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Children 2018, 5(1), 9; doi:10.3390/children5010009

A Retrospective Review of Resuscitation Planning at a Children’s Hospital

1
Paediatric Palliative Care Service, Division of Medicine, Children’s Health Queensland Hospital and Health Service, South Brisbane, QLD 4101, Australia
2
Bone Marrow and Transplant Service, Children’s Health Queensland Hospital and Health Service, South Brisbane, QLD 4101, Australia
3
Behavioural Sciences Unit, School of Women’s and Children’s Health, University of New South Wales, Randwick, NSW 2031, Australia
4
Children’s Health Queensland Clinical Unit, Faculty of Medicine, University of Queensland, South Brisbane, QLD 4101, Australia
*
Author to whom correspondence should be addressed.
Received: 30 November 2017 / Revised: 18 December 2017 / Accepted: 20 December 2017 / Published: 4 January 2018
(This article belongs to the Special Issue Pediatric Palliative Care)
View Full-Text   |   Download PDF [1197 KB, uploaded 4 January 2018]   |  

Abstract

Resuscitation plans (RP) are an important clinical indicator relating to care at the end of life in paediatrics. A retrospective review of the medical records of children who had been referred to the Royal Children’s Hospital, Brisbane, Australia who died in the calendar year 2011 was performed. Of 62 records available, 40 patients (65%) had a life limiting condition and 43 medical records (69%) contained a documented RP. This study demonstrated that both the underlying condition (life-limiting or life-threatening) and the setting of care (Pediatric Intensive Care Unit or home) influenced the development of resuscitation plans. Patients referred to the paediatric palliative care (PPC) service had a significantly longer time interval from documentation of a resuscitation plan to death and were more likely to die at home. All of the patients who died in the paediatric intensive care unit (PICU) had a RP that was documented within the last 48 h of life. Most RPs were not easy to locate. Documentation of discussions related to resuscitation planning should accommodate patient and family centered care based on individual needs. With varied diagnoses and settings of care, it is important that there is inter-professional collaboration, particularly involving PICU and PPC services, in developing protocols of how to manage this difficult but inevitable clinical scenario. View Full-Text
Keywords: resuscitation plan; advance care plan; paediatric palliative care; shared decision-making resuscitation plan; advance care plan; paediatric palliative care; shared decision-making
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Kelly, J.; Ritchie, J.; Donovan, L.; Graham, C.; Herbert, A. A Retrospective Review of Resuscitation Planning at a Children’s Hospital. Children 2018, 5, 9.

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