Paediatric Intensive Care

One in 70 children are admitted to paediatric intensive care (PIC) at some time during childhood. Most paediatric junior doctors will rotate through PIC, and will be involved in organising acute intensive care for critically ill children. The range of children and their illnesses going through PIC is vast, making it a hugely diverse specialty. A critically ill child will end up there regardless of their underlying disease, and as a result consultants in PIC must be true generalists and need to acquire knowledge and skills in all areas of paediatrics, as well as acquiring significant knowledge of anaesthesia and surgery.

From setting up the ventilator, to managing low cardiac output, Paediatric Intensive Care gives practical and realistic advice for children's doctors and nurses in intensive care. Information is presented in easily-accessible '5 minute chunks' to enable you to quickly get the answers you need, with extensive cross-referencing ensuring that different aspects of a particular clinical problem are fully covered. With detailed answers to specific problems and expert guidance on how to manage the complex issues faced in PIC, this handbook is an indispensible guide for all those who provide care to sick children.

Table of Contents

General introduction to paediatric intensive care
1: An introduction to paediatric intensive care
2: Epidemiology and outcome of paediatric intensive care
3: Paediatric resuscitation and critical care outreach
4: Clinical assessment
5: Physics and clinical measurement
6: Vascular access and monitoring
7: Applied physiology
Organ system support and related practical procedures
8: Airway management and ventilation
9: Anaesthesia
10: Analgesia and sedation
11: Circulatory support
12: Cardiopulmonary bypass
13: Managing fluids and electrolytes/acid base
14: Renal replacement therapies
15: Nutrition
16: Heat-related illness
17: Prescribing
18: Transport and retrieval
19: Imaging in paediatric intensive care
Specific specialties
20: Cardiac disorders and post-operative care
21: Respiratory disease
22: Neurocritical care
23: Trauma
24: Infection control policies and PICU
25: Immunity and infection
26: Sepsis and multiple organ failure
27: Laboratory investigations for infectious disease
28: Antimicrobial use on the PICU
29: Neonatology
30: Gastroenterology and hepatology
31: Nephrology
32: Diabetes and endocrinology
33: Metabolic
34: Haematology and oncology
35: Brain death, organ donation, and transplantation
36: Poisoning
37: Technology dependent children
38: Genetic syndromes
39: Paediatric intensive care medicine in the developing world
Compassionate and family-orientated care
40: The child and family in PICU
41: Aspects of the law in paediatric intensive care
42: Clinical governance, audit and risk management
43: Child protection

Peter Barry, Consultant in Paediatric Intensive Care, University Hospitals of Leicester NHS Trust and Honorary Senior Lecturer, Department of Child Health, University of Leicester NHS Trust, UK, Kevin Morris, Consultant in Paediatric Intensive Care, Birmingham Children's Hospital, UK, and Tariq Ali, Consultant in Paediatric Intensive Care and Anaesthesia, John Radcliffe Hospital, Oxford, UK

Peter Barry has published over 60 papers and review articles in the fields of paediatric intensive care, inhalational drug delivery and high altitude medicine. He is currently a consultant in paediatric intensive care, University Hospitals of Leicester NHS Trust, and an honorary senior lecturer at the Department of Child Health, University of Leicester.

Kevin Morris is a consultant in paediatric intensive care at Birmingham Children's Hospital and an honorary clinical senior lecturer at the University of Birmingham. He trained in adult medicine before completing his training in paediatrics in Newcastle upon Tyne and Birmingham. Further studies in PICU were conducted in Toronto, Canada and Melbourne, Australia before taking up his current post in 1997. He has a particular research interest in traumatic brain injury (TBI) in children.

Tariq Ali began his training at St Barts and Homerton Hospitals in London before completing his specialist training at University College Hospital and Great Ormond Street Hospital for Sick Children in London. He has worked abroad as a visiting consultant at the Baragwanath hospital in Soweto, Johannesburg, South Africa and has worked briefly for Medicin Sans Frontieres during the conflict in Rwanda. He is a fellow of the Royal College of Anaesthetists and the Royal College of Paediatrics and Child Health. He has been a consultant in paediatric intensive care and anaesthesia at the John Radcliffe Hospital, Oxford since 1999.