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Paediatric intensive care

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https://www.readbyqxmd.com/read/28714493/handwashing-practices-in-neonatal-intensive-care-unit-paediatric-intensive-care-unit-and-neonatal-nurseries-in-patan-hospital
#1
S Joshi, P Amatya, B Poudel, S A Yadav
BACKGROUND: Hand hygiene has been identified as the single most important factor in minimising hospital acquired infections. However, compliance of handwashing guidelines has remained low. The aim of this study was to study the handwashing practices in the Paediatric and Neonatal intensive care units and Neonatal nurseries in Patan Hospital, and secondly to re-evaluate the improvement on compliance of handwashing guidelines after intervention. METHODS: Pre-intervention study was conducted by covertly observing the handwashing practices by the healthcare workers...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28705790/children-with-life-limiting-conditions-in-paediatric-intensive-care-units-a-national-cohort-data-linkage-study
#2
Lorna K Fraser, Roger Parslow
OBJECTIVE: To determine how many children are admitted to paediatric intensive care unit (PICU) with life-limiting conditions (LLCs) and their outcomes. DESIGN: National cohort, data-linkage study. SETTING: PICUs in England. PATIENTS: Children admitted to a UK PICU (1 January 2004 and 31 March 2015) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to hospital episodes statistics enabled identification of children with a LLC using an International Classification of Diseases (ICD10) code list...
July 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28705570/la-pose-de-voie-veineuse-p%C3%A3-diatrique-par-les-%C3%A3-quipes-de-smur-adultes
#3
REVIEW
Frédéric Lemoine, Hugues Lefort, Sabine Lemoine, Benoît Frattini, Daniel Jost
Paediatric perfusion during pre-hospital care is a major issue in the event of life-threatening emergencies. Access, often restricted, to backup specialising in paediatrics, implies the existence of practices on protocols for the adult mobile emergency and intensive care service (Smur) in partnership with paediatricians. Paediatric perfusion practices were assessed in these teams. The results show the presence of a paediatric protocol in the adult Smur teams is not very common. Nursing practices seem to be evolving towards the recommendations, thanks to technological advances such as the use of the intraosseous device...
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28692913/particle-and-bioaerosol-characteristics-in-a-paediatric-intensive-care-unit
#4
Congrong He, Ian M Mackay, Kay Ramsay, Zhen Liang, Timothy Kidd, Luke D Knibbs, Graham Johnson, Donna McNeale, Rebecca Stockwell, Mark G Coulthard, Debbie A Long, Tara J Williams, Caroline Duchaine, Natalie Smith, Claire Wainwright, Lidia Morawska
The paediatric intensive care unit (PICU) provides care to critically ill neonates, infants and children. These patients are vulnerable and susceptible to the environment surrounding them, yet there is little information available on indoor air quality and factors affecting it within a PICU. To address this gap in knowledge we conducted continuous indoor and outdoor airborne particle concentration measurements over a two-week period at the Royal Children's Hospital PICU in Brisbane, Australia, and we also collected 82 bioaerosol samples to test for the presence of bacterial and viral pathogens...
July 7, 2017: Environment International
https://www.readbyqxmd.com/read/28691745/prospective-evaluation-of-the-whitt-neonatal-trigger-score-in-an-at-risk-neonatal-population
#5
Anna Robinson, Lucinda C Winckworth, Georgios Eleftheriou, Rebecca Hewitson, Harriet Holme
AIM: The aim of this study was to prospectively evaluate the Whitt Neonatal Trigger Score (W-NTS), determining optimum threshold scores for consideration of medical intervention and intensive care unit admission. METHODS: All neonates on the postnatal ward (PNW) with a set of pre-defined risk factors were scored on the W-NTS. Neonates were divided into three groups: 'unwell' admitted to neonatal intensive care unit (NICU); 'well', who remained on the PNW receiving standard care; and 'intervention', who received antibiotics but did not require admission to NICU...
July 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#6
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28688610/-materials-for-the-paediatric-resuscitation-trolley-or-backpack-expert-recommendations
#7
Jesús López-Herce Cid, Antonio Rodríguez Núñez, Ángel Carrillo Álvarez, Gonzalo Zeballos Serrato, Cecilia Martínez Fernández-Llamazares, Custodio Calvo Macías
Cardio-respiratory arrest (CPA) is infrequent in children, but it can occur in any place and at any time. This fact means that every health care facility must always have the staff and material ready to resuscitate a child. These recommendations are the consensus of experts of the Spanish Paediatric and Neonatal Resuscitation Group on the material and medication for paediatric and neonatal resuscitation and their distribution and use. CPR trolleys and backpacks must include the essential material to quickly and efficiently perform a paediatric CPR...
