From the Departments of Cardiology.
Pediatric and Neonatal Intensive Care.
Pediatr Emerg Care. 2020 Oct;36(10):e558-e563. doi: 10.1097/PEC.0000000000001403.
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.
在儿科复苏区治疗不同年龄和疾病的患者时，管理错误很常见。本研究旨在通过视频记录分析儿科复苏区遵循高级创伤生命支持和儿科高级生命支持指南的情况，并确定管理错误。
对苏黎世大学儿童医院儿科复苏区在 13 个月期间收治的所有患者进行视频记录。确定每位患者对高级创伤生命支持指南和儿科高级生命支持指南的治疗依从性和错误。
在研究期间，共记录了 128 名患者（65.6%为手术患者，34.4%为内科疾病患者）。最常见的入院原因是创伤性脑损伤（21.1%）、多发伤（20.3%）和癫痫发作（14.8%）。从紧急医疗服务到医院医生的准确交接与气道、呼吸、循环和残疾顺序的遵守情况（相关系数 [CC]，0.205；P = 0.021）、明确的团队领导与气道、呼吸、循环和残疾顺序的遵守情况（CC，0.856；P < 0.001）以及准确交接和明确的团队领导（CC，0.186；P = 0.037）之间存在统计学显著相关性。还揭示了意外错误。即使在 20%的脊柱/四肢受伤患者中，接受手术的入院患者中有 40%遗漏了颈椎检查/稳定。
视频记录是评估儿科复苏区患者管理的有用工具。分析不符合指南的错误有助于关注和集中注意特定项目，以改善患者护理。
