Nithya, S (2018) Impact of pre-hospital care on the outcome of the children presenting to pediatric emergency with acute respiratory illness (ARI) in a tertiary care center from south india. Masters thesis, Christian Medical College, Vellore.
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Abstract
Background: Data on impact of Pre-hospital care in pediatric emergencies are limited. Objectives: To study the impact of pre-hospital care and transport among children admitted in Paediatric Emergency Services (PES) with ARI. Methods: Prospective observational study including children of age >1 month to <16 years admitted in PES with ARI between January and June 2017. The effect of pre-hospital care among the “adequately treated” and “inadequately treated” was measured using PRESS score, respiratory support given and nature of admission. Results: Of 152 children included, 80(64%) were infants. Majority (79.7%) reached PES after 48 hrs of illness. While 125 (82%) were inadequately treated, 27(18%) were adequately treated. More children in the “adequately treated” group had PRESS-severe score as compared to the inadequately treated group (18/27 vs 58/125, p = 0.05). A significantly higher number of patients in the adequately treated group required high flow oxygen (HFO) (26% Vs 16%, p =0.042). No difference was found in the rates of advanced airway placement between the two groups (7.5% vs 1.6%, p= 0.145). PHDU and PICU admission rates were not significantly different (11.1% vs 9.6%&7.4% vs2.4%, p=0.396). Ambulance was the mode of transport in 11(7%) children. Of the 76 with severe PRESS score, 10% used ambulance (8/76vs68/79,p=0.07). 18.5% of children requiring HFO and 25% needing advanced airway were transported by ambulance (1/4vs 3/4, p value = 0.042). Conclusion: Severe PRESS score and HFO requirement were significantly high among the adequately treated group. Ambulance utilisation was significantly less even among those with severe PRESS score and requiring advanced airway.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Pre hospital care: pre hospital transport: ARI: PRESS: PALS |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Aug 2018 00:07 |
| Last Modified: | 15 Aug 2018 00:07 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/9202 |
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