Abstract:
OBJECTIVE:To describe current practice during stabilisation of children presenting with critical illness to the district general hospital (DGH), preceding retrieval to intensive care. DESIGN:Observational study using prospectively collected transport data. SETTING:A centralised intensive care retrieval service in England and referring DGHs. PATIENTS:Emergency transports to intensive care during 2-month epochs from 4 consecutive years (2005-2008). INTERVENTIONS:None. MAIN OUTCOME MEASURES:Proportion of key airway, breathing, and circulatory and neurological stabilisation procedures, such as endotracheal intubation, mechanical ventilation, vascular access, and initiation of inotropic agents, performed by referring hospital staff prior to the arrival of the retrieval team. RESULTS:706 emergency retrievals were examined over a 4-year period. The median age of transported children was 10 months (IQR, 18 days to 43 months). DGH staff performed the majority of endotracheal intubations (93.7%, CI 91.3% to 95.5%), initiated mechanical ventilation in 76.9% of cases (CI 73.0% to 80.4%), inserted central venous catheters frequently (67.4%, CI 61.7% to 72.6%), and initiated inotropic agents in 43.7% (CI 36.6% to 51.1%). The retrieval team was more likely to perform interventions such as reintubation for air leak, repositioning of misplaced tracheal tubes, and administration of osmotic agents for raised intracranial pressure. The performance of one or more interventions by the retrieval team was associated with severity of illness, rather than patient age, diagnostic group, or team response time (OR 3.62, 95% CI 1.47 to 8.92). CONCLUSIONS:DGH staff appropriately performs the majority of initial stabilisation procedures in critically ill children prior to retrieval. This practice has not changed significantly for the past 4 years, attesting to the crucial role played by district hospital staff in a centralised model of paediatric intensive care.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Lampariello S,Clement M,Aralihond AP,Lutman D,Montgomery MA,Petros AJ,Ramnarayan Pdoi
10.1136/adc.2008.151266subject
Has Abstractpub_date
2010-09-01 00:00:00pages
681-5issue
9eissn
0003-9888issn
1468-2044pii
adc.2008.151266journal_volume
95pub_type
杂志文章abstract:BACKGROUND:Several studies have shown an increased incidence of neurodevelopmental impairment in very preterm survivors at school age compared with controls. AIM:To compare findings in the same cohort at 8 years and 15 years. METHODS:A total of 151 of the 224 eligible infants born before 33 weeks of gestation from 19...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2002.006676
更新日期:2004-03-01 00:00:00
abstract::This study was carried out on the way in which children's beds were used by the specialty of paediatrics in a district general hospital. Five differing ways were found of interpreting the present Department of Health guidelines on health services information (Körner recommendations). These gave bed occupancy figures v...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.4.504
更新日期:1991-04-01 00:00:00
abstract::The range of thermal control and the thermoneutral range of preterm infants under 30 weeks' gestation was calculated by extrapolation of data from studies on more mature infants. Even assuming some thermoregulatory capacity, the range of control is less than 3 degrees C, the thermoneutral range is less than 0.5 degree...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.7.504
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:Intensive care patients are susceptible to developing painful corneal epithelial deficits. Provision of eye care to prevent deficits was limited in our paediatric intensive care unit (PICU) population. INTERVENTIONS:A new eye care bundle was introduced, comprising a guideline for eye care, the addition of e...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-310410
更新日期:2016-09-01 00:00:00
abstract::We report a child who presented with a progressive neurological disorder associated with hypertension and paroxysms of irritability and sweating in whom an abnormality of catecholamine metabolism or excretion was demonstrated. An elder sister died at the age of 2 1/2 years with similar clinical symptoms but without bl...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.8.682
更新日期:1978-08-01 00:00:00
abstract:AIM:To identify the experiences of patients, parents or carers when a child/young person is prescribed a new long-term medicine. METHOD:Patients' prescribed a new long-term (>6 weeks) medicine were recruited from a single UK paediatric hospital out-patient pharmacy.A semi-structured questionnaire was administered to p...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.58
更新日期:2016-09-01 00:00:00
