Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

Background Critically ill children require optimum feeding in the intensive care units for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units. Methods A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N = 42). Results The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral, and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children. Conclusions Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU are recommended to reduce possible infant and child mortality resulting from suboptimal feeding.

Fifteen-minute consultation: Intubation of the critically ill child presenting to the emergency department

Intubation of critically ill children presenting to the emergency department is a high-risk procedure. Our article aims to offer a step-by-step guide as to how to plan and execute a rapid, successful intubation in a way that minimises risk of adverse events and patient harm. We address considerations such as the need for adequate resuscitation before intubation and selection of equipment and personnel. We also discuss drug choice for induction and peri-intubation instability, difficult airway considerations as well as postintubation care. Focus is also given on the value of preintubation checklists, both in terms of equipment selection and in the context of staff role designation and intubation plan clarity. Finally, in cases of failed intubation, we recommend the application of the Vortex approach, highlighting, thus, the importance of avoiding task fixation and maintaining our focus on what matters most: adequate oxygenation.

Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

Background: Critically ill children require optimum feeding in the intensive care for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units.Methods: A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N=42).Results: The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children.Conclusions: Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU is recommended to reduce possible infant and child mortality resulting from feeding.