Boldly going… Introducing conflict management training to Starship Children's Hospital.

Conflict between health professionals and whānau (families) in paediatric hospitals is common and leads to significant distress for families and staff. The likelihood of challenges and conflict around communication and critical medical decision-making is increased where there are cultural and social complexities. Training staff to recognise and manage conflict as early as possible improves patient/whānau outcomes and staff well-being.

Tetanus in New Zealand children: Intensive care management of a vaccine preventable disease.

Aim: To review management of children admitted with tetanus to Starship Children's Hospital from 2000 to 2013.

Methods: Retrospective chart review of children aged 0-15 years admitted to Starship Children's Hospital with tetanus from 2000 to 2013. Follow-up of immunisation status was via the National Immunisation Register and/or phone contact with patient's primary health care provider.

7-year retrospective review of quad bike injuries admitted to Starship Children's Hospital.

Aims: To ascertain morbidity and mortality of children who presented to Starship Children's Hospital with injuries from a quad bike incident from 2007 to 2014, and to review whether current guidelines are sufficient to prevent injury.

Methods: A retrospective case note review of all children under the age of 16 years who presented to Starship Hospital with an injury sustained whilst riding a quad bike between January 2007 and July 2014.

Results: Twenty-seven patients were identified through both the Starship Children's Hospital Trauma and Paediatric Intensive Care databases with injuries resulting from a quad bike incident.

Varicella in a Paediatric Intensive Care Unit: 10-year review from Starship Children's Hospital, New Zealand.

Aims: Varicella is now a vaccine-preventable disease but is generally considered benign, making it a low priority for a funded universal immunisation scheme. We aimed to increase the knowledge of the severity, morbidity and mortality caused by varicella, by a review of cases requiring paediatric intensive care in New Zealand where vaccine is available but not funded.

Methods: This is a retrospective chart review of children admitted to the paediatric intensive care unit (PICU) over a 10-year period (July 2001-July 2011) identified from the PICU database with a primary or secondary code for varicella.

Scoliosis repair in a teenager with Duchenne's muscular dystrophy: who calls the shots?

In this exchange, a clinician (the first author) presents a case scenario for comment by an ethicist (the second author). The case concerns a 15-year-old boy with Duchenne's muscular dystrophy requested palliative surgical correction of a 60 degree thoraco-lumbar scoliosis. The surgical team were initially reluctant to offer surgery given their assessment of the perioperative and postoperative risks (anesthetic review suggested an 80% chance of surviving the surgery and 50% likelihood of returning home), but the operation proceeded.

Serious injuries from dishwasher powder ingestions in small children.

Aims: To describe patterns and severity of caustic injuries sustained from dishwasher powder ingestion and highlight need for national safety standards.

Methods: Retrospective chart review of admissions for caustic ingestion to Starship Children's Hospital from January 2003 to January 2005 and review of New Zealand National Poisons Centre data.

Results: Between January 2003 and January 2005, the National Poisons Centre recorded 610 dishwashing powder ingestions, with 88% of children less than 2 years old.

Outcome in neonates with congenital heart disease referred for respiratory extracorporeal membrane oxygenation.

Aim: To evaluate the proportion of neonates referred for extracorporeal membrane oxygenation (ECMO) support in the modern era of advanced conventional treatments for respiratory failure who actually had congenital heart disease (CHD), and to assess the impact of this diagnostic route on patient condition and outcome.

Methods: A retrospective case-note review of neonatal ECMO and cardiac admissions to a single, tertiary ECMO and cardiac intensive care unit (ICU) between March 1999 and February 2002.

Results: 287 symptomatic neonates presented to the ICU with previously undiagnosed cardiac or respiratory disease.