Paediatric admissions to a district general hospital intensive care unit

The characteristics of all the paediatric admissions made to a district general hospital over a three-year period were analysed in this study. Paediatric admissions averaged 23 per year (10% of the total admissions to the unit over that time). The mean age was six years, median age was four years. Sixty-two per cent were medical admissions and 38% surgical. Forty-seven per cent of the surgical admissions involved head injuries. Seventy-four per cent of medical admissions were directly related to upper and lower airway problems. Mean total admission time was six days, with a median of two days. Fifty-nine per cent (40) of all cases required intubation for a mean period of five days (median = three days). All cases were PRISM scored (Pollack, Ruttimann & Getson 1988). The mean score was 8. Ninety-four percent of admissions surviving to go home. There were a total of four deaths over the three-year period. The PRISM scores of those who died had a mean of 30, which was significantly different (P < 0.05) from the survivors who had a mean PRISM score of six and a median of four. The organs of one of the nonsurvivors were transplanted. Currently there is considerable interest in the feasibility of transferring all paediatric intensive care patients to a regional centre, the consequences of such a policy must be carefully assessed if its implementation is to be a success.