Andrew Argent Criteria for admission and refusal to PICU

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PICU data on treatment of septic shockMedian time (minutes )from RCWMCHpresentation toACCM/APLS guidelines(minutes)1 st fluid bolus 52 5intubation 135 15starting inotropes 217 15PICU admission 240 60Median time (minutes)from RCWMCH PICUadmission to1 st fluid bolus 15intubation 301 st dosehydrocortisone1140 60Rossouw et al, unpublished data, 2011
what happens to our patients?• ventilator associated pneumoniaMorrow et al, Pediatr Crit Care Med, 2011Morrow & Argent, J Paediatr Child Health, 2009Morrow et al, J Paediatr Child Health, 2006Figaji et al, Childs Nerv Syst, 2009• other studies including nosocomial infection,fluid, cardiac patientsHatherill et al, Intensive Care Med, 2007Hatherill et al, Arch Dis Child, 2005
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Page 12 and 13: PICU at the RCWMCH - staffing• me
Page 14 and 15: the good we aim to achieve• monit
Page 16 and 17: can we do harm?• is it possible t
Page 18 and 19: the response …• development of
Page 20 and 21: who should be admitted?anyone who c
Page 22 and 23: when should life-sustaining therapy
Page 24 and 25: 20022003(16 m)2006 2007 2011Exposed
Page 26 and 27: the child who is too well• where
Page 28 and 29: issues on implementation• dissemi
Page 30 and 31: easons for refusalsn %no beds 95 65
Page 32 and 33: admittedrefused
Page 36 and 37: A 4 RDaniels and Sabin, Health Affa
Page 38 and 39: and the staff …

Andrew Argent Criteria for admission and refusal to PICU

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