abstract:AIMS:To review the results of long term high dose intravenous immunoglobulin treatment. METHODS:162 treatment years in 18 patients with hypogammaglobulinaemia who received intravenous immunoglobulin treatment between 1973 and 1993 were reviewed. RESULTS:A mean dose of 0.42 g/kg immunoglobulin resulted in a mean troug...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.74.6.527
更新日期:1996-06-01 00:00:00
abstract::The output of the drug and the particle size produced by various nebulisers were assessed, and sensible nebulisation times for sodium cromoglycate calculated. Three of the four nebuliser systems tested produced over 80% of total drug output within the first five minutes of nebulisation. We suggest that five minutes is...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.9.1270
更新日期:1989-09-01 00:00:00
abstract::To test whether early treatment could postpone the chronic colonisation of the respiratory tract with mucoid strains of Pseudomonas aeruginosa in patients with cystic fibrosis, we performed a pilot study in 28 patients aged 2 to 18 years. A two week course of azlocillin (150 mg/kg/day) and tobramycin (10 to 15 mg/kg/d...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.7.1022
更新日期:1989-07-01 00:00:00
abstract::Ninety seven teachers of diabetic pupils in Liverpool completed a questionnaire designed to assess their knowledge of diabetes mellitus and the sources from which they had obtained information. The survey aimed to evaluate their understanding and to aid in planning an alternative policy of teacher education. Only 24 t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.9.692
更新日期:1983-09-01 00:00:00
abstract::Rubella vaccination was offered to a cohort of schoolgirls 14 years and over whose immune state was unknown. This increased the percentage vaccinated or known to be immune from 86% to 90%. It is recommended that rubella vaccination should be offered to girls until they leave school at 16 years of age. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.63.8.983
更新日期:1988-08-01 00:00:00
abstract::The contribution of abnormal cardiac function to hypotension and metabolic acidosis, which affect approximately 40% of ventilated very low birthweight infants in the first 24 hours after birth was assessed using M mode, two dimensional, and Doppler echocardiography in 75 very low birthweight infants during the first f...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.68.1_spec_no.17
更新日期:1993-01-01 00:00:00
abstract::A 12 year old Asian girl with a four year history of poorly controlled insulin dependent diabetes mellitus developed overt diabetic nephropathy. There were no clinical features of Rabson-Mendenhall syndrome. Screening for microalbuminuria would have identified incipient diabetic nephropathy and highlighted the importa...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.77.6.524
更新日期:1997-12-01 00:00:00
abstract::A retrospective analysis was made of the incidence and severity of the idiopathic respiratory distress syndrome (RDS) in babies of less than 35 weeks' gestation born at this hospital from January 1967-December 1974. There was a lower incidence of RDS in babies born after pregnancies complicated only by prolonged ruptu...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.9.674
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVES:To determine long-term seroprotection after serogroup C meningococcal (MenC) vaccination at the age of 9-12 years, with or without booster vaccination at the age of 13-15 years. DESIGN:Observational cohort study; follow-on from randomised study. SETTING:Participants were recruited from English secondary sc...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,随机对照试验
doi:10.1136/archdischild-2013-303893
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that reduced fetal growth leads to altered plasma insulin-like growth factor-1 (IGF-1) concentrations in childhood. DESIGN:A follow up study of 4 year old children whose birth weights were recorded, and of 7 year old children whose weight, length, head circumference, and placental weig...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.73.4.287
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:The number of trips to the tropics taken by children with chronic health disorders (CHDs) is increasing. METHODS:All of the children with CHDs who attended two international vaccination centres in France before travelling to the tropics were included in a prospective, exposed/unexposed study. Each child was...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-309436
更新日期:2016-11-01 00:00:00
abstract::The fetal heart beat, detected by ultrasound, was recorded for five minutes from 934 antenatal women--266 at 30 to 35 weeks' gestation and 718 at 36 to 41 weeks. Episodes of bradycardia < 100/minute ranging from 5-30 seconds' duration occurred in 3 (1.1%) of the former and in 9 (1.3%) of the latter group. Tachycardia ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.7.506
更新日期:1980-07-01 00:00:00
