The gestational age at birth in Australia has slowly but steadily declined over the past 30 years, mainly due to increase in planned births (caesarian sections, inductions of labor). The effects of this decline in gestational age to child health are evident at many levels – intensive care, paediatric care, community, and school.
Synopsis The Royal Children’s Hospital welcomes patients from all over our beautiful country for cardiac treatment, but we also acknowledge that this can be a frightening time for Aboriginal and Torres Strait Islander children and their families that can bring up feelings of fear, sadness, homesickness, and isolation. Many of our Aboriginal and Torres Strait … Continued
Olivia is a 14-year-old girl from rural NSW who was diagnosed with Pre B Acute Lymphoblastic Leukemia (ALL). The treatment is long and arduous, but if treated immediately has a 90 percent survival rate. Without treatment she will die within four weeks. Olivia has other conditions including epileptic encephalopathy (DEE), a severe intellectual disability, global developmental delay, communication difficulties, drug-resistant seizures and behavioural difficulties. The cancer therapy would require Olivia to have over 50 general anaesthetics as she won’t accept treatment without being restrained.
In the emergency setting, sepsis is the primary or differential diagnosis for a substantial proportion of febrile or unwell children. In this Grand Round, we will discuss challenges with early recognition and initial management of sepsis in children. We will discuss RCH efforts to improve the care of children with sepsis, including local, national, and international collaborations.
We are all problem solvers. We are accustomed to applying the scientific method and quality improvement models to deliver better care. Design thinking is an approach to solving problems that emphasizes a human-centred and iterative process to create innovative solutions. Six years ago, we invited design students into the PICU to see if we could find better ways of teaching congenital heart disease. This is the story of that journey.
The last 3 decades has seen major advances in neonatal intensive care – this has led to increased survival in our tiniest and most immature newborns. The CRE in Newborn Medicine is in its 13th year, supporting new initiatives to improve how we care for our newborn babies. This presentation highlights the innovative work that is happening in newborn research.
Outcomes following the intensive care management of critically ill children have improved dramatically over the past few decades. Advances in the provision of intensive care has led to increased rates of survival, but for some children who experience critical illness there are lasting consequences.
Hospitalisation for treatment of serious illness can place infants, and their families, at risk with respect to their mental health. Trauma responses are common, and optimal infant-parent relationship development may be disrupted. Significant additional environmental and psychosocial burdens were placed on this group in 2020 as a consequence of measures adopted to protect the community from COVID-19.
The Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM) monitors the causes and factors involved in all child deaths throughout Victoria, and provides recommendations to Government, health care professionals and the community. In recent years the Council has identified the social and economic gradient in risk of child deaths, which includes virtually all causes, from accidental trauma, drowning, SIDS, infections and chronic illnesses. The Council has long recommended improvements in the systems for provision of child welfare and support to families who are vulnerable, especially families of children with chronic illness, and these needs are magnified in the COVID-19 pandemic era.
Dr Doug Bryan is a paediatrician who has worked at the Royal Children’s Hospital since 1970. During those 48 years the prognosis and life prospects for children with chronic and complex medical conditions have improved dramatically. This has occurred partly from the discovery of new interventions but also in large part to the development of systems of care that specifically focus on the care and needs of these children and their families.
