“Critical care without walls” - Impact of a “pediatric emergency team” on Picu admissions from the wards and overall mortality

Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these new therapeutic regimens. The goal of this review is to include practical points on important advances in the treatment of sepsis and provide a vision of future immunotherapeutic approaches.

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An Assessment of Critical Care Interventions and Resource Utilization During Medical Emergency Team Activations in Nonhospitalized Patients

The Joint Commission Journal on Quality and Patient Safety ◽

10.1016/s1553-7250(14)40073-4 ◽

2014 ◽

Vol 40 (12) ◽

pp. 567-574 ◽

Cited By ~ 1

Author(s):

Matthew P. Gilman ◽

Yuxiu Lei ◽

Timothy N. Liesching ◽

James M. Dargin

Keyword(s):

Critical Care ◽

Resource Utilization ◽

Medical Emergency Team ◽

Medical Emergency ◽

Emergency Team

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(P1-103) Utilization of a Pediatric Disaster Coalition as a Model for Regional Pediatric Disaster Planning

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11004365 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s132-s132

Author(s):

G. Foltin ◽

A. Flamm ◽

A. Cooper ◽

M. Sagy ◽

B.M. Greenwald ◽

...

Keyword(s):

Critical Care ◽

Emergency Preparedness ◽

Large Scale ◽

Pediatric Emergency ◽

Mass Casualty ◽

Metropolitan Region ◽

Pediatric Care ◽

Preparedness Planning ◽

Field Triage ◽

Care Surgery

PurposeThere remains a lack of comprehensive pediatric emergency preparedness planning worldwide. A disaster or mass-casualty incident (MCI) involving pediatric patients could overwhelm existing pediatric resources within the New York City (NYC) metropolitan region. The NYC Department of Health and Mental Hygiene (DOHMH) recognizing the importance to plan for a MCI with a large number of pediatric victims, implemented a project (the Pediatric Disaster Coalition; PDC), to address gaps in the healthcare system to provide effective and timely pediatric care during a MCI.MethodsThe PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from the NYC pediatric/children's hospitals, DOHMH, Office of Emergency Management, and Fire Department (FDNY). Two committees addressed pediatric prehospital triage, transport, and pediatric critical care (PCC) surge capacities. They developed guidelines and recommendations for pediatric field triage and transport, matching patients' needs to resources, and increasing PCC Surge Capacities.ResultsSurge recommendations were formulated. The algorithm developed provides specific pediatric triage criteria that identify severity of illness using the traditional Red, Yellow, and Green categories plus an Orange designation for continual reassessments that has been adopted by FDNY that has trained > 3,000 FDNY EMS personnel in its use. Triaged patients can be transported to appropriate resources based on a tiered system that defines pediatric hospital capabilities. The Surge Committee has created PCC Surge Capacity Guideline that can be used by hospitals to create their individual PCC surge plans. 15 of 25 NYC hospitals with PCC capabilities are participating with PDC planning; 5 have completed surge plans, 3 are nea completion, and 7 are in development. The completed plans add 92 surge beds to 244 regularly available PICU beds. The goal is to increase the PCC surge bed capacity by 200 + beds.ConclusionsThe project is an effective, multidisciplinary group approach to planning for a regional, large-scale pediatric MCI. Regional lead agencies must emphasize pediatric emergency preparedness in their disaster plans.

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