ABSTRACT 696

Le résumé fourni par la source

Background and aims: Widespread application of the severe sepsis resuscitation bundle is limited by clinician knowledge, skills and experience and the bundle compliance reached only 31%. We adjust the UK first hour basic care tasks(BCT) of septic shock and used the adjusted tasks in pediatric patients in 3 tertiary teaching hospital in shanghai in china. Aims: The aim of this study is to survey the compliance of BCT and to evaluate the medical simulation on improving the compliance. Methods: A prospective cohort study was performed with the survey checklists were completed by the doctors who care for the pediatric septic shock patients in the 3 hospitals. A simulated case scenario of septic shock were administered to the clinicians and nurses in one hospital once every 3 months. Results: 73 patients were enrolled including 47 patients in one simulated hospital (SH) and 26 patients in the two non-simulated hospitals(NSH). The total compliance of the tasks is 45.2% (33/73). The compliance in SH was significantly higher compared to that in NSH (61.7% (29/47)vs 15.4%(4/26), p<0.01). All of the patients were taken blood and other cultures and were measured the serum lactate and given the empirical intravenous antibiotics. The main problems were iv/io in more than ten minutes, do not deliver high-flow oxygen, start IV fluid resuscitation with less doses and in longer time, and seldom commence accurate urine output measurement. Conclusions: Medical simulation is an effective method of educating first hour basic care tasks of septic shock in pediatric patients to clinicians and nurses on the front line and improve the compliance of bundles.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.