6581 A comparison of unplanned PICU transfers pre and post Covid-19 in Birmingham, UK

Objectives Respiratory viruses are the top cause of unplanned intensive care admissions in children in the UK.¹ Preventative measures, such as social distancing, during the Covid- 19 pandemic led to a reduction in the transmission of and immunity to other airborne viruses in the paediatric population between 2020–2021.² The subsequent relaxation of COVID-19 restrictions meant that winter 2022 was predicted to be extremely challenging for PICUs across the UK, with a surge of severe respiratory illnesses predicted.³ This service evaluation aims to compare the number and characteristics of unplanned PICU transfers from a district general hospital in Birmingham, UK, pre and post COVID-19. Methods This is a retrospective service evaluation of all PICU transfers by KIDS NTS (KIDS/NTS (Kids Intensive Care and Decision Support & Neonatal Transfer Service) for children (0–16 years) from Birmingham Heartlands Hospital, UK. The winter period of 1st Sep 2018 – 28th Feb 2019 was compared to the same period in 2022/2023. Unplanned emergency patient transfers to a PICU were identified from a departmental transfer list. Data was collected from paper notes. Results There was a 125% increase in the number of emergency transfers in 2022/23 vs 2018/19. 75% of patients in 2018/19 had respiratory or airway related diagnoses leading to transfer compared to 38.9% of patients in 2022/23. Table 1 demonstrates the heterogeneity of conditions in 2022/23 vs 2018/19. However, results were limited by poor documentation and lack of access to the KIDS NTS database. Conclusion There appears to be an increase in number of KIDS NTS transfers and heterogeneity of diagnoses in the post-pandemic setting. This supports the national finding that demand for PICU beds is increasing year on year.⁴ Increased heterogeneity of diagnoses may be linked to changes in characteristics of the paediatric population.⁵ This includes improved survival rate for preterm infants and increasing numbers of children with chronic and/or life limiting conditions. However, the small sample size and relatively short time period between cohorts makes analysis of this impossible. Finally, this service evaluation was limited by poor documentation, which is a known issue in emergency transfers.⁶ The use of standardised transfer documentation may be of benefit to improve this. References Paediatric Critical Care and Specialised Surgery in Children Review. NHS England, 2017. Lumley, et al. Changes in paediatric respiratory infections at a UK teaching hospital 2016–2021; impact of the SARS-CoV-2 pandemic. 2021. Whittaker. Statement on behalf of the members of the UK Paediatric Critical Care Society (PCCS). 2020. Paediatric Intensive Care – State of the Nation Report 2022. PICANet, 2023. Lewis, et al. Emergency paediatric critical care in England: describing trends using routine hospital data. 2020. Stevenson, et al. Emergency department organisation of critical care transfers in the UK. 2005.