Consideration should be given to appropriate strategies for recognising and managing anxiety of children particularly at induction, such as play specialists, counselling, psychological support and anaesthetic training around managing preoperative anxiety.3
Staff should take into consideration the needs of patients who have a hospital passport. A copy of the hospital passport should be kept in the patients notes and should be referred to throughout the perioperative pathway.
Children with learning disabilities should ideally be recovered in an area with lower levels of noise and lighting and a familiar presence, such as a parent or their carer.
The presence of learning disability practitioners in recovery when a patient with learning disability is being recovered should be considered.
Consideration should be given to reuniting patients with learning and/ or communication difficulties with their parents and/ or carers as soon as possible following a procedure.
Staff should liaise with a trust lead for patients with learning difficulties.40
Where children present with major trauma to a non-trauma centre, the guidelines for emergency resuscitation, stabilisation and transfer detailed below should apply.
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 MDT in caring for the critically ill child.39 Individual hospitals will have different personnel providing anaesthetic support to these teams.
