Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay.
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
19
1
2018
medline:
29
5
2021
entrez:
19
1
2018
Statut:
ppublish
Résumé
In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed. Treatment adherence to advanced trauma life support guidelines and pediatric advanced life support guidelines and errors per patient were identified. During the study period, 128 patients were recorded (65.6% with surgical, 34.4% with medical diseases). The most common causes for admission were traumatic brain injury (21.1%), multiple trauma (20.3%), and seizures (14.8%). There was a statistically significant correlation between accurate handover from emergency medical service to hospital physicians and adherence to airway, breathing, circulation, and disability sequence (correlation coefficient [CC], 0.205; P = 0.021), existence of a defined team leader and adherence to airway, breathing, circulation, and disability sequence (CC, 0.856; P < 0.001), and accurate hand over and existence of a defined team leader (CC, 0.186; P = 0.037). Unexpected errors were revealed. Cervical spine examination/stabilization was omitted in 40% of admitted surgical patients, even in 20% of patients with an injury of spine/limbs. Video recording is a useful tool to evaluate patient management in the pediatric resuscitation bay. Analyzing errors of missing the adherence to the guidelines helps to pay attention and focus on specific items to improve patient care.
Identifiants
pubmed: 29346233
doi: 10.1097/PEC.0000000000001403
pii: 00006565-202010000-00015
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e558-e563Références
Paul R, Neuman MI, Monuteaux MC, et al. Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics. 2012;130:e273–e280.
Larsen GY, Mecham N, Greenberg R. An emergency department septic shock protocol and care guideline for children initiated at triage. Pediatrics. 2011;127:e1585–e1592.
Webman R, Fritzeen JL, Yang J, et al. Classification and team response to nonroutine events occurring during pediatric trauma resuscitation. J Trauma Acute Care Surg. 2016;81:666–673.
Pucher PH, Aggarwal R, Twaij A, et al. Identifying and addressing preventable process errors in trauma care. World J Surg. 2013;37:752–758.
Yamada NK, Yaeger KA, Halamek LP. Analysis and classification of errors made by teams during neonatal resuscitation. Resuscitation. 2015;96:109–113.
Claudet I, Bounes V, Fédérici S, et al. Epidemiology of admissions in a pediatric resuscitation room. Pediatr Emerg Care. 2009;25:312–316.
Chavez H, Garcia CT, Sakers C, et al. Epidemiology of the critically ill child in the resuscitation bay. Pediatr Emerg Care. 2018;34:6–9.
Oakley E, Stocker S, Staubli G, et al. Using video recording to identify management errors in pediatric trauma resuscitation. Pediatrics. 2006;117:658–564.
Fitzgerald M, Gocentas R, Dziukas L, et al. Using video audit to improve trauma resuscitation—time for a new approach. Can J Surg. 2006;49:208–211.
Kortbeek JB, Al Turki SA, Ali J, et al. Advanced trauma life support, 8th edition, the evidence for change. J Trauma. 2008;64:1638–1650.
Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S876–S908.
Hoff WS, Reilly PM, Rotondo MF, et al. The importance of the command-physician in trauma resuscitation. J Trauma. 1997;43:772–777.
Hunziker S, Tschan F, Semmer NK, et al. Hands-on time during cardiopulmonary resuscitation is affected by the process of teambuilding: a prospective randomised simulator-based trial. BMC Emerg Med. 2009;9:3.
Kelleher DC, Waterhouse LJ, Parsons SE, et al. Factors associated with patient exposure and environmental control during pediatric trauma resuscitation. J Trauma Acute Care Surg. 2013;74:622–627.