ObjectiveTo review the characteristics and outcome of cardiopulmonary resuscitation in children at a rural hospital in Kenya.Patients and methodAll children aged 0–14 years who experienced ≥1 episode of respiratory or cardiopulmonary arrest during April 2002–2004 were prospectively identified. Demographic variables, cause of hospitalisation, type and duration of arrest, resuscitation measures taken and outcomes were determined.Results114 children experienced at least one episode of respiratory arrest (RA) or cardiopulmonary arrest (CPA). Cardiopulmonary resuscitation (CPR) was performed on all children. “Do not resuscitate order” (DNR) was given in 15 patients after initial resuscitation. Eighty two patients (72%) had RA and 32 (28%) had CPA. 25/82 (30%) patients with RA survived initial CPR compared to 5/32 (16%) with CPA. Survival at discharge was 22% (18/82) in children who had RA while no one with CPA survived at discharge. The leading underlying diseases were severe malaria, septicaemia and severe malnutrition. Prolonged resuscitation beyond 15 min and receiving adrenaline [epinephrine] (at least one dose of 10 μg/kg IV) were predictive of poor final outcome.ConclusionCardiopulmonary arrest after admission has a very poor prognosis in our hospital. Infectious diseases are the main underlying causes of arrest. If a child fails to respond to the basic tenements of PALS within 15 min then it is unlikely that further efforts to sustain life will be fruitful in hospitals where ventilation facilities are not present.

Aim: Medical Device-Related Pressure Ulcers are skin breakdowns related to certain medical devices that increase morbidity, lengthen hospital stays, and increase the cost of treatment. Approximately one third of reported pressure ulcers are associated with medical devices. The aim of this study is to examine the impact of a suggested nursing intervention protocol on the occurrence of medical device-related pressure ulcers in critically ill patients. Design: A prospective, quasi-experimental research design was used in this study. Methods: 100 patients participated in our study, divided into study and control groups. The researchers selected Endo-tracheal and Nasogastric tubes to examine their association with the development of pressure ulcers. The researchers observed the prevalence of pressure ulcers caused by the selected devices through daily clinical observation. Patients receiving routine care were used as a control group, while the suggested nursing intervention protocol was implemented to the study group of patients. The results of the given protocol on the study subjects were compared to the collected base line data for the control group. Results: The study revealed a highly statistically and clinically significant difference between the study and control groups in relation to incidence of endo-tracheal and nasogastric tube pressure ulcers. The results indicate that the incidence of endo-tracheal tube pressure ulcers decreased from 90% to 32.1% after implementation of the suggested nursing intervention protocol (p = 0.031), whereas the incidence of nasogastric tubes pressure ulcers fell from 77.8% to 13.1% (p = 0.012). Conclusion: the examined evidence based suggested nursing intervention protocol proved highly effective in reducing the occurrence of selected Medical Device-Related Pressure Ulcers in critically ill patients.