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Background: Critical care is a multidisciplinary and interprofessional specialty devoted to treating patients who already have or are at danger of developing acute, life-threatening organ dysfunction. Due to the higher disease load and mortality from preventable illness, patient outcomes in intensive care units are challenging in settings with inadequate resources. This study aimed to determine factors associated with outcomes of pediatric patients admitted to intensive care units. Methods: A cross-sectional study was conducted at Wolaita Sodo and Hawassa University teaching hospitals in southern Ethiopia. Data were entered and analyzed using SPSS version 25. Normality tests using the Shapiro-Wilk and Kolmogorov-Smirnov data were normally distributed. The frequency, percentage, and cross-tabulation of the different variables were then determined. Finally, the magnitude and associated factors were first analyzed using binary logistic regression and then multivariate logistic regression. Statistical significance was set at P < 0.05. Results: A total of 396 Pediatric ICU patients were included in this study, and 165 (41.7%) deaths were recorded. The odds of patients from urban areas (AOR = 45%, CI 95%: 8%, 67% p-value = 0.025) were less likely to die than those in rural areas. Patients with co morbidities (AOR = 9.4, CI 95%: 4.5, 19.7, p = 0.000) were more likely to die than pediatric patients with no co-morbidities. Patients admitted with Acute respiratory distress syndrome (AOR = 12.86, CI 95%: 4.3, 39.2, p = 0.000) were more likely to die than those with not. Pediatric patients on mechanical ventilation (AOR = 3, CI 95%: 1.7, 5.9, p = 0.000) more likely to die than not mechanically ventilated. Conclusion: Mortality of paediatric ICU patients was high (40.7%) in this study. Co-morbid disease, residency, the use of inotropes, and the length of ICU stay were all statistically significant predictors of death.
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Background: Almost all children with burns experience pain as a result of a complex pathophysiologic process that is usually untreated, and up to 38% of all pediatric burn victims develop anxiety disorders due to pain after hospital admission. Hence, it is important to manage pain and anxiety in the care of burn victim children. The goal of this review was to develop an evidence-based guideline for procedural pain management and sedation for burned children undergoing wound care procedures. Methodology: The review was reported according to Reporting Items for practice Guidelines in Healthcare (RIGHT) protocol. A search of literature was done from Cochrane review, PubMed, Google Scholar, Embase, web of science and Hinari database key words "pediatrics", "children", "burn", "procedural wound care", "wound dressing", "non-pharmacological", "analgesia", "pain management" and "sedation" were used. Extraction and filtering of the results was determined based on the interventions, outcome, population, and methodological quality, and inclusion and exclusion criteria. Finally, 6 systematic review and meta-analysis, 1observational study, and 16 randomized control trial Studies were appraised for quality, and conclusion was made based on their level of evidence and grade of recommendation. Conclusion and recommendation: For effective management of procedural pain and accompanying anxiety during WCP in children, we recommend using non-pharmacological strategies as an adjunct with calculated dose of analgesics based on the children's analgesic requirements. We also recommend ketamine-dexmedetomidine as an effective first-line analgesic-sedation, and ketamine-propofol, propofol-remifentanil, propofol-fentanyl, and ketamine-midazolam as useful sedative-analgesic options.
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Background: Patient satisfaction with postoperative pain management is a vital tool for measuring the quality of care in health centers, which associated with the care process and care outcome. There is still few evidence on factor for patient satisfaction with postoperative pain management. Objective: These study aimed to assess magnitude of Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital, from Feb 1- Apr 30, 2021. Method: Institutional based cross-sectional study was conducted among 335 adult patients using a systematic random sampling technique. Data were collected through structured questionnaires based on the modified APS-POQ to obtain responses from the patients. Both bivariable and multivariable logistic regression analysis was done to evaluate the association. P-value less than 0.05 was considered as statistically significant. Result: The find of this study revealed that 74.5% of patients were satisfied with overall pain management services. Patients with ASA I (AOR = 2.3; 95%CI: (1.06-5.08), received multimodal analgesics (AOR 4.30; 95% CI: (2.02-9.18), no perceived pain (AOR = 6.7; 95% CI: (1.54-29.7), had pain discussion (AOR = 8.9; 95% CI: (3.67-21.90) and waiting for analgesia service less than 30 min (AOR = 6.3; 95% CI: (1.34-29.58) were more satisfied. Conclusion: The study shows that patient satisfaction with postoperative pain management was low in our setup compared to many studies. Thus, there is a need to improve the quality of pain management services in the study area.
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PURPOSE: Emergency drugs and essential equipment are important to successfully manage patients in the intensive care unit (ICUs). The absence of these emergency drugs and essential equipment might result in mortality and morbidity which is more compounded in resource-limited settings. This study aims to assess the availability of emergency drugs and essential equipment in ICUs in hospitals in Ethiopia. MATERIALS AND METHODS: A cross-sectional descriptive study design was employed in the intensive care unit of nine Amhara regional state hospitals in Ethiopia. This study was done from August 01, 2020, to September 01, 2020. The data were collected using a structured questionnaire, which were adopted from the Emergency Medicine Society of South Africa (EMSSA) guidelines. Tables and narration were used to describe results. RESULTS: There were deficiencies of essential emergency items particularly in the pediatrics domain, devices to confirm tracheal intubation and equipment for managing difficult intubation. Emergency drugs like adrenaline, salbutamol puff, atropine, aspirin, furosemide, hydrocortisone, insulin, lidocaine, and medical oxygen were available in all ICUs, whereas amiodarone, sodium bicarbonate, glucagon, ipratropium nebulization, thiamine were not available in all ICUs. CONCLUSIONS AND RECOMMENDATIONS: There were considerable deficiencies in emergency drugs and essential equipment. Based on our findings, we recommend to develop standardized checklists, regular audits, and healthcare personnel awareness program to improve checking, maintaining, restocking, and repairing the equipment in the emergency trolley.