Update on Paediatric ALERT Helen Peet Consultant in critical care and Anaesthesia Portsmouth Medical Lead for ALERT

Background 26% of preventable deaths in adults were related to failures in monitoring An EWS is not enough only when placed within a whole system of care are better outcomes achieved Improved systems should relate to children just as much as adults Research has shown that 26% of preventable deaths were related to failures in clinical monitoring. These included failure to set up systems, failure to respond to deterioration and failure to act on test results (Hogan et al, 2012).1 In 2015 around 7% of patient safety incidents reported to the National Reporting and Learning System (NRLS) as death or severe harm were related to a failure to recognise or act on deterioration. N 2016 RCP and RCPCH brought together a raft of documents to help a system wide approach to the recognition of the deteriorating patient of all ages. At the heart of these documents is the need to recognise the deterioratiion and respond underpinned with basic education and training

ALERT So where could ALERT fit into all this after all there are numerous courses already available to those who want them but we are not any of these. We have always wanted to fit in before any of the clever stuff, to us it is about simplicity and targetting the right group. We asked all centres to let us know if they felt it was a useful exercise to embark on (and maybe I was secretly hoping you would say no) but you said yes..

Introducing…

Nuts and Bolts-1 Collaborative work across specialties Same recognisable format A-F assessment (introduced F in Obstetrics) Same 3 stage approach As little jargon as possible

Chapters The Child With Breathing Difficulties Hypotension Disordered conscious level Sepsis Pain Safeguarding Special circumstances Anaphylaxis Cardiac Conditions Diabetic Ketoacidosis (D.K.A) Immunosuppression Chronic and Acute Kidney Disease Deteriorating Surgical Patient

Scenarios QI project from PICU trainee in Wessex Wide range from asthma and bronchiolitis to meningococcal sepsis Adapted for target audience

Chapters written Graphics sourced Children bribed to be photographed First bundle sent to printers Scenarios being adapted Draft programme in progress

Pilot centres Early 2018 will need course centres to run pilots and feedback Range of centres from DGH to larger hospitals

Questions

Last Thoughts “Working together for the sick or injured child: the Tanner Report” 2006….. ……..2017 Time to respond