PICANet Annual Meeting 2022 – Videos of Presentations

Professor Richard Feltbower is a Professor of Epidemiology at the University of Leeds and PICANet Co-Principal Investigator. He presents the key findings of the PICANet 2021 Annual Report .

Dr Marilyn McDougall is a Paediatric Intensive Care Consultant at the Evelina London Childrens Hospital (Guys & St Thomas’ NHS Trust) and South Thames Retrieval Service. She is the Clinical Director of the South Thames Paediatric Network and Honorary Senior Lecturer at Kings College London. Her key area of interest is education and training for all health care professionals including Retrieval Nurse Practitioners. She co-edited the third edition of ‘Children in Intensive Care: A survival guide’.

Dr McDougall addresses the lack of recent information regarding children with Diabetic Ketoacidosis (DKA) admitted to PICUs in England. For this study, PICU admissions between January 2010 and December 2020 of children with the primary or secondary diagnosis of DKA or diabetes mellitus were reviewed. The impact of the COVID-19 pandemic was analysed by comparing 2020 to 2010-2019.

More details of the Special Chapter discussed in this talk can be found here.

Dr Lyn Palmer is a full time research nurse at PICANet at the University of Leicester and part time ECMO specialist. She holds a PhD in ECMO transport.

Dr Palmer’s talk concentrated on the impact of COVID-19 on PICUs, specifically the intake of adult patients to PICU, what this meant for paediatric beds, and the skill mix of staff who were redeployed to other areas during this period.

More details of the Special Chapter discussed in this talk can be found here.

Kirsten Cromie is a PICANet Research Statistician, working extensively with data from the COVID-19 Customised Data Collection. She has been heavily involved in the production of the PICANet 2021 Annual Report COVID and PIMS-TS Special Chapter.

Her talk summarised key findings from the Special Chapter; describing the presentation, management, and outcomes of COVID-19 within PICU, both overall and by phases of the pandemic. A section of the talk focuses on PIMS-TS admissions. Finally, she outlines ‘what’s next’ for PICANet to help further support understanding of COVID-19 and PIMS-TS in paediatric intensive care.

More details of the Special Chapter discussed in this talk can be found here.

Dr Pascale du Pré is a Paediatric Intensive Care Consultant at Great Ormond Street Hospital. In her role as the Medical Lead for Child Death Reviews for GOSH, she has been actively involved establishing a robust system of child death reviews in a tertiary centre.  She critically reviews all deaths within the existing Trust Mortality Review Group (established in 2012) and is responsible for chairing Child Death Review Meetings for all child deaths at GOSH and for preparing and submitting quarterly Learning from Death reports and presenting these at Trust Governance Meetings.

Dr Adrian Plunkett is a Consultant Paediatric Intensivist at Birmingham Women’s and Children’s NHS Foundation Trust.

This session includes a discussion between two PICU clinicians talking about their experience of using RSPRT plots to monitor mortality in their units. It covers how the units were first informed about the mortality RSPRT alerts, their initial reactions, a description of the investigation that took place, the main findings and cause of the RSPRT spike, and suggestions of how the metric might be improved. The discussion was facilitated by Professor Richard Feltbower.

Dr Natasha Alvarado is a Senior Research Fellow in Applied Health Research, based at the University of Bradford and the Wolfson Centre for Applied Health Research. Her research interests are the implementation and evaluation of complex healthcare interventions. She uses programme theory approaches to explore how, why, and in what circumstances interventions work as intended or not.

Between October 2017 and December 2020, a novel, web-based, quality dashboard (QualDash) was co-designed with NHS staff, installed in five NHS Trusts and evaluated via practice observations and an interrupted time series analysis. QualDash was designed to support use of national clinical audit data in quality improvement; specifically, data from the Paediatric Intensive Care Audit Network and the Myocardial Ischaemia National Audit Project.   During dashboard development, a wise participant warned the research team that clinicians may ‘tar it [QualDash] with a dodgy brush’ if it did not work as intended on installation.  This presentation will recount our experience of introducing QualDash into practice, our attempts to avoid the dodgy brush, and consider the supports, constraints and complexities of introducing technology within the NHS.

Dr Ramnarayan (Ram) is currently a Reader in Paediatric Critical Care at Imperial College London and practices paediatric intensive care at St Mary’s Hospital (PICU) and retrieval at the Children’s Acute Transport Service (CATS). Until Oct 2021, Ram was the Lead for the CATS retrieval service. He is the Chief Investigator of an NIHR-funded mixed methods study of PICU transport (DEPICT) and two RCTs of non-invasive respiratory support (FIRST ABC step-up and step-down trials), and is a co-investigator in two ongoing PICU RCTs (Oxy-PICU and PRESSURE). He has published extensively (>100 peer-reviewed articles), written several book chapters and lectures regularly at national and international scientific meetings. He is an active member of the international ventilator liberation guideline group. He holds several national leadership roles (Chair, Study Group of the UK Paediatric Critical Care Society; Member, NHS England Clinical Reference Group) and has led the referral and transport dataset development as part of the Paediatric Intensive Care Audit Network (PICANet).

Nearly 5000 critically ill children require transport from general hospitals without a PICU on-site to tertiary centre PICUs each year. The majority of these transports are performed by paediatric critical care transport teams (PCCTs). National standards specify that PCCTs should reach the patient’s bedside within 3 hours of the referral being accepted – however, there is no evidence to support this standard. In addition, there is a scarcity of literature describing the experience of the child/their family during PICU transport. The DEPICT study is an NIHR funded mixed methods study with four workstreams: Workstream A (analysis of PICANet data linked to mortality and hospital episodes), Workstream B (questionnaires and interviews to explore the parental experience of PICU transport), Workstream C (health economic evaluation) and Workstream D (mathematical modelling to explore alternative clinically and cost effective models of service delivery).