Hospitals should have clear operational policies regarding the care of young people aged 16-18 years of age and for all 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.21
Staff without recent paediatric experience or training may be able to contribute transferable skills as part of the MDT (e.g. expertise with ultrasound to assist with 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 (including airway equipment), medications (including anaesthetic drugs) and fluids should be available to prepare an infant or child for transfer to the paediatric intensive care unit (PICU).41
There should be immediate access to protocols for management of acute life-threatening conditions. These will often be agreed with the local PICU network or paediatric intensive care transport team. Protocols should include acute respiratory, cardiovascular or neurological emergencies, trauma, poisoning and major burns.13
Hospitals without a suitable paediatric or neonatal intensive care bed should obtain the advice of the local PICU transport team as soon as possible during the management of the sick or critically injured child or young person.
Specialist tertiary paediatric centres with PICU facilities should provide clinical advice and help in locating a suitable PICU bed once a referral has been made.
Data should be collected for all referrals to PICU.
There should be a nominated lead consultant and nurse within general critical care units, who are responsible for the policies and procedures for babies and children when they are admitted.13
In the event of unusual circumstances (e.g. pandemic flu) adult critical care units should have a contingency plan for longer periods of paediatric critical care delivery.