July 5, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28687343/the-montreux-definition-of-neonatal-ards-biological-and-clinical-background-behind-the-description-of-a-new-entity
#8
REVIEW
Daniele De Luca, Anton H van Kaam, David G Tingay, Sherry E Courtney, Olivier Danhaive, Virgilio P Carnielli, Luc J Zimmermann, Martin C J Kneyber, Pierre Tissieres, Joe Brierley, Giorgio Conti, Jane J Pillow, Peter C Rimensberger
Acute respiratory distress syndrome (ARDS) is undefined in neonates, despite the long-standing existing formal recognition of ARDS syndrome in later life. We describe the Neonatal ARDS Project: an international, collaborative, multicentre, and multidisciplinary project which aimed to produce an ARDS consensus definition for neonates that is applicable from the perinatal period. The definition was created through discussions between five expert members of the European Society for Paediatric and Neonatal Intensive Care; four experts of the European Society for Paediatric Research; two independent experts from the USA and two from Australia...
July 4, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28684015/bioimpedance-spectroscopy-measurements-of-phase-angle-and-height-for-age-are-predictive-of-outcome-in-children-following-surgery-for-congenital-heart-disease
#9
L V Marino, R Meyer, M Johnson, C Newell, C Johnstone, A Magee, K Sykes, S A Wootton, J V Pappachan
OBJECTIVE: Children with congenital heart disease (CHD) are often growth restricted (low weight- and/or height-for-age) which may increase risk of poor post operative resilience. Bioelectrical impedance spectroscopy (BIS) has been used to determine body composition in different clinical settings and has been shown to mark differences in nutritional state and clinical outcome. In disease conditions were fluid is not normally distributed it is proposed that raw impedance values and BIS derived phase-angle may serve as prognostic indicators of clinical outcome...
June 28, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28682011/extravasation-injury-in-a-paediatric-population
#10
Adrian D Murphy, Robert F Gilmour, Chris J Coombs
BACKGROUND: Extravasation occurs when a drug is inadvertently administered outside of the vein. Depending on the substance involved, this may lead to tissue necrosis with significant long-term morbidity. Children, particularly neonates, are particularly susceptible to extravasation with up to 70% of children in neonatal intensive care unit having some form of extravasation injury. These injuries are commonly referred to plastic surgeons for ongoing management. METHODS: We prospectively collected information on all extravasation injuries referred to the plastic surgery department in a children's hospital over an 18-month period...
July 6, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28681809/an-outbreak-of-burkholderia-cepacia-complex-in-the-paediatric-unit-of-a-tertiary-care-hospital
#11
Swapna Mali, Lona Dash, Vikas Gautam, Jayanthi Shastri, Sunil Kumar
INTRODUCTION: Burkholderia cepacia complex (Bcc) has emerged as a serious nosocomial pathogen worldwide especially in patients with indwelling catheters and cystic fibrosis. Bcc is a common contaminant of pharmaceutical products. We describe an outbreak of Bcc bacteraemia amongst children admitted in Paediatric Intensive Care Unit (PICU) and paediatric ward at a tertiary care hospital, Mumbai, in Western India. MATERIALS AND METHODS: Blood culture samples from paediatric patients yielded growth of non-fermenting, oxidase positive, motile, Gram negative bacilli (NFGNB) (76/909) over a period of 8 months...
April 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28679836/effects-of-the-i-pass-nursing-handoff-bundle-on-communication-quality-and-workflow
#12
Amy J Starmer, Kumiko O Schnock, Aimee Lyons, Rebecca S Hehn, Dionne A Graham, Carol Keohane, Christopher P Landrigan
BACKGROUND AND OBJECTIVE: Handoff communication errors are a leading source of sentinel events. We sought to determine the impact of a handoff improvement programme for nurses. METHODS: We conducted a prospective pre-post intervention study on a paediatric intensive care unit in 2011-2012. The I-PASS Nursing Handoff Bundle intervention consisted of educational training, verbal handoff I-PASS mnemonic implementation, and visual materials to provide reinforcement and sustainability...
