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This Notebook was previously published in Evidence-Based Medicine. It provides an example of how 3 clinicians used evidence-based decision making in a hospital setting. We welcome submissions of similar examples of using evidence in clinical decision making.
Last year, 2 children recovering from acute severe pancreatitis were transferred from the intensive care unit (ICU) to our care in the paediatric ward.
Patient 1 was a 9-year old girl diagnosed with acute severe pancreatitis (Imrie score = 5, computed tomography [CT] abdomen staging = Balthazar E, which included pancreatic necrosis).1–2 She received antibiotics (ceftriaxone, metronidazole), analgesics (pethidine, fentanyl), anti-acid therapy (ranitidine), and nasojejunal feeding. She had been in hospital for 25 days (16 in ICU) and had received nasojejunal tube feeding for 20 days.
Patient 2 was a 9-year old boy, again with acute severe pancreatitis (Imrie score = 4, CT abdomen staging = Balthazar E). In the Emergencias Pediátricas Hospital, he was admitted to the ICU, where he received antibiotic therapy (ciprofloxacin, metronidazole), analgesics (pethidine), anti-acid therapy (ranitidine), and nasojejunal feeding. He had been in hospital for 9 days (7 days in ICU) and had been feeding by nasojejunal tube for 4 days. He asked during the ward round, “When are …
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