Can ACCM-PALS Guidelines Be Relevant to Community Practice?
Although prospective studies will need to be conducted to determine definitively whether the new ACCM-PALS Guidelines will be effective in improving outcome in pediatric-neonatal septic shock, our study lends support for its application to the community hospital setting. However, because these new ACCM-PALS Guidelines were developed in pediatric academic centers without specific regard for the community physician, barriers to its successful translation and implementation into the community hospital setting may exist. One barrier could be related to specialized technical skills needed to execute specific therapies. For example, not all health care providers who care for children possess sufficient pediatric airway management skills to perform oral endotracheal intubation. Also, some community physicians may not be comfortable placing central venous lines in critically ill children. However, these requisite technical skills did not seem to restrict the execution of these therapeutic inte
