Critical Care in Public Health Emergencies

Management of critical care emergencies in children with autism spectrum disorder

BACKGROUND

Managing critical care emergencies in children with autism spectrum disorder (ASD) presents unique challenges due to their distinct sensory sensitivities, communication difficulties, and behavioral issues. Effective strategies and protocols are essential for optimal care in these high-stress situations.

AIM

To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD. The review focuses on key areas, including sensory-friendly environments, communication strategies, behavioral management, and the role of multidisciplinary approaches.

METHODS

A comprehensive search was conducted across major medical databases, including PubMed, Embase, and Cochrane Library, for studies published between 2000 and 2023. Studies were selected based on their relevance to critical care management in children with ASD, encompassing randomized controlled trials, observational studies, qualitative research, and case studies. Data were extracted and analyzed to identify common themes, successful strategies, and areas for improvement.

RESULTS

The review identified 50 studies that met the inclusion criteria. Findings highlighted the importance of creating sensory-friendly environments, utilizing effective communication strategies, and implementing individualized behavioral management plans. These findings, derived from a comprehensive review of current evidence, provide valuable insights into the best practices for managing critical care emergencies in children with ASD. Sensory modifications, such as reduced lighting and noise, visual aids, and augmentative and alternative communication tools, enhanced patient comfort and cooperation. The involvement of multidisciplinary teams was crucial in delivering holistic care. Case studies provided practical insights and underscored the need for continuous refinement of protocols.

CONCLUSION

The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD. Sensory-friendly adjustments, effective communication, and behavioral strategies supported by a multidisciplinary team are integral to improving outcomes. Despite progress, ongoing refinement of care practices and protocols is necessary. This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.

Iranian primary healthcare system's response to the COVID-19 pandemic using the healthcare incident command system

The present study aimed to evaluate the effects of the healthcare incident command system (HICS) on the district health networks (DHNs) covered by provincial Medical Universities (PMU) in terms of the management and commanding of the COVID-19 pandemic in Iran. This study was a cross-sectional survey. The study was performed in Iran in June 2020 in 60 DHNs, 41 of which had an active HICS. Data were collected on eight HCIS dimensions from all 60 DHNs by trained crisis management experts to evaluate the effects of HICS use on management of the COVID-19 pandemic. For all the 60 DHNs, the mean score of the COVID-19 incident command and management was 78.79 ± 11.90 (range 20-100); with mean scores highest for organizational support and coordination and lowest for logistic and planning. Significant differences were observed between the DHNs with active HICS and DHNs with inactive or no HICS in terms of the mean scores of incident management and command and their associated dimensions. According to the results, the HICS use had a positive impact on the improvement of incident management and command and all the related dimensions. Therefore, the HICS could be conducted and implemented in primary healthcare for the systematic and proper management of crises caused by infectious diseases and increasing primary healthcare system efficiency in response to these crises.