Abstract Description
Background:
Rural Australians face poorer health outcomes than their metropolitan counterparts 1. Children are vulnerable, partly due to limited access to paediatric guidelines, equipment and software 2-8. Little is published about strengths and challenges of paediatric resuscitation in rural, regional and remote (RRR) Queensland. An outreach education service, Simulation Training Optimising Resuscitation for Kids (STORK) identified opportunities to use their courses to understand and help optimise regional paediatric resuscitation.
Objectives:
To document challenges faced by healthcare providers during a pediatric resuscitation course and ensure information reaches stakeholders.
Methods:
During simulated pediatric resuscitation, participants and faculty vocalised challenges. Participants co-generated solutions and identified local advocates. Summaries for stakeholders included service strengths and improvement opportunities. Site follow-up identified actions made and supported ongoing challenges.
Results:
Between March and December 2023, 40 Optimus PRIME courses were delivered. Thirty-seven course summaries were sent. Using the safety software in infusion pumps, 57% and 81% of centers were unable to correctly administer adrenaline or phenytoin respectively. One or more pieces of paediatric oxygenation or ventilation equipment were lacking at 68% of sites. Of RRR sites, 38% were unfamiliar with the Queensland Health pediatric guidelines. On average sites solved 40% (0-75%) of identified problems by follow-up.
Conclusion:
We highlight challenges for healthcare providers across Queensland and demonstrate educational teams can contribute to their resolution. Many problems perceived as local were occurring statewide. Our findings inform further advocacy. Statewide consistency synergising with local expertise is needed to ensure every child in Queensland has access to optimal resuscitation.
References:
- Australian Institute of Health and Welfare. (2023). Rural and remote health. Retrieved from https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health
- Pai, P. K., & Klinkner, D. B. (2022). Pediatric trauma in the rural and low resourced communities. Seminars in pediatric surgery, 31(5), 151222. https://doi.org/10.1016/j.sempedsurg.2022.151222
- Suruda, A., Vernon, D. D., Reading, J., Cook, L., Nechodom, P., Leonard, D., & Dean, J. M. (1999). Pre-hospital emergency medical services: a population based study of pediatric utilization. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 5(4), 294–297. https://doi.org/10.1136/ip.5.4.294
- Dharmar, M., Marcin, J. P., Romano, P. S., Andrada, E. R., Overly, F., Valente, J. H., Harvey, D. J., Cole, S. L., & Kuppermann, N. (2008). Quality of care of children in the emergency department: association with hospital setting and physician training. The Journal of pediatrics, 153(6), 783–789. https://doi.org/10.1016/j.jpeds.2008.05.025
- Cohn, S. L., Gautam, B., Preddy, J. S., Connors, J. R., & Kennedy, S. E. (2016). Barriers to the use of paediatric clinical practice guidelines in rural and regional New South Wales Australia. The Australian journal of rural health, 24(1), 23–28. https://doi.org/10.1111/ajr.12190
- Moore, B., Sapien, R., & Committee on Pediatric Emergency Medicine (2012). The role of the pediatrician in rural emergency medical services for children. Pediatrics, 130(5), 978–982. https://doi.org/10.1542/peds.2012-2547
- Lieng, M. K., Marcin, J. P., Sigal, I. S., Haynes, S. C., Dayal, P., Tancredi, D. J., Gausche-Hill, M., Mouzoon, J. L., Romano, P. S., & Rosenthal, J. L. (2022). Association between emergency department pediatric readiness and transfer of noninjured children in small rural hospitals. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 38(1), 293–302. https://doi.org/10.1111/jrh.12566
- Gausche-Hill, M., Schmitz, C., & Lewis, R. J. (2007). Pediatric preparedness of US emergency departments: a 2003 survey. Pediatrics, 120(6), 1229–1237. https://doi.org/10.1542/peds.2006-3780
Speakers
Authors
1. Submitting Authors
Doctor Alexandra St-Onge-St-Hilaire - Simulation Training Optimising Resuscitation for Kids (STORK), Children's Health Queensland (Queensland, Australia)
3. Contributing Authors
Doctor Ben Symon - , Doctor Ben Lawton - , Doctor Jason Acworth - , Louise Dodson -