Subject(s)
Bronchodilator Agents/therapeutic use , Hydrocortisone/therapeutic use , Hyperglycemia/diagnosis , Ipratropium/therapeutic use , Respiratory Tract Infections/drug therapy , Albuterol/administration & dosage , Albuterol/therapeutic use , Diabetes Mellitus, Type 1/diagnosis , Diagnosis, Differential , Humans , Hydrocortisone/administration & dosage , Infant , Injections, Intravenous , Ipratropium/administration & dosage , Male , Nebulizers and Vaporizers , Respiratory Sounds , Respiratory Tract Infections/virologyABSTRACT
OBJECTIVE: This feasibility study aimed to determine the maximum theoretical distance the Edinburgh Paediatric Retrieval Team (EPRT) could travel to retrieve head injured children without additional delay in reaching definitive care. DESIGN: A prospective audit was conducted over 2 years to determine the current practice for paediatric head injury transfers (stabilisation, referral, and transfer time) undertaken by primary hospital staff, and the performance (mobilisation and travel time) of the EPRT. A novel formula was devised and used to determine the theoretical maximum radius within which the EPRT could reach a referring hospital during their stabilisation of head injured patients. MEASUREMENTS AND RESULTS: During the study period, 27 head injured patients were transferred to our unit by road and the EPRT conducted 194 road retrievals. The median stabilisation time for the head injured patients was 3.6 h. Median time to refer these patients to neurosurgical services was 1 h after presenting to primary hospitals. Median mobilisation time for EPRT was 1 h. Using our novel formula, 67 miles was the theoretical maximum radius within which the EPRT could reach a referring hospital during their stabilisation of head injured patients. CONCLUSIONS: Specialist team retrieval of paediatric head injury is a possibility, but not without significant organisational changes such as availability of second teams, early referral of patients and utilisation of the mobilisation time as a cancellation window. Our novel formula offers other teams a starting point to assess their own performance and to develop services.
Subject(s)
Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/therapy , Patient Care Team , Child , Clinical Audit , Feasibility Studies , Humans , Patient Transfer/statistics & numerical data , Prospective Studies , Time Factors , United Kingdom/epidemiologyABSTRACT
This is the first known study in the United Kingdom to investigate, among Specialist Registrars (i.e., doctors in training in pediatrics), the priority afforded to, the prevalence of, and the ability to recognize, diagnose, and manage three key areas of exploratory behavior: namely, sexual health, substance misuse, and self-harm. We demonstrate that, although trainees recognize the importance of diagnosis and intervention, they lack training and do not believe that they have the appropriate skills, knowledge, or confidence to carry out these important tasks.
