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Equipment suitable for this age group, e.g. pulse oximeter sensors of an appropriate size, should be available and checked.

Where children present with major trauma to a non-trauma centre, the guidelines for emergency resuscitation, stabilisation and transfer detailed below should apply.

The whole operating team should agree to any change to a published operating list. This list should be rewritten or reprinted, including a date and time of the update.⁷² After a change in the theatre list a further team brief should take place.

Hospitals admitting children should be part of a fully funded critical care network.

Paediatric early warning scores should be used to help identify the deteriorating or critically ill child.

There should be local hospital protocols in place that are clear on the roles and responsibilities of the multidisciplinary team in caring for the critically ill child.³⁷ Individual hospitals will have different personnel providing anaesthetic support to these teams.

Hospitals should have clear operational policies regarding the care of young people aged 16-18 years of age and for preterm babies who have been discharged from neonatal units.¹³

Individuals with responsibilities for paediatric resuscitation and stabilisation should fulfil the training requirements and maintain their competencies.¹⁹

Staff without recent paediatric experience or training may be able to contribute transferable skills as part of the multidisciplinary team, e.g. expertise with ultrasound to assist line placement or echocardiography skills, and such contribution should be supported by local protocols. 

In all emergency departments receiving infants and children, neonatal and paediatric resuscitation equipment, medications (including anaesthetic drugs) and fluids should be available to prepare an infant or child for PICU transfer.³⁸