abstract::Three clinically normal sibs were discovered to have type II hyperprolinaemia in a routine serum amino acid screening programme in Sicily. In addition to the basic biochemical features of type II hyperprolinaemia, all 3 children had marked hyperglycinaemia, whereas their parents had both normal blood proline and glyci...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.50.8.637
更新日期:1975-08-01 00:00:00
abstract::Five cases of serious injuries to children wearing superhero costumes, involving extreme risk-taking behaviour, are presented here. Although children have always displayed behaviour seemingly unwise to the adult eye, the advent of superhero role models can give unrealistic expectations to the child, which may lead to ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.109793
更新日期:2007-03-01 00:00:00
abstract::We describe the results of a prospective study in which 120 women who developed hypertension in the last trimester of pregnancy were randomly allocated in double blind manner to atenolol or placebo. The mean duration of treatment was five weeks. The only difference between groups during the neonatal period was in resp...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.59.11.1061
更新日期:1984-11-01 00:00:00
abstract:AIM:To evaluate gastric emptying in girls with Turner's syndrome to detect if gastrointestinal motor dysfunction was present. SUBJECTS:Thirteen girls (mean age 8.1 years) with Turner's syndrome, seven girls with familial short stature (6.1 years), and eight control girls (7.6 years). METHODS:Gastric emptying studies ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.5.440
更新日期:1996-11-01 00:00:00
abstract::A girl was born to a mother who had undergone treatment for epilepsy with carbamazepine during pregnancy. The infant had dysmorphic features and was physically and mentally retarded. We consider that the malformations were the result of the maternal treatment with carbamazepine. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.5.641
更新日期:1991-05-01 00:00:00
abstract::A 6-week-old girl with fever, hypernatraemia, dehydration, and polyuria failed to concentrate urine in response to exogenous vasopressin administration. There was no family history of nephrogenic diabetes insipidus. When she was 15 months old, the infusion of vasopressin did not produce an increase in urinary cyclic-A...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.11.unknown
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:To investigate the accuracy of morphine infusions prepared for neonates in relation to the label strength and to identify the differences in deviation between infusions made in neonatal intensive care unit (NICU) and those dispensed ready-to-use from pharmacy. METHODS:Unused portions of morphine solution for...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2013-304522
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:The development, delivery and evaluation of a training programme for medical and nursing professionals on best practice for informing families of their child's disability. DESIGN:A 2 h training course on 'Best practice guidelines for informing families of their child's disability' was designed based on the f...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2012-303037
更新日期:2013-06-01 00:00:00
abstract::Travel for the purposes of obtaining medical treatment is increasing, but very little is known about the extent or nature of child medical travel. This paper discusses the outcome of a systematic search for academic literature on paediatric medical travel, outlines the potential significance of 'return health migratio...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2012-303189
更新日期:2013-06-01 00:00:00
abstract:RATIONALE:Accurate weight measurements are essential for both growth monitoring and drug dose calculations in children. Weight can be accurately measured using calibrated scales in resource-rich settings; however, reliable scales are often not available in resource-poor regions or emergency situations. Current age and/...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-309645
更新日期:2017-01-01 00:00:00
abstract:AIMS:To investigate how parents report children's respiratory sounds on video compared to a clinical "gold standard". METHODS:Five clinicians agreed on 10 video clips of children with audible breathing. These responses were the "gold standard". The clips were shown to parents of children: (a) with asthma/wheeze; (b) w...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.84.1.31
更新日期:2001-01-01 00:00:00
abstract:AIM:To assess the time it takes for paediatric TTA and inpatient orders to be dispensed and sent to ward. This is to establish if the Trust is meeting an operational Key Performance Indicator (KPI). STANDARDS KPIS:▸ 85% of urgent items (TTAs) dispensed within 1 hour.▸ 85% of non-urgent items (most inpatient orders) di...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.67
更新日期:2016-09-01 00:00:00