Remote Pediatric Critical Care Telephone Consultations: Quality and Outcomes

Abstract

There are no studies describing the nature and quality of telephone consultations for critically ill children despite being an important part of pediatric intensive care. We described pediatric telephone consultations to a PICU in Ontario, Canada in 2011 and 2012. Of 203 consultations, 104 patients (51.2%) were admitted to the PICU; this was associated with weekend consultations (p = 0.005) and referral hospital location (p = 0.036). Frequency of interruptions was 1 in every 3.2 (2.0, 5.7) minutes and not associated with call content. Twenty-one percent of consults had limited discussion of vital signs. Our study described our center's remote critical care consultation program and outcomes.

Direct vs. redirected admission of critically ill children to PICU after interfacility transfer: a retrospective cohort study

“…There is also increasing recognition that some children referred to tertiary center PICUs may not require critical care and could potentially be cared for and monitored in other care areas and institutions (11)(12)(13)(14)(15)(16). In a study describing transport in Ontario, Canada, approximately half of children for whom transport and access to PICU services were requested were not ultimately admitted to an intensive care (17). Little is known about patient characteristics which may determine the possibility of safe observation and delayed admission to ICU after initial transport and reassessment.…”