Resource Utilization in Children who Receive a Pediatric Intensive Care Unit Consult in the Emergency Department: A Retrospective Cohort Study
Title
Resource Utilization in Children who Receive a Pediatric Intensive Care Unit Consult in the Emergency Department: A Retrospective Cohort Study
Creator
Boggs S; de Caen G; Lobos AT; Plint AC; Krmpotic K
Identifier
Publisher
Journal of Intensive Care Medicine
Date
2022
Subject
critical care; nursing; critical illness; intensive care units; pediatric; pediatrics resource utilization
Description
OBJECTIVES: To describe the characteristics, critical care resource requirements, and outcomes of children who were hospitalized after a Pediatric Intensive Care Unit (PICU) consult in the Emergency Department (ED). METHODS: In this single-centre retrospective cohort study, we conducted chart reviews for children (<18 years) hospitalized following a PICU consult in the ED to examine patient characteristics, timing of consult, ED length of stay, Medical Emergency Team (MET) utilization, PICU nursing workload, and critical care interventions for children who were and were not admitted to the PICU. RESULTS: During the one-year study period, 247 PICU consults were performed in the ED resulting in 161 (65.2%) direct admissions to PICU and 1 indirect PICU admission via the ward. Of 105 children with complex chronic conditions, 73 (69.5%) were admitted to PICU, including 32 (91.4%) of 35 children with chronic home ventilatory needs, only 2 (6.2%) of whom received a critical care intervention beyond respiratory support. Within 24 h of hospitalization, 112 (69.1%) of 162 PICU admissions received a critical care-specific intervention. Of 86 (34.8%) ward admissions, 16 (18.6%) were reviewed by the MET. Children admitted to the ward had a significantly longer post-consult ED length of stay than children admitted to PICU (median 428 min vs. 130 min; p <0.0001). CONCLUSIONS: Over two-thirds of children admitted to PICU from the ED required early critical care interventions, with the remainder potentially benefitting from closer monitoring or a higher frequency of non-critical care interventions than can be reasonably provided on general inpatient wards. More research is needed to evaluate critical care and hospital resource utilization when children are triaged to the ward following a PICU consult in the ED.
Rights
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Citation List Month
October 2022 List
URL Address
Collection
Citation
Boggs S; de Caen G; Lobos AT; Plint AC; Krmpotic K, “Resource Utilization in Children who Receive a Pediatric Intensive Care Unit Consult in the Emergency Department: A Retrospective Cohort Study,” Pediatric Palliative Care Library, accessed April 23, 2024, https://pedpalascnetlibrary.omeka.net/items/show/18401.