ASUIUD University Hospital
DAME, PEDIATRICS
DAME, Departments of Pediatrics, University Hospital Udine

Author Of 2 Presentations

IN SITU SIMULATIONS IN PEDIATRIC EMERGENCY ROOM (PER): RESILIENCY AND TEAM WORK ANALYSIS. ONE YEAR EXPERIENCE.

Presenter
Room
Exhibition Area
Date
19.06.2019
Session Time
10:00 - 16:00
Session Name
POSTER VIEWING 10: Health services research, administration, education, information technology
Presentation Time
07:00 - 18:00
Duration
1 Minute

Abstract

Background

In all critical situations involving children, emotional impact is huge, even for professionals: pediatric emergencies represent a very strong challenge for physicians and nurses.

Objectives

To analyze team working with a special regard to the attitude of different professional figures involved (pediatricians, residents, nurses) with in situ simulation in a PER in a tertiary pediatric hospital.

Methods

We performed, from March 2018 to March 2019, 10 high fidelity in situ simulations involved all the PER team in Udine University Hospital. A team composed of four rescuers (a pediatric consultant, a resident and two nurses) attended monthly a simulated scenario. Five facilitators observed the team in every training situation. Before and after simulation all the participants filled out a questionnaire to explore and measure: 1) self-awareness, 2) resiliency, 3) social skills, 4) sense of responsibility, 5) ability to motivate the group. We also decided to include the psychologist as an actor into each scenario, performing one of the parents.


Results

We performed 10 simulations which included 10 pediatricians, 10 residents and 20 nurses. Simulation improved the technical and not-technical skills especially in residents group. Resiliency pattern resulted increased after the simulation in all groups categories. Simulation implemented mostly the categories “sense of responsibility” and “social skills” across nurses, were higher scores has also been recorded.

Conclusion

Simulation improved the management of both technical and not-technical skills. The questionnaire was a good predictor of self-sense, is quick, reproducible, not operator sensitive and can be applied in further studies.

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GLIAL FIBRILLARY ACIDIC PROTEIN PLASMA LEVELS DURING CONGENITAL HEART DISEASE SURGERY AND OVER 24 HOURS POST-SURGERY

Presenter
Room
Poster Area 2
Date
19.06.2019
Session Time
12:20 - 13:40
Session Name
POSTER WALK SESSION 02
Presentation Time
07:00 - 18:00
Duration
5 Minutes

Abstract

Background

Background. Neuro-cognitive deficits affect nearly 50% of children with complex congenital heart diseases (CHD). Newly acquired brain injury in CHD children affect 30% postoperatively.

Objectives

Objective. We determined GFAP levels during surgery and for the first 24h after surgery to find out the pivotal timepoint of brain injury during the perioperative period of CHD surgeries.

Methods

Methods. We studied 43 children: 9 univentricular physiology (UNIV); 16 septal defects (SD); 5 transpositions of the great arteries (TGA), 4 tetralogies of Fallot (TOF), and 9 surgical controls. GFAP was measured by ELISA during surgeries and intensive care stay.

Results

Results. In controls, mean GFAP (ng/ml) before, after at least 30 min from anesthesia induction, and after surgery were 0.14 ± 0.05, 0.13 ± 0.05, 0.16 ± 0.07, respectively. In CHD patients all GFAP levels collected during intensive care stay were significantly lower than the maximum GFAP level recorded during cardiopulmonary bypass (CPB): at 6h 0.26 ± 0.16; 12h 0.25 ± 0.16; 24h 0.27 ± 0.17 vs. the maximum GFAP 1.69 ± 1.74 during surgery (p<0.001, Wilcoxon Signed Rank Test). There were no GFAP differences between time points in all children. In 10% of the intensive care samples (4 patients: 1 SD, 1 TOF, 2 UNIV), GFAP reached the supposed cut-off for clinical evidence of brain injury (0.46 ng/ml).

Conclusion

Conclusions. The highest GFAP values were recorded during the CPB run at the end of rewarming rather than in the early post-operative phase. Neurodevelopmental studies are ongoing to correlate GFAP levels to children outcome.

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