Following OHCA all patients have esophageal temperatures below normal in the pre-hospital phase and on arrival in the Emergency Department. Patients who achieve ROSC following OHCA and survive to hospital discharge are warmer on arrival in ICU and take longer to reach target MTH temperatures compared to patients who die in hospital. The mechanisms of action underlying esophageal temperature and survival from OHCA remain unclear and further research is warranted to clarify this relationship.

Torovirus remains the most commonly identified cause of NVG at The Hospital for Sick Children. Most NVG cases were epidemiologically linked, and a significant reduction in cases occurred after the institution of enhanced infection control practices following an outbreak of vancomycin-resistant Enterococcus. Improved education and surveillance for NVG should lead to further reduction in this problem.

viruses has decreased by more than 80% and routine radiography for children with low risk acute ankle injuries has decreased from 86% to 57%. CONCLUSION: Developing and implementing a Choosing Wisely top 5 list at a childrens hospital aims to promote a culture of quality, evidence-based and high-value care. We have plans for further improvements in the current project, sustaining the gains already achieved, and to expand the initiative to other areas in our institution. This model, along with lessons learned, is being shared with paediatric healthcare providers across the country through presentation at meetings and rounds, as well as publication in various media and high impact journals.

Background and aims: Intra-abdominal hypertension, identified as an independent risk factor for death, leads to Abdominal Compartment Syndrome (ACS), which might be involved in the dysfunction of gastrointestinal tracts, respiratory system, cardiovascular system, renal system, and cerebrum. Aims: To compare the survival rates of between volume-controlled percutaneous catheter drainage (PCD) and non-PCD in children with massive ascites resulted from ACS. Methods: We conducted a comparative series case-study in 18 children with ACS treated in a university hospital southern China from April 2011 to June 2013. Patients with ACS were identified by intravesical pressure over 10 mmHg with evidence of newly-onset of organ dysfunction or failure. Massive ascites were revealed by ultrasonography and drained by PCD after ultrasound localization. Results: Of these 18 enrolled children, 11were treated with PCD, and 7 were treated without PCD. The etiology of these children included abdominal tumor (56%), capillary leak of post-operation of liver or kidney transplantation (17%), cirrhosis (17%) and urinary ascites (11%). For ACS, gastrointestinal tracts and pulmonary were the most frequently affected organs, while the cerebrum was the least involved. High intra-abdominal pressure (IAP) was closely associated with high mortality. Treatment with PCD significantly decreased IAP, abdominal circumference, and the number of organ dysfunction. PCD treatment also significantly reduced the mortality from 100% to 18.2%. However, we also found that as the complications of PCD, abdominal infection (9%)and electrolyte imbalance(9%)occasionally occurred. Conclusions: Controlled peritoneal drainage, a minimally invasive and safe decompression, is effective in patients with ACS and should be considered in children with massive ascites.