Tips on Preventing Infections in Pediatric Settings

Thomas Sandora, MD, MPH, hospital epidemiologist at Boston Children’s Hospital, explains the different ways to prevent bloodstream infections in children and pneumonia for children who are on ventilators in pediatric settings.

Interview Transcript (slightly modified for readability).

“[There are] different ways that we [prevent infections], and it varies depending on the type of infection.

To prevent bloodstream infections, for example, in adults, one of the common things is to minimize the number of times that you enter a central line and to take the line out as soon as possible to reduce the risk of infection. In children, that’s a little bit harder because we don’t like to stick children with needles because it’s scary and makes them cry, so, people tend to leave the lines in place and to use them for every blood draw and to keep them in longer than they need to be. We have to work with providers about remembering the risk associated with the use of those kinds of devices.

Another example is for preventing pneumonia for children who are on ventilators in the intensive care unit. One of the recommended strategies is to elevate the head of the bed, up to 30 to 45 degrees, [and] that reduces the risk of pneumonia developing when you’re on a ventilator. In young children, if you tilt the bed up that high, they slide right off [of] the bottom because they can’t keep themselves seated in that position, so, we have to use a smaller degree of head of bed elevation. We have to tailor some of the typical strategies that are used for adults and make them more child friendly.”