July 5, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28674611/reducing-the-number-of-unnecessary-liver-function-tests-requested-on-the-paediatric-intensive-care-unit
#13
Lynn Sinitsky, Joe Brierley
Between January and October 2014, Great Ormond Street Hospital Paediatric Intensive Care Unit (PICU) was spending an average £23,392 on blood tests per month. Blood tests should be requested based on previous results and the patient's clinical condition, medication and nutritional status. However, more blood tests were being ordered than clinically indicated: an audit in October 2014 showed liver function tests (LFTs) were requested daily on most patients, even with previous normal results. A driver diagram identified three primary drivers for blood test requesting: decision-making, situational awareness and computer-based ordering...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28674126/healthcare-professional-perceptions-of-family-centred-rounds-in-french-nicus-a-cross-sectional-study
#14
Véronique Thébaud, Marion Lecorguillé, Jean-Michel Roué, Jacques Sizun
OBJECTIVE: To assess the perceptions of healthcare professionals (HCPs) regarding parental presence at medical rounds in French neonatal intensive care units (NICUs). We hypothesised that HCPs would perceive barriers against allowing parental participation in round discussions. METHODS: This cross-sectional study approached 304 HCPs from three groups; group 1: French professionals that attended an annual French-speaking meeting of the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP); group 2: NICU professionals from a tertiary care academic hospital in western France; and group 3: paediatric residents from six French universities...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28673223/proceedings-of-the-12th-international-conference-on-rapid-response-systems-and-medical-emergency-teams
#15
D Jones, J Holmes, J Currey, E Fugaccia, A J Psirides, M Y Singh, G J Fennessy, K Hillman, D V Pilcher, R Bellomo, M DeVita
Rapid Response Teams (RRTs) have been introduced into hospitals worldwide in an effort to improve the outcomes of deteriorating hospitalised patients. Recently, there has been increased awareness of the need to develop systems other than RRTs for deteriorating patients. In May 2016, the 12th International Conference on Rapid Response Systems and Medical Emergency Teams was held in Melbourne. This represented a collaboration between the newly constituted International Society for Rapid Response Systems (iSRRS) and the Australian and New Zealand Intensive Care Society...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28668993/trauma-related-admissions-to-the-picu-at-chris-hani-baragwanath-academic-hospital-johannesburg
#16
Nirav Patel, I Khofi-Phiri, L R Mathiva, A Grieve, J Loveland, G D Nethathe
BACKGROUND: Paediatric trauma is a major cause of morbidity and mortality in low and middle income countries. Data from these regions are scant. We aimed to describe the demographic and injury profile, treatment modality and outcome of trauma admissions to the paediatric intensive care unit at Chris Hani Baragwanath Academic Hospital (CHBAH). METHODS: A retrospective record review of trauma cases admitted to the PICU at CHBAH from 2011 to 2013 was performed. RESULTS: One-fifth of admissions were due to trauma...
July 1, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28663106/parents-experiences-and-the-effect-on-the-family-two-years-after-their-child-was-admitted-to-a-picu-an-interview-study
#17
Karina Terp, Annica Sjöström-Strand
BACKGROUND: For parents, having a child admitted to a paediatric intensive care unit (PICU) is a very stressful experience filled with anxiety. Parents are often scared and traumatised. This stress can lead to PTSD. AIM: The aim was to describe parents' experiences and the effect on the family two years after their child was admitted to a paediatric intensive care unit. MATERIAL AND METHODS: Ten parents were interviewed according to a semi-structured interview guide...
June 26, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28651511/outcomes-of-children-admitted-to-intensive-care-after-out-of-hospital-cardiac-arrest-in-victoria-australia
#18
Anri Forrest, Warwick W Butt, Siva P Namachivayam
OBJECTIVES: Paediatric out-of-hospital cardiac arrest (OHCA) is an uncommon event but is associated with high mortality and severe neurological sequelae among survivors. Most studies of paediatric OHCA are population-based, with very few reports on the cohort admitted to the paediatric intensive care unit (PICU). We sought to determine outcomes and predictors of neurologically intact survival in these children admitted to the PICU. DESIGN AND SETTING: Retrospective analysis of data prospectively collected from the PICU and emergency department (ED) databases and cross-checked with medical records and coronial reports for January 2005 to December 2014...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28641582/a-multicentre-randomised-controlled-trial-of-levetiracetam-versus-phenytoin-for-convulsive-status-epilepticus-in-children-protocol-convulsive-status-epilepticus-paediatric-trial-consept-a-predict-study
#19
Stuart R Dalziel, Jeremy Furyk, Megan Bonisch, Ed Oakley, Meredith Borland, Jocelyn Neutze, Susan Donath, Cynthia Sharpe, Simon Harvey, Andrew Davidson, Simon Craig, Natalie Phillips, Shane George, Arjun Rao, Nicholas Cheng, Michael Zhang, Kam Sinn, Amit Kochar, Christine Brabyn, Franz E Babl
BACKGROUND: Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile...
June 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28640510/paediatric-intensive-care-nurses-decision-making-around-gastric-residual-volume-measurement
#20
Lyvonne N Tume, Lynne Latten, Lindsay Kenworthy
BACKGROUND: Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS: We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS: This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK...
June 22, 2017: Nursing in Critical Care
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