Sage Journals: Discover world-class research

Abstract

Since the Department of Health Report ‘Paediatric Intensive Care: A framework for the future’ in 1997, paediatric intensive care services have been centralised and 24-hour retrieval services developed. However, all hospitals admitting critically ill children must be able to resuscitate and stabilise prior to retrieval, and occasionally undertake the ‘time-critical’ transfers themselves. This article reviews the clinical and organisational skills involved in the retrieval process, and also suggests ways in which knowledge and skills can be maintained.

Keywords

stabilisation retrieval transport paediatric intensive care critically ill child

References

Department of Health. Paediatric Intensive Care – A Framework for the Future. London: Department of Health; 1997.

Ramnarayan

Polke

. The state of paediatric intensive care retrieval in Britain. Arch Dis Child 2012; 97: 145–49.

Ramnarayan

Thiru

Parslow

. Effect of specialist retrieval teams on outcomes in children admitted to paediatric intensive care units in England and Wales: a retrospective cohort study. Lancet 2010; 376: 698–704.

Ramnarayan

Britto

Tanna

. Does the use of a specialised paediatric retrieval service result in the loss of vital stabilisation skills among referring hospital staff? Arch Dis Child 2003; 88: 851–54.

Hindocha

Beringer

Handel

. A district general hospital's experience of critically ill children. JICS 2008; 9: 63–65.

Advanced Life Support Group. Advanced Paediatric Life Support (APLS) Course. Available from: http://www.alsg.org/uk/APLS (Accessed 2 March 2013).

Children's Acute Transport Service. Referral Form. Available from: http://site.cats.nhs.uk/wp-content/uploads/2012/08/Referrer_prompt_-sheet.pdf (Accessed 2 March 2013).

Rollin

. Working together for the sick or injured child: the Tanner report. Anaesthesia 2006; 61: 1135–37.

Children's Acute Transport Service. Clinical Guidelines: Waiting for the Retrieval Team. Available from: http://site.cats.nhs.uk/wp-content/uploads/2012/08/cats_waiting_for_team_dgh_2011.pdf Accessed 2 March 2013.

10.

Borrows

Lutman

Montgomery

. Effect of patient- and team-related factors on stabilization time during pediatric intensive care transport. Pediatr Crit Care Med 2010; 11: 451–56.

11.

Paediatric Airway Guidelines Group. Paediatric Difficult Airway Guidelines. 2012. Available from: http://www.das.uk.com/content/paediatric-difficult-airway-guidelines (Accessed 2 March 2013).

12.

Cummins

Hazinski

. Guidelines based on the principle ‘First, do no harm’. New guidelines on tracheal tube confirmation and prevention of dislodgment. Resuscitation 2000; 46: 443–47.

13.

Newth

Rachman

Patel

Hammer

. The use of cuffed versus uncuffed endotracheal tubes in pediatric intensive care. J Pediatr 2004; 144: 333–37.

14.

Weiss

Dullenkopf

Fischer

. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth 2009; 103: 867–73.

15.

BestBETs. Do cuffed endotracheal tubes increase the risk of airway mucosal injury and post-extubation stridor in children? 2005. Available from: http://www.bestbets.org/bets/bet.php?id=1088 (Accessed 2 March 2013).

16.

Khine

Corddry

Kettrick

. Comparison of cuffed and uncuffed endotracheal tubes in young children during general anesthesia. Anesthesiol 1997; 86: 627–31; discussion 27A.

17.

Parwani

Hoffman

Russell

. Practicing paramedics cannot generate or estimate safe endotracheal tube cuff pressure using standard techniques. Prehosp Emerg Care 2007; 11: 307–11.

18.

Advanced Life Support Group. Paediatric and neonatal safe transfer & retrieval. The practical approach (PaNSTaR). Oxford: Blackwell; 2008.

19.

Lutman

Petros

. Inhaled nitric oxide in neonatal and paediatric transport. Early Hum Dev 2008; 84: 725–29.

20.

Vidacare. 2012. Available from: http://www.vidacare.com/EZ-IO/Clinical-Applications-and-Education.aspx (Accessed 2 March 2013).

21.

