1 40 2 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource April 2024 List Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month April List 2024 URL Address <a href="http://doi.org/10.3389/fped.2024.1272648" target="_blank" rel="noreferrer noopener"> http://doi.org/10.3389/fped.2024.1272648</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Perceived potentially inappropriate treatment in the PICU: frequency, contributing factors and the distress it triggers Publisher An entity responsible for making the resource available Frontiers in Pediatrics Date A point or period of time associated with an event in the lifecycle of the resource 2024 Subject The topic of the resource distress; medical futility; death & dying; end-of-life (EOL); ethical conflict; potentially inappropriate treatment Creator An entity primarily responsible for making the resource Sarpal A; Miller MR; Martin CM; Sibbald RW; Speechley KN Description An account of the resource BACKGROUND: Potentially inappropriate treatment in critically ill adults is associated with healthcare provider distress and burnout. Knowledge regarding perceived potentially inappropriate treatment amongst pediatric healthcare providers is limited. OBJECTIVES: Determine the frequency and factors associated with potentially inappropriate treatment in critically ill children as perceived by providers, and describe the factors that providers report contribute to the distress they experience when providing treatment perceived as potentially inappropriate. METHODS: Prospective observational mixed-methods study in a single tertiary level PICU conducted between March 2 and September 14, 2018. Patients 0-17 years inclusive with: (1) ≥1 organ system dysfunction (2) moderate to severe mental and physical disabilities, or (3) baseline dependence on medical technology were enrolled if they remained admitted to the PICU for ≥48 h, and were not medically fit for transfer/discharge. The frequency of perceived potentially inappropriate treatment was stratified into three groups based on degree of consensus (1, 2 or 3 providers) regarding the appropriateness of ongoing active treatment per enrolled patient. Distress was self-reported using a 100-point scale. RESULTS: Of 374 patients admitted during the study, 133 satisfied the inclusion-exclusion criteria. Eighteen patients (unanimous - 3 patients, 2 providers - 7 patients; single provider - 8 patients) were perceived as receiving potentially inappropriate treatment; unanimous consensus was associated with 100% mortality on 3-month follow up post PICU discharge. Fifty-three percent of providers experienced distress secondary to providing treatment perceived as potentially inappropriate. Qualitative thematic analysis revealed five themes regarding factors associated with provider distress: (1) suffering including a sense of causing harm, (2) conflict, (3) quality of life, (4) resource utilization, and (5) uncertainty. CONCLUSIONS: While treatment perceived as potentially inappropriate was infrequent, provider distress was commonly observed. By identifying specific factor(s) contributing to perceived potentially inappropriate treatment and any associated provider distress, organizations can design, implement and assess targeted interventions. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.3389/fped.2024.1272648" target="_blank" rel="noreferrer noopener">10.3389/fped.2024.1272648</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). 2024 April List 2024 Death & Dying Distress end-of-life (EOL) ethical conflict Frontiers in Pediatrics Martin CM Medical Futility Miller MR potentially inappropriate treatment Sarpal A Sibbald RW Speechley KN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource May 2022 List Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month May 2022 List URL Address <a href="http://doi.org/10.3389/fped.2021.793008" target="_blank" rel="noreferrer noopener">http://doi.org/​10.3389/fped.2021.793008</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Clinical and Physiologic Factors Associated With Mode of Death in Pediatric Severe TBI Publisher An entity responsible for making the resource available Frontiers in Pediatrics Date A point or period of time associated with an event in the lifecycle of the resource 2021 Subject The topic of the resource Clinical factors; Death; Pediatrics; Physiologic factors; Traumatic brain injury Creator An entity primarily responsible for making the resource Baird TD; Miller MR; Cameron S; Fraser DD; Tijssen JA Description An account of the resource Aims and Objectives: Severe traumatic brain injury (sTBI) is the leading cause of death in children. Our aim was to determine the mode of death for children who died with sTBI in a Pediatric Critical Care Unit (PCCU) and evaluate factors associated with mortality. Method(s): We performed a retrospective cohort study of all severely injured trauma patients (Injury Severity Score >= 12) with sTBI (Glasgow Coma Scale [GCS] <= 8 and Maximum Abbreviated Injury Scale >= 4) admitted to a Canadian PCCU (2000-2016). We analyzed mode of death, clinical factors, interventions, lab values within 24 h of admission (early) and pre-death (48 h prior to death), and reviewed meeting notes in patients who died in the PCCU. Result(s): Of 195 included patients with sTBI, 55 (28%) died in the PCCU. Of these, 31 (56%) had a physiologic death (neurologic determination of death or cardiac arrest), while 24 (44%) had withdrawal of life-sustaining therapies (WLST). Median (IQR) times to death were 35.2 (11.8, 86.4) hours in the physiologic group and 79.5 (17.6, 231.3) hours in the WLST group (p = 0.08). The physiologic group had higher partial thromboplastin time (PTT) within 24 h of admission (p = 0.04) and lower albumin prior to death (p = 0.04). Conclusion(s): Almost half of sTBI deaths in the PCCU were by WLST. There was a trend toward a longer time to death in these patients. We found few early and late (pre-death) factors associated with mode of death, namely higher PTT and lower albumin. Copyright © 2021 Baird, Miller, Cameron, Fraser and Tijssen. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.3389/fped.2021.793008" target="_blank" rel="noreferrer noopener">10.3389/fped.2021.793008</a> 2021 Baird TD Cameron S Clinical factors Death Fraser DD Frontiers in Pediatrics May 2022 List Miller MR Pediatrics Physiologic factors Tijssen JA traumatic brain injury