The success of treating a pediatric emergency depends greatly on the preparation and collaboration of the team. Working together, working well, working in a coordinated manner are essential elements when dealing with a pediatric emergency; and this is what happened on Sunday morning 21 January at the Pediatrics SOC of the ASP of Crotone, directed by Dr. Stefania ZampognaAn extraordinary synergy made it possible to stabilize an 8-year-old girl who was in critical condition due to severe hypovolemic shock due to diabetic ketoacidosis (DKA), characterized by Kussmaul’s breathing and altered state of consciousness.
The pediatric team promptly applied the international protocols for the management of critically ill patients, an approach that involves in the first instance the stabilization of the patient with the administration of O2, maintenance of airway patency and positioning of venous accesses. The difficulty in finding a traditional venous access due to the severe state of shock was brilliantly overcome by positioning an intraosseous access thanks to the use of an electric drill. As is known, compared to traditional venous access, the intraosseous route has the advantage of exploiting a dense vascular network which does not collapse even in seriously compromised patients.
It is necessary to underline the excellent team work carried out by the staff made up of paediatricians, nurses and the anesthetist Dr. Tommaso Sorrentino. This multidisciplinary collaboration allowed for a timely, effective, crucial and life-saving intervention.
Outcome of the Intervention
The mortality rate in children with DKA varies from 0.15 to 0.30% and one of the most fearful complications is represented by cerebral edema which is the basis of 60-90% of cases of death. The patient has been successfully stabilized and is currently being managed and monitored in the Pediatric SOC and is receiving all the necessary subintensive care. Her condition is stable and her life is no longer in danger.
Importance of Training
This case highlights the vital importance of continuous training and preparation of healthcare personnel in the management of pediatric emergencies. It is a clear example of how training and practice can make a difference in critical situations. It is a notable achievement for our hospital, as it is the first time that an operation of this type (pediatric intraosseous access) has been performed in a Calabrian Spoke Hospital.
Our Company will continue to promote advanced training among healthcare personnel and support the adoption of innovative protocols and techniques. Dr. Stefania Zampogna would like to express gratitude to the Director of the Anesthesia and Resuscitation Facility, Dr Serafino Vulcan , for the continuous support and constant collaboration and to Dr. Sorrentino Tommaso for the promptness he showed in positioning the intraosseous access. Thanks to the entire pediatric team, who put the safety and well-being of their little patients first on a daily basis. This event demonstrates the power of collaboration and advanced education to save lives.