Audit of unbooked paediatric post-anaesthesia admissions to intensive care

We performed an audit of booked and unbooked admissions to a paediatric intensive care unit (PICU) after anaesthesia over a 19 month period in order to determine whether unbooked admissions were predictable, or whether there were any preventable anaesthetic factors responsible for PICU admission, and to evaluate the necessity of PICU admission in all study patients. Data was collected from the PICU database and from the medical records, especially the anaesthesia records, of unbooked admissions. There were 640 admissions to the PICU from the operating theatres, with 35 (5%) unbooked. Of the unbooked admissions, 71% were considered predictable and 20% had preventable features. There was an appropriate use of intensive care resources by these unbooked patients, with 77% having PICU-specific therapies (compared with 88% of booked cases). This quality assurance tool was relatively easy to perform, however it has numerous limitations hampering future routine use.