Murphy

Arnold

. Ultrasound-assisted vascular access in children. Contin Educ Anaesth Crit Care Pain 2011; 11: 44–49.

22.

Dellinger

Levy

Rhodes

. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013; 41: 580–637.

23.

Children's Acute Transport Service. Electronic Drug Calculator. Available from: http://site.cats.nhs.uk/wp-content/uploads/2012/08/dgh_drugcalculator_v1.1.pdf (Accessed 2 March 2013).

24.

Duke

Molyneux

. Intravenous fluids for seriously ill children: time to reconsider. Lancet 2003; 362: 1320–23.

25.

Yung

Keeley

. Randomised controlled trial of intravenous maintenance fluids. J Paediatr Child Health 2009; 45: 9–14.

26.

Montanana

Modesto

Alapont

. The use of isotonic fluid as maintenance therapy prevents iatrogenic hyponatremia in pediatrics: a randomized, controlled open study. Pediatr Crit Care Med 2008; 9: 589–97.

27.

Neville

Sandeman

Rubinstein

. Prevention of hyponatremia during maintenance intravenous fluid administration: a prospective randomized study of fluid type versus fluid rate. J Pediatr 2010; 156: 313–19 e1–2.

28.

Saba

Fairbairn

Houghton

. A randomized controlled trial of isotonic versus hypotonic maintenance intravenous fluids in hospitalized children. BMC Pediatr 2011; 11: 82.

29.

General Medical Council. Protecting children and young people: The responsibilities of all doctors. 2012.

30.

Royal College of Paediatrics and Child Health. Safeguarding Children and Young people: roles and competencies for health care staff. Intercollegiate document. 2010. Available from: http://www.ukpics.org.uk/documents/SafeguardingChildrenandYoungpeople2010.pdf (Accessed 2 March 2013).

31.

Royal College of Paediatrics and Child Health. Safeguarding in 2012: views from the frontline. 2012. Available from: http://www.rcpch.ac.uk/system/files/protected/page/020412Safeguarding2012.pdf (Accessed 2 March 2013).

32.

Association of Paediatric Anaesthetists, Royal College of Paediatrics and Child Health, Royal College of Anaesthetists. Child Protection and the Anaesthetist: Safeguarding Children in the Operating Theatre. Intercollegiate Document. 2007. Available from: http://www.apagbi.org.uk/sites/default/files/RCPCH_v2_2007.pdf (Accessed 2 March 2013).

33.

Society of British Neurological Surgeons, Royal College of Anaesthetists. Joint Statement from the Society of British Neurological Surgeons (SBNS) and Royal College of Anaesthetists (RCoA) Regarding the Provision of Emergency Paediatric Neurosurgical Services. 2010. Available from: http://www.rcoa.ac.uk/document-store/provision-of-emergency-paediatric-neurosurgical-services (Accessed 2 March 2013).

34.

South Thames Retrieval Service. Clinical Guidelines: Time Critical Neurosurgical Transfer. Available from: http://www.strs.nhs.uk/resources/pdf/guidelines/neurosurgtransfer.pdf (Accessed 2 March 2013).

35.

Children's Acute Transport Service. Clinical Guidelines: Acute Neurosurgical Emergency. Available from: http://site.cats.nhs.uk/wp-content/uploads/2012/08/cats_neurosurgical_2011.pdf (Accessed 2 March 2013).

36.

Dharmar

Marcin

. A picture is worth a thousand words: critical care consultations to emergency departments using telemedicine. Pediatr Crit Care Med 2009; 10: 606–07.

37.

Lutman

Montgomery

Ramnarayan

Petros

. Ambulance and aeromedical accident rates during emergency retrieval in Great Britain. Emerg Med J 2008; 25: 301–02.

38.

Davies

Tibby

Murdoch

. Should parents accompany critically ill children during inter-hospital transport? Arch Dis Child 2005; 90: 1270–73.

39.

Tasker

. Inter-hospital transport for children and their parent(s). Arch Dis Child 2005; 90: 1217–18.

40.

Lutman

Petros

. How many oxygen cylinders do you need to take on transport? A nomogram for cylinder size and duration. Emerg Med J 2006; 23: 703–04.

41.

