Related Experiment Video
Updated: Sep 5, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Resource Utilization in Children who Receive a Pediatric Intensive Care Unit Consult in the Emergency Department: A
Samantha Boggs1,2, Genevieve de Caen3, Anna-Theresa Lobos1,2,4
1Division of Pediatric Critical Care, 27338CHEO, Ottawa, Canada.
Insights
Most children admitted to the Pediatric Intensive Care Unit (PICU) from the Emergency Department (ED) need critical care interventions. Further research is needed on resource use for children not admitted to the PICU after an ED consult.
Area of Science:
- Pediatric Critical Care Medicine
- Emergency Medicine
- Healthcare Resource Utilization
Background:
- Pediatric Intensive Care Unit (PICU) consults in the Emergency Department (ED) are crucial for timely care of critically ill children.
- Understanding the characteristics and resource needs of these patients is essential for optimizing care pathways.
Purpose of the Study:
- To describe the characteristics of children hospitalized after an ED PICU consult.
- To analyze critical care resource requirements and patient outcomes.
- To compare resource utilization between PICU admissions and ward admissions following ED PICU consults.
Main Methods:
- Single-center retrospective cohort study.
- Chart review of children (<18 years) hospitalized after an ED PICU consult.
- Analysis of patient demographics, consult timing, ED length of stay, Medical Emergency Team (MET) utilization, PICU nursing workload, and critical care interventions.
Main Results:
- 247 PICU consults occurred, with 65.2% direct PICU admissions.
- Children with complex chronic conditions, including home ventilation needs, were frequently admitted to PICU.
- Within 24 hours, 69.1% of PICU admissions received critical care interventions; 18.6% of ward admissions were reviewed by MET.
- Ward admissions had significantly longer post-consult ED length of stay (428 min vs. 130 min).
Conclusions:
- Over two-thirds of ED-to-PICU admitted children required early critical care interventions.
- The remaining children may benefit from enhanced monitoring or interventions not feasible on general wards.
- Further research is needed to optimize critical care and hospital resource allocation for children triaged to wards post-PICU consult.
Objectives:
To describe the characteristics, critical care resource requirements, and outcomes of children who were hospitalized after a Pediatric Intensive Care Unit (PICU) consult in the Emergency Department (ED).
Methods:
In this single-centre retrospective cohort study, we conducted chart reviews for children (<18 years) hospitalized following a PICU consult in the ED to examine patient characteristics, timing of consult, ED length of stay, Medical Emergency Team (MET) utilization, PICU nursing workload, and critical care interventions for children who were and were not admitted to the PICU.
Results:
During the one-year study period, 247 PICU consults were performed in the ED resulting in 161 (65.2%) direct admissions to PICU and 1 indirect PICU admission via the ward. Of 105 children with complex chronic conditions, 73 (69.5%) were admitted to PICU, including 32 (91.4%) of 35 children with chronic home ventilatory needs, only 2 (6.2%) of whom received a critical care intervention beyond respiratory support. Within 24 h of hospitalization, 112 (69.1%) of 162 PICU admissions received a critical care-specific intervention. Of 86 (34.8%) ward admissions, 16 (18.6%) were reviewed by the MET. Children admitted to the ward had a significantly longer post-consult ED length of stay than children admitted to PICU (median 428 min vs. 130 min; p <0.0001).
Conclusions:
Over two-thirds of children admitted to PICU from the ED required early critical care interventions, with the remainder potentially benefitting from closer monitoring or a higher frequency of non-critical care interventions than can be reasonably provided on general inpatient wards. More research is needed to evaluate critical care and hospital resource utilization when children are triaged to the ward following a PICU consult in the ED.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
05:56Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
Published on: September 6, 2024
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...