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Paediatric out-of-hospital clinical deterioration: a mixed-methods scoping review protocol
Alanowd Alghaith1,2,3, Gregory Adam Whitley4, Sara Alsuwais2,3,5
1Social science APPlied Healthcare and Improvement REsearch (SAPPHIRE) Group, Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK asma9@leicester.ac.uk.
Insights
Recognizing deteriorating pediatric patients in pre-hospital settings is challenging. This review assesses research on identifying out-of-hospital pediatric clinical deterioration by emergency medical staff.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Pre-hospital Care
Background:
- Identifying pediatric clinical deterioration in pre-hospital settings is difficult due to lower patient numbers and scarce information.
- Physiological changes preceding cardiac arrest can be detected with continuous monitoring, enabling early critical illness identification.
- Early recognition of pediatric deterioration is crucial for timely intervention.
Purpose of the Study:
- To conduct a scoping review assessing the extent, range, and nature of published research.
- To evaluate research on recognizing pediatric out-of-hospital clinical deterioration by pre-hospital staff.
Main Methods:
- The review follows the Joanna Briggs Institute (JBI) methodology for scoping reviews.
- Systematic searches of major databases (MEDLINE, EMBASE, Web of Science, CINAHL, Scopus) were performed.
- Included studies published in English from January 1990 to March 2024, encompassing all study designs.
Main Results:
- This section is to be filled after the review is completed and results are available.
Conclusions:
- This section is to be filled after the review is completed and conclusions are drawn.
Introduction:
In pre-hospital settings, identifying a deteriorating child can be challenging, especially considering that the proportion of paediatric patients with acute illnesses is lower compared with adults. This challenge is exacerbated in pre-hospital settings, where information might be scarce. Physiological alterations indicating changes in a patient's condition can be detected hours preceding a cardiac arrest. Therefore, maintaining continuous monitoring of the patient's clinical condition is crucial to detecting any physiological changes promptly, facilitating early identification of critical illness. This scoping review aims to assess the extent, range and nature of published research related to recognising paediatric out-of-hospital clinical deterioration by pre-hospital staff.
Methods And Analysis:
This scoping review is registered with the Open Science Framework. The review will follow the Joanna Briggs Institute's (JBI) methodology for scoping reviews. A systematic search of relevant databases (MEDLINE, EMBASE, Web of Science, CINAHL and Scopus) will be conducted. In this scoping review, all types of study designs including quantitative and qualitative studies will be considered. The inclusion is limited to English-language studies published between January 1990 and March 2024. Two independent reviewers (AG and SS) will conduct a thorough screening of titles and abstracts against the pre-defined inclusion criteria for the review. For the selected citations, the full texts will undergo detailed assessment by the two reviewers, ensuring alignment with the inclusion criteria. A quality assessment of the included studies will be done using the Mixed Methods Appraisal Tool. The findings will be presented using diagrams or tables, supplemented by narrative summaries following the JBI guidelines.
Ethics And Dissemination:
Ethical approval is not required. The findings will be disseminated through publication in a peer-reviewed journal and presentation at conferences and/or seminars.
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