintubation checklists, both in terms of equipment selection and in the context of staff role designation and intubation plan clarity. Finally, in cases of failed intubation, we recommend the application of the Vortex approach, highlighting, thus, the importance of avoiding task fixation and maintaining our focus on what matters most: adequate oxygenation.

scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background Critically ill children require optimum feeding in the intensive care units for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units. Methods A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N = 42). Results The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral, and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children. Conclusions Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU are recommended to reduce possible infant and child mortality resulting from suboptimal feeding.

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