Transport of critically ill children to paediatric intensive care units in the UK and Ireland: 2013-2022.

Objective: To explore the trends and changes in the transport of children to paediatric intensive care units (PICUs) between 2013 and 2022.

Design: Retrospective analysis of routinely collected data.

Patients: Children transported for care in a PICU in the UK and Ireland aged<16 years.

Can critical care transport be safely reduced in children intubated during emergency management of status epilepticus in the United Kingdom: a national audit with case-control analysis.

Objective: This study describes the baseline clinical characteristics, predictors of successful extubation at referring hospitals and short-term outcomes of children intubated for status epilepticus and referred to United Kingdom (UK) paediatric critical care transport teams (PCCTs).

Design: Multicentre audit with case-control analysis, conducted between 1 September 2018 and 1 September 2020.

Setting: This study involved 10 UK PCCTs.

Development of the Children's ACuTe UltraSound (CACTUS) point-of-care ultrasound (POCUS)-accredited training in the UK: a descriptive study.

Point-of-care ultrasound (POCUS) is an established, evidence-supported tool that can be used in neonatal and paediatric medicine, offering clinicians immediate diagnostic insights, assessment of interventions and improved safety profiles and success rate of various procedures. Its effective use requires an established education programme, governance and standardisation to ensure competence in this skill. While adult clinical practice has established POCUS training protocols, this had not been replicated in paediatrics.

Point-of-care ultrasound as a diagnostic tool in respiratory assessment in awake paediatric patients: a comparative study.

Background: Chest X-ray (CXR) has typically been the main investigation in children with suspected respiratory pathology. Recent advances in lung point-of-care ultrasound (POCUS) have shown the potential for it to be comparative, if not better, than CXR. The objective of this study was to compare CXR with lung POCUS in children with respiratory illness in a ward-based setting at a paediatric teaching hospital.

Management of tetralogy of Fallot in the pediatric intensive care unit.

Tetralogy of Fallot (ToF) is one of the most common congenital cyanotic heart lesions and can present to a variety of health care professionals, including teams working in pediatric intensive care. Pediatric intensive care teams may care for a child with ToF pre-operatively, peri-operatively, and post-operatively. Each stage of management presents its own unique challenges.

Fifteen-minute consultation: Point of care ultrasound in the management of paediatric shock.

The use of point of care ultrasound (POCUS) in the assessment of the acutely shocked adult patient has been well established for over a decade. Comparatively, its use in paediatrics has been limited, but this is starting to change with the recent introduction of Children's Acute Ultrasound training. This article highlights the pathophysiology of shock in children and demonstrates how bedside ultrasound can be used to assist decision making in the clinical assessment of the neonate, infant or older child presenting with undifferentiated shock.

Psychological impact of working in paediatric intensive care. A UK-wide prevalence study.

Objective: To determine the prevalence of work-related psychological distress in staff working in UK paediatric intensive care units (PICU).

Design: Online (Qualtrics) staff questionnaire, conducted April to May 2018.

Setting: Staff working in 29 PICUs and 10 PICU transport services were invited to participate.

The role of point-of-care ultrasound in pediatric acute respiratory distress syndrome: emerging evidence for its use.

Pediatric acute respiratory distress syndrome (PARDS) remains an important cause of significant morbidity and mortality. The 2015 PALICC definition of PARDS requires chest imaging to diagnose the presence of new pulmonary infiltrate(s). Traditionally chest radiography or computerised tomography have been used.

Fifteen-minute consultation: Using point of care ultrasound to assess children with respiratory failure.

Point of care ultrasound (POCUS) is well established in adult emergency medicine and critical care. It is used for immediate diagnosis and evaluation of the impact of bedside interventions in the acutely unwell child. This article highlights how ultrasound can be helpful in paediatric practice when dealing with the neonate, infant or older child with undifferentiated respiratory distress, respiratory failure or ventilation problems.

Preoperative bioelectrical impedance predicts intensive care length of stay in children following cardiac surgery.

We have previously shown that children with a bioelectrical impedance spectroscopy phase angle at 50° (PA 50°) of <2.7 on postoperative day 2 had a four-fold increase in the risk of prolonged paediatric intensive care length of stay. In this study, we demonstrate a relationship between a baseline measure of phase angle 200/5° and postoperative length of stay.

Protocol for a randomised pilot multiple centre trial of conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU).

Introduction: Optimal targets for systemic oxygenation in paediatric critical illness are unknown. Observational data indicate that high levels of arterial oxygenation are associated with poor outcomes in resuscitation of the newborn and in adult critical illness. Within paediatric intensive care units (PICUs), staff prevent severe hypoxia wherever possible, but beyond this there is no consensus.

Impact of child death on paediatric trainees.

Objective: To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death.

Design: A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ test.

The Accuracy of Noninvasive Peripheral Pulse Oximetry After Palliative Cardiac Surgery in Patients With Cyanotic Congenital Heart Disease.

Background: Children with cyanotic congenital heart disease (CCHD) live with oxyhemoglobin saturations that are typically expressed as percentages in the range of 70s and 80s. Peripheral pulse oximetry (measurement of SpO) performs poorly in this range and yet is widely used to inform clinical decisions in these patients. The reference standard is co-oximetry of arterial samples (SaO).

Accuracy of the Masimo SET® LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease.

Unlabelled: Introduction Non-invasive peripheral pulse oximeters are routinely used to measure oxyhaemoglobin saturation (SpO2) in cyanotic congenital heart disease. These probes are calibrated in healthy adult volunteers between arterial saturations of ~75 and 100%, using the gold standard of co-oximetry on arterial blood samples. There are little data to attest their accuracy in cyanotic congenital heart disease.

Short-term renal support in postoperative repair of tetralogy of Fallot in the paediatric intensive care unit: can we predict those who need it?

Introduction: Fluid balance and renal function can be difficult to manage in the postoperative infant with tetralogy of Fallot. High fluid volumes are often needed to maintain cardiac output. Aims To stratify patients at risk for advanced renal support following tetralogy of Fallot repair.

15-minute consultation: a structured approach to the assessment of chest pain in a child.

This article aims to provide a concise, structured approach to the child with chest pain. Chest pain is a common presenting symptom in children but, unlike in adults, the cause is rarely cardiac. We review the main causes of chest pain in children and discuss the important features that may alert those assessing paediatric chest pain to serious underlying pathology.

Twelve tips for teaching with ultrasound in the undergraduate curriculum.

With ever increasing use of imaging as a diagnostic tool in medicine, medical schools are being urged to further integrate imaging into their curricula. Ultrasound is one such way of doing so-enabling students to bridge the gap between form and function, medical school and clinical practice. As a non-invasive imaging technique, with low risk when compared to other methods of imaging, ultrasound is ideal for integration into basic science and clinical teaching.

Implantable cardioverter defibrillator therapy in paediatric practice: a single-centre UK experience with focus on subcutaneous defibrillation.

Aims: Sudden cardiac death (SCD) risk can be managed by implantable cardioverter defibrillators (ICD). Defibrillation shocks can be delivered via ICD generator and/or intracardiac or subcutaneous coil configurations. We present our single-centre use of childhood ICDs.

Ultrasound and cadaveric prosections as methods for teaching cardiac anatomy: a comparative study.

This study compared the efficacy of two cardiac anatomy teaching modalities, ultrasound imaging and cadaveric prosections, for learning cardiac gross anatomy. One hundred and eight first-year medical students participated. Two weeks prior to the teaching intervention, students completed a pretest to assess their prior knowledge and to ensure that groups were equally randomized.