Global resource needs in paediatric emergency and critical care: an international survey

BACKGROUND AND OBJECTIVES

Access to life-saving paediatric acute care resources is limited globally, particularly in regions with the highest burden of paediatric critical illness. We aim to determine, using a global expert consensus survey, the essential paediatric emergency and critical care resources that critically ill children should have access to in resource-limited settings (RLS) as determined by providers in those settings.

METHODS/STUDY DESIGN

In this international modified Delphi study, core researchers established a list of hospital readiness requirements based on existing clinical guidelines and tools, including equipment, drugs, consumables, laboratory tests, human resources, training, and infrastructure. Medical providers from RLS answered the availability of these items in their settings and their perception of the need for them on a Likert scale. Respondents were recruited via a broad, international sampling strategy. The survey was provided in English, Arabic, French, and Spanish.

RESULTS/EXPECTED RESULTS

The 198 respondents were distributed primarily throughout the global south, with 60% of respondents working in low- and low-middle-income countries. Data analysis of round one of the Delphi found limited access to the preliminary list of hospital readiness requirements and consensus (>75% agreement) that the listed items were essential for the care of critically ill children in their settings.

CONCLUSIONS/DISCUSSION

Consensus on hospital readiness requirements was established with all elements achieving >75% agreement, and most items achieving >90% agreement. Present availability of these resources is significantly limited in respondent settings. This global consensus survey established paediatric acute care standards that critically ill children should have access to in settings where resources limit care, as determined by providers in those settings. The resulting cohesive list should be used to inform effective emergency and critical care capacity-building in RLS.