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Improving Delirium Screening in Critically Ill Pediatric Trauma Patients
Christine Perlick1, Amy Vestovich, Dennis W Simon
1Author Affiliations: Department of Pediatric Surgery, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (Ms Perlick); Department of Critical Care Medicine, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (Ms Vestovich, Dr Simon); and Department of Pediatric Surgery, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (Dr Gaines, Dr Richardson, Dr Strotmeyer).
A delirium intervention improved screening compliance in pediatric trauma patients. Delirium was linked to longer intensive care unit stays and specific discharge needs.
Area of Science:
- Pediatric Critical Care Medicine
- Trauma Surgery
- Neuroscience
Background:
- Delirium is a common complication in critically ill children, associated with adverse outcomes.
- Existing delirium screening protocols are primarily for adults, lacking standardization in pediatric populations.
- Effective delirium management in pediatric trauma requires targeted screening and intervention strategies.
Purpose of the Study:
- To assess the impact of a multicomponent delirium initiative on screening compliance in pediatric trauma patients.
- To identify key risk factors associated with delirium development in this cohort.
- To improve early detection and management of delirium in critically ill children.
Main Methods:
- A pre- and postintervention study design was employed at a Level I pediatric trauma center.
- The Cornell Assessment of Pediatric Delirium tool was used for screening critically ill children (0-18 years) admitted with traumatic injuries.
- Interventions included multidisciplinary education, electronic health record optimization, and feedback audits.
Main Results:
- Delirium screening compliance significantly increased from 20% to 68% postintervention.
- Delirium was diagnosed in 2.7% of patients, with a higher incidence in those with head injuries.
- Delirium correlated with older age, higher Injury Severity Scores, and increased need for blood transfusions.
Conclusions:
- A multicomponent delirium intervention effectively enhanced screening rates in pediatric trauma intensive care units.
- Delirium in pediatric trauma patients is associated with prolonged intensive care unit length of stay and altered discharge disposition.
- Standardized delirium screening and management are crucial for improving outcomes in critically ill pediatric trauma patients.
