Download Free Medical Paediatric Sepsis Screening in the Emergency Department PowerPoint Presentation

Paediatric Sepsis Screening in the Emergency Department PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Pediatrics, which is titled "Paediatric Sepsis Screening in the Emergency Department", to know about Paediatric Sepsis Screening in the Emergency Department.

Tags : Pediatrics, Sepsis Screening, Emergency Department

Published on : Aug 03, 2021 | Views : 921 | Downloads : 2

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Dr Neil Thompson Paediatric Emergency Department
Slide 2-

Learning Objectives The challenges to screening for sepsis in children NICE guidance and other tools The approach from Imperial College Healthcare NHS Trust’s Paediatric Emergency Department to sepsis screening in children
Slide 3-

Why are we talking about sepsis?
Slide 4-

ppt slide no 4 content not found
Slide 5-

Problems No useful definition of sepsis in paediatrics
Slide 6-

ppt slide no 6 content not found
Slide 7-

Problems No useful definition of sepsis in paediatrics Febrile illnesses are common
Slide 8-

3,842,708 attendances to Emergency Services Under 14s 2014-2015. 20-30% of ED attendances are due to fever 4 – 6 episodes in first 2 years Majority are viral
Slide 9-

Problems No useful definition of sepsis in paediatrics Febrile illnesses are common Sepsis isn’t that common in children
Slide 10-

38 - 44,000 lives annually in the U.K costs the NHS an estimated £2.5 billion.
Slide 11-

Retrospective review of data in 7 states in the US 0.89 cases per 1000 paediatric population 9.7 per 1000 - newborns 2.25 per 1000 - <1yr 0.23 per 1000 – 1-19yrs Hartman ME, Linde-Zwirble WT, Angus DC, et al. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med 2013;14:686-93.
Slide 12-

270, 461 ED attendances 176 with severe sepsis (0.07% - 7 in 10,000) 8 deaths Van de Voorde, Emerson et al Paediatric community-acquired septic shock: results from the REPEM network study. Eur J Pediatr. 2013 May;172(5):667-74
Slide 13-

ppt slide no 13 content not found
Slide 14-

Sepsis in children 1000 children admitted annually to PICU in UK with sepsis Risk factors: Extreme prematurity pre-existing co-morbidities immunocompromise 20% mortality
Slide 15-

Problems No useful definition of sepsis in paediatrics Febrile illnesses are common Sepsis isn’t that common in children There’s no magic test
Slide 16-

ppt slide no 16 content not found
Slide 17-

Problems No useful definition of sepsis in paediatrics Febrile illnesses are common Sepsis isn’t that common in children There’s no magic test Children can change
Slide 18-

title text Roland D, Snelson E ‘So why didn’t you think this baby was ill?’ Decision-making in acute paediatrics Archives of Disease in Childhood - Education and Practice 2019;104:43-48.
Slide 19-

Problems No useful definition of sepsis in paediatrics Febrile illnesses are common Sepsis isn’t that common in children There’s no magic test Children can change Problems with systems
Slide 20-

ppt slide no 20 content not found
Slide 21-

How do we treat it? text
Slide 22-

Large PED (85,000/yr) Implemented protocol for recognition and management of sepsis Cruz, Perry, William et al Implementation of Goal-Directed Therapy for Children With Suspected Sepsis in the Emergency Department Pediatrics 2011; 127 (3) e758 -e766
Slide 23-

text
Slide 24-

NICE guidance 15 studies included – all low quality There is a trend in the evidence that if any of the following is a cause for concern: elevated temperature, heart rate or respiratory rate; hypothermia; hypotension; altered mental state; low oxygen saturation; low urine output.
Slide 25-

NICE guidance The GDG concurred that none of the signs and symptoms alone is sufficient to make a diagnosis of sepsis, or to predict patient outcome. While the available evidence was of very low quality the GDG also recognised that sepsis can be overwhelming and of rapid onset with few early clinical signs.
Slide 26-

ppt slide no 26 content not found
Slide 27-

ppt slide no 27 content not found
Slide 28-

ppt slide no 28 content not found
Slide 29-

ppt slide no 29 content not found
Slide 30-

ppt slide no 30 content not found
Slide 31-

‹#›
Slide 32-

Quality Improvement Methodology Starting with work done at the Royal Free Hospital Redesigned flowchart PDSA cycles with multidisciplinary input Data collected on all those who triggered red or amber
Slide 33-

ppt slide no 33 content not found
Slide 34-

ppt slide no 34 content not found
Slide 35-

ppt slide no 35 content not found
Slide 36-

Changes in physiological limits
Slide 37-

Lessons learned It’s still difficult! Using a paper form in a computerised process It distorts the flow of the department Need to have buy-in of all staff
Slide 38-

Going forward How to link to PEWS and electronic systems How to measure success How to link to other areas – wards / theatres / primary care? Research ongoing Delphi process Biomarkers Outcome measures
Slide 39-

title text
Slide 40-

Summary Paediatric sepsis is rare but devastating Paediatric sepsis is difficult to spot Tools for screening are imperfect There is much progress to be made