Royal College of Anaesthetists. CPD Matrix. Available from: http://www.rcoa.ac.uk/document-store/cpd-matrix (Accessed 2 March 2013).

42.

Resuscitation Council (UK). European Paediatric Life Support (EPLS) Provider Course. Available from: http://www.resus.org.uk/pages/eplsgen.htm (Accessed 2 March 2013).

43.

Bristol Medical Simulation Centre. Advanced Paediatric Intensive Care Simulation Course (APICS). Available from: http://www.bmsc.co.uk/courses/APICS.htm (Accessed 2 March 2013).

44.

MEPA. Managing Emergencies in Paediatric Anaesthesia Course. https://mepa.org.uk/ (Accessed December 2013).

45.

MEPA. Managing Emergencies in Paediatric Anaesthesia For Consultants Course. Available from: https://mepa.org.uk/ (Accessed December 2013).

46.

Paediatric Intensive Care Society. Courses for PICS trainees. Available from: http://www.ukpics.org.uk/Trainee_courses.html (Accessed 2 March 2013).

47.

Great Ormond Street Hospital for Children NHS Trust. Paediatric Airway Course. Available from: http://www.apagbi.org.uk/sites/default/files/images/PaediatricAirwayCourse-2.pdf (Accessed 2 March 2013).

48.

Oxford University Hospitals NHS Trust. Oxford Paediatric Difficult Airway Workshop. Available from: http://www.das.uk.com/content/oxford-paediatric-difficult-airway-workshop (Accessed 8 December 2013).

49.

Emergency Medical Retrieval Service. Available from: http://www.emrs.scot.nhs.uk/ (Accessed 2 March 2013).

50.

London Deanery. Simulation & Technology-enhanced Learning Initiative. STeLI faculty development. Available from: http://simulation.londondeanery.ac.uk/faculty-development (Accessed 2 March 2013).

51.

Advanced Life Support Group. Paediatric Life Support (PLS) Course. Available from: http://www.alsg.org/uk/PLS (Accessed 2 March 2013).

52.

Resuscitation Council (UK). Newborn Life Support (NLS) Course. Available from: http://www.resus.org.uk/pages/nlsinfo.htm (Accessed 2 March 2013).

53.

Advanced Life Support Group. Paediatric and neonatal safe transfer and retrieval (PaNSTaR). Available from: http://www.alsg.org/uk/node/16 (Accessed 2 March 2013).

54.

EMBRACE. Paediatric Safe Transfer And Communication Course (PSTAC). Available from: http://www.montagusimulation.co.uk/Courses/CourseDetail.aspx?referrer=courselist&id=55 (Accessed 2 March 2013).

55.

Bristol Medical Simulation Centre. South West Paediatric Life Support and Transfer Course (SPLAT). Available from: http://www.bmsc.co.uk/courses/SPLAT.htm (Accessed 2 March 2013).

56.

Children's Acute Transport Service. Situation Critical Study Day. Available from: http://site.cats.nhs.uk/situation-critical/ (Accessed 2 March 2013).

57.

Children's Acute Transport Service. CAts Stabilisation and Transport (CAST) Simulation Course. Available from: http://site.cats.nhs.uk/cats-stabilisation-and-transport-cast-simulation-course/ (Accessed 2 March 2013).

58.

OxSTaR. Oxford Paediatric Emergencies Resuscitation and Stabilisation course - A team response. Available from: http://www.oxstar.ox.ac.uk/courses-2/ (Accessed December 2013).

59.

KIDS. Stabilisation of the critically ill child. Available from: http://kids.bch.nhs.uk/stabilisation-course/ (Accessed 2 March 2013).

60.

University Hospitals of Leicester NHS Trust. Paediatric and infant critical care transport course. Available from: http://www.apagbi.org.uk/sites/default/files/images/PaediatricandInfantCriticalCareTransportCourse.pdf (Accessed 2 March 2013).

61.

The Southampton Neonatal And Paediatric Simulation Group. SNAPS Train the trainers course. Available from: http://www.sort.nhs.uk/Media/Education/SNAPS-Train-the-trainer-course-6,7June2013.pdf (Accessed 2 March 2013).

Stabilisation and Transport of the Critically Ill Child

Abstract

Keywords

References