Great Challenges in Pediatrics

Corno, Antonio F.

doi:10.3389/fped.2013.00005

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Recognition of critical illness may be challenging as the signs and symptoms may be subtle and because of pediatric patients' ability to compensate which can mask deterioration. 1 2 Despite this, the vast majority of hospitalized pediatric patients do not need critical care interventions. Therefore, institutions develop their admission criteria and protocols to triage patients in an effort to accurately match the needs of pediatric patients to the proper level of care.…”

Section: Introductionmentioning

confidence: 99%

A Single-Center Retrospective Evaluation of Unplanned Pediatric Critical Care Upgrades

Yoder

Dillon

DeMartini

et al. 2021

J Pediatr Intensive Care

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Background Inappropriate triage of critically ill pediatric patients can lead to poor outcomes and suboptimal resource utilization. This study aimed to determine and describe the demographic characteristics, diagnostic categories, and timing of unplanned upgrades to the pediatric intensive care unit (PICU) that required short (< 24 hours of care) and extended (≥ 24 hours of care) stays. In this article, we hypothesized that we will identify demographic characteristics, diagnostic categories, and frequent upgrade timing periods in both of these groups that may justify more optimal triage strategies. Methods This was a single-institution retrospective study of unplanned PICU upgrades between 2012 and 2018. The cohort was divided into two groups (short and extended PICU stay). We reviewed the electronic health record and evaluated for: demographics, mortality scores, upgrade timing (7a-3p, 3p-11p, 11p-7a), lead-in time (time spent on clinical service before upgrade), patient origin, and diagnostic category. Results Four hundred and ninety-eight patients' unplanned PICU upgrades were included. One hundred and nine patients (21.9%) required a short and 389 (78.1%) required an extended PICU stay. Lead-in time (mean, standard deviation) was significantly lower in the short group (0.65 ± 0.66 vs. 0.91 ± 0.82) (p = 0.0006). A higher proportion of short group patients (59, 46.1%) were upgraded during the 3p-11p shift (p = 0.0077). Conclusion We found that approximately one-fifth of PICU upgrades required less than 24 hours of critical care services, were more likely to be transferred between 3p-11p, and had lower lead-in times. In institutions where ill pediatric patients can be admitted to either a PICU or a monitored step-down unit, this study highlights quality improvement opportunities, particularly in recognizing which pediatric patients truly need critical care.

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Section: Introductionmentioning

confidence: 99%

A Single-Center Retrospective Evaluation of Unplanned Pediatric Critical Care Upgrades

Yoder

Dillon

DeMartini

et al. 2021

J Pediatr Intensive Care

View full text Add to dashboard Cite

show abstract

“…Paediatrics presents unique clinical challenges with major implications for morbidity and mortality where care is suboptimal 1. Similarly, setting up a children’s hospital in a low-income to middle-income country (LMIC), such as Pakistan, brings its own set of trials and tribulations: from resource allocation to the provision of high-quality affordable care 2.…”

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confidence: 99%