Dutch paediatrician's opinions about acute care for critically ill children in general hospitals

Paediatricians in general hospitals have limited experience with critically ill children, due to the low incidence and their diversity in age, pathology and presentation. Consequently, adequate organization, training and materials and medication are of major importance. This voluntary and anonymous survey-based study was conducted to gain insight in the current status of these aspects. In June 2012, all 687 paediatricians employed at 84 general hospitals in The Netherlands received a hardcopy questionnaire with questions relating to demographics, organization, training and materials and medication concerning the acute care for critically ill children. Of the sent questionnaires, 41.3 % were eligible for analysis. According to the organization of the acute care of critically ill children, 73.9 % of the respondents indicated verbal agreements were made, of which 77.0 % stated that these were recorded in written protocols. Taskforces were present according to 64.5 % of our respondents. Of the respondents, 64.4 % were Advanced Paediatric Life Support (APLS) certified. Of the stated training scenarios, 90.8 % were available in their hospital, which were followed on a regular basis by 63.9 % of the paediatricians. Paediatric resuscitation carts were present on both emergency department and paediatric ward according to 95.1 %. Materials (37.7 %) and medication (45.3 %) were frequently lacking. Conclusion: Paediatricians from general hospitals in The Netherlands consider that acute care for critically ill children has to be improved in terms of organization, training and teamwork, and medication and materials. National guidelines concerning the organization and training may contribute to this improvement, as well as a standardized inventory list for paediatric resuscitation carts.