Archives of disease in childhood
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Multicenter Study
Place of death and palliative care following discharge from paediatric intensive care units.
To determine where children die following discharge from paediatric intensive care units (PICUs) in Great Britain and to investigate if this varies by discharge to palliative care. ⋯ Children referred to palliative care services at discharge from PICU are more likely to die in the community (home or hospice) than children not referred to palliative care.
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Multicenter Study
Treatment for paediatric low cardiac output syndrome: results from the European EuLoCOS-Paed survey.
To characterise current hospital practice and use of prescribing resources related to drug treatment for low cardiac output syndrome (LCOS) in children with open heart surgery (OHS) in Europe. ⋯ Drug treatment for LCOS in children with OHS across Europe is highly variable, possibly partly reflecting the lack of evidence and prescribing standards on the use of medicines. Milrinone, epinephrine, dopamine and dobutamine are mostly used, and should be prioritised for future research on LCOS treatment. Such research should be aimed at increasing the level of evidence for clinical practice guidelines to improve the standard of care.
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Multicenter Study
Determinants of outcomes following acute child encephalopathy and encephalitis: pivotal effect of early and delayed cooling.
Acute encephalopathy/encephalitis is one of the most important causatives of mortality and neurological deficit during childhood. The aim of this retrospective observational study was to investigate clinical variables and therapeutic options associated with the outcome of children with acute encephalopathy/encephalitis. ⋯ Without therapeutic hypothermia, the outcome of children was determined by variables suggestive of the severity of encephalopathy/encephalitis at admission. Hypothermia may have pivotal impacts on the outcome of children according to the timing of cooling initiation following acute encephalopathy/encephalitis.
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Multicenter Study Comparative Study Controlled Clinical Trial
A community intervention trial to evaluate emergency care practitioners in the management of children.
To evaluate the impact of emergency care practitioners (ECPs) on the patient care pathway for children presenting with minor conditions in unscheduled care settings. ⋯ ECPs are not as effective as usual health providers in discharging children after assessment of urgent healthcare problems. This has implications for the workload of other paediatric providers such as the emergency department. ECPs may be better targeted to settings and patients groups in which there is more evidence of their effectiveness in patient care pathways.
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Multicenter Study
Detection of child abuse in emergency departments: a multi-centre study.
This study examines the detection rates of suspected child abuse in the emergency departments of seven Dutch hospitals complying and not complying with screening guidelines for child abuse. ⋯ During a 6-month period, emergency department staff suspected child abuse in 0.2% of all children visiting the emergency department of seven Dutch hospitals. The numbers of suspected abuse cases detected were low, but an increase is likely if uniform screening guidelines are widely implemented.