Tina Kendrick, C. Li, W-Q. He, C. Stirling, J. Gillis, A. Berry, N. Nassar.
Abstract:
Background and Aims
Published reports of the number and outcomes of infants with bronchiolitis who require medical retrieval are scarce. We aimed to examine characteristics, admission, and management of infants with bronchiolitis retrieved by a state-wide service.
Methods
We conducted a population-based data linkage study. All infants aged <12-months with a diagnosis of bronchiolitis and who required medical retrieval between 2015-2022 in New South Wales (NSW) and Australian Capital Territory (ACT), Australia were identified from the NSW Newborn and paediatric Emergency Transport Service (NETS) database. Data were linked to corresponding records in NSW and ACT Admitted Patient Data Collections. Infant characteristics, admission and post-retrieval management were captured. Potentially avoidable retrievals were defined as those not admitted to ICU or undergoing major procedures.
Results
Of 1,159 retrievals, 60.4% were male, with 47% aged <3-months. Following retrieval, 945 (81.5%) were admitted to ICU and considered unavoidable. 29 (2.5%) discharged directly from the emergency department and 185 (16%) were admitted to paediatric wards. For infants admitted to wards, 59 (5.9%) required surgery or other complex procedures, while 126 (10.9%) received oxygen therapy and/or IV therapy. Older infants >6-months (65.7%) had higher percentages of potentially avoidable retrievals.
Discussion
Medical retrieval is an essential critical care service, though acknowledged as costly and disruptive for families. One in seven (13.4%) retrievals for bronchiolitis were potentially avoidable for infants not requiring intensive care admission or complex procedures. Older infants who required oxygen administration and/or IV therapy may have been successfully managed in local paediatric wards closer to home, reducing the burden on families.
Biographies:
Tina is the Paediatric Clinical Nurse Consultant at NETS NSW – the state specialist paediatric retrieval service, hosted by the Sydney Children’s Hospitals Network. Tina has been practicing, teaching and researching in paediatrics and critical care for over three decades. She has co-authored book chapters and journal articles on care of critically ill children, critical care practice standards and credentialing for specialist critical care nurses, along with transition to specialty practice. Tina’s current research focuses on infants retrieved with bronchiolitis. She is a Fellow of the Australian College of Critical Care Nurses and the Australian College of Nursing, a doctoral candidate at the University of Tasmania and a Research Affiliate of the University of Sydney.