Epidemiology of Admissions in a Pediatric Resuscitation Room

Claudet, I.; Bounes, Vincent; Fédérici, Sonia; Laporte, Eve; Pajot, C.; Micheau, Pascale; Grouteau, E.

doi:10.1097/pec.0b013e3181a341ac

Cited by 22 publications

(18 citation statements)

References 18 publications

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“…The rhythms included ventricular fi brillation (VF), pulseless ventricular tachycardia, pulseless electrical activity (PEA), and asystole. In this study, VF includes patients with pulseless ventricular tachycardia.The etiologies of ICU admissions were divided into seventeen major categories: (1) conditions originating in the peri-natal period; (2) diseases of the respiratory system; (3) injury and poisoning; (4) infectious and parasitic diseases; (5) diseases of the nervous system and sense organs; (6) symptoms, signs and ill-defi ned conditions; (7) congenital abnormalities; (8) diseases of the digestive system; (9) diseases of the circulatory system; (10) diseases of the blood and blood-forming organs; (11) endocrine, nutritional, metabolic and immunity disorders; (12) diseases of the genitourinary system; (13) diseases of the skin and subcutaneous tissue; (14) neoplasms; (15) mental disorders; (16) diseases of the musculoskeletal system and connective tissue; and (17) complications of pregnancy, childbirth, and the puerperium. Correlations between related factors, including gender, age, hospital course, and diff erent years and etiologies, were also analyzed.…”

Section: Methodsmentioning

confidence: 99%

Epidemiology of Pediatric Critically-ill Patients Presenting to the Pediatric Emergency Department

et al. 2013

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This study aimed to analyze the epidemiologic patterns of pediatric critically-ill patients presenting to the emergency department (ED) and the etiologies of intensive care unit (ICU) admission of different age groups.This retrospective study of all children aged less than 18 years presenting with critical illnesses to the ED was conducted in a tertiary medical center in Taiwan from 2003 to 2007. All patients transferred to the ICU from the ED were included without distinction. Demographic data of critically-ill children admitted to the ED and ICU were analyzed. Etiologies of the ICU admissions were analyzed by various age groups.There were 2978 critically-ill children admitted to the ICU from the ED. In 120 pediatric patients with out-of-hospital cardiac arrest, cases with pulseless electrical activity or ventricular fibrillation had higher successful CPR rates than patients with asystole (both p<0.05). In patients admitted to ICUs, complications from the perinatal period, respiratory system diseases, accidental injuries and poisoning were the predominant etiologies respectively in young children (42.5%), school-aged children (38.5%), and adolescents (47.9%). Moreover, the most common of which was respiratory distress syndrome in neonates followed by bacterial pneumonia and status epilepticus.Epidemiologic analysis may provide primary clinicians to identify significant differences in admission rates based on different etiologies of various age groups.

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Section: Methodsmentioning

confidence: 99%

Epidemiology of Pediatric Critically-ill Patients Presenting to the Pediatric Emergency Department

et al. 2013

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“…Other studies, however, have showed most of the children are being younger than 1 year. 1,13,14 There is a possible explanation for increased numbers of preschool children in our study. While our hospital has one of the most advanced pediatric intensive care units in available in Turkey, it has a comparatively smaller neonatal intensive care unit.…”

Section: Discussionmentioning

confidence: 82%

Frequency and outcomes of endotracheal intubation in the pediatric emergency department

et al. 2017

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Intubation is a core airway skill in Pediatric Emergency Medicine (PEM). The data on pediatric endotracheal intubation in the emergency department, especially in developing countries, is currently very limited. This study was designed to describe the frequency, clinical features and outcomes of pediatric intubation in a large children's hospital.We performed a retrospective analysis of PEM medical records between January 2014 and December 2015 that involved any attempted intubations of children younger than 18 years. The medical records were reviewed to describe the intubation process, demographics, clinical features and outcomes.A total of 110,000 patients visited our emergency department during the study period. Ninety-one of them (1/1300) were intubated. The median age was 2 years, (F/M: 1) and 25 patients were younger than 12 months. Respiratory failure was the most common indication for intubation (42%), followed by status epilepticus (26%) and sepsis-shock (16%). Mortality was associated with prolonged chest compression (more than 10 minute). A poor outcome was associated with sepsis-shock and cardiac diseases; however, better outcomes were associated with status epilepticus (p<0.001). The first attempt success (FAS) was achieved in 60/91 (66 %) patients and the FAS rate was also higher in younger patients (p=0.002). The discharge rate of all intubated patients in our study was sixty-four percent.Pediatric residents performed the majority of intubations. A higher FAS rate was associated with younger patients. Favorable outcomes were directly related to duration of cardiopulmonary resuscitation and main diagnosis.

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“…In our study group, 41% of the surgical patients were admitted to the ICU, in comparison with other studies showing admittance to the ICU of less than 20%. 6,12 Although patient safety is the most important aspect and therefore patient should be liberally treated in the resuscitation bay, this is definitely an aspect that needs constant reevaluation and improvement.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, the main causes seemed to be neurological, respiratory, cardiocirculatory problems, and trauma. 6,7 As previous studies have shown, video recording is more effective than medical record review in detecting management errors in pediatric trauma resuscitation. 8,9 Therefore, the aim of our study was to analyze the adherence to advanced trauma life support (ATLS) and PALS guidelines and identify management errors in the pediatric resuscitation bay by using video recordings.…”

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confidence: 99%

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Borns¹,

Ersch²,

Dobrovoljac³

et al. 2018

Pediatr Emer Care

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Objective In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. Methods Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed. Treatment adherence to advanced trauma life support guidelines and pediatric advanced life support guidelines and errors per patient were identified. Results During the study period, 128 patients were recorded (65.6% with surgical, 34.4% with medical diseases). The most common causes for admission were traumatic brain injury (21.1%), multiple trauma (20.3%), and seizures (14.8%). There was a statistically significant correlation between accurate handover from emergency medical service to hospital physicians and adherence to airway, breathing, circulation, and disability sequence (correlation coefficient [CC], 0.205; P = 0.021), existence of a defined team leader and adherence to airway, breathing, circulation, and disability sequence (CC, 0.856; P < 0.001), and accurate hand over and existence of a defined team leader (CC, 0.186; P = 0.037). Unexpected errors were revealed. Cervical spine examination/stabilization was omitted in 40% of admitted surgical patients, even in 20% of patients with an injury of spine/limbs. Conclusions Video recording is a useful tool to evaluate patient management in the pediatric resuscitation bay. Analyzing errors of missing the adherence to the guidelines helps to pay attention and focus on specific items to improve patient care.

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Epidemiology of Admissions in a Pediatric Resuscitation Room

Abstract: In addition to national guidelines for PRR management, the teaching and knowledge of the different diagnosis admitted in the PRR and their resuscitation technical procedures warranty a serener approach of those stressful situations.

Cited by 22 publications

References 18 publications

Epidemiology of Pediatric Critically-ill Patients Presenting to the Pediatric Emergency Department

Epidemiology of Pediatric Critically-ill Patients Presenting to the Pediatric Emergency Department

Frequency and outcomes of endotracheal intubation in the pediatric emergency department

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

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