The centralised nature of paediatric intensive care means that the majority of critically ill children will present for initial management to a hospital without specialist PICU facilities. These children will then need to transferred to PICU. Evidence suggests that this is best undertaken by specially trained teams.
Occasionally, there are children for whom the benefits of retrieval are outweighed by the requirement for urgent surgery - this is typically children with and intracranial haematoma or a blocked ventriculo-peritoneal shunt. The most rapid way to transport these children to theatre is for the referring hospital to transfer them. All hospitals who potentially deal with such children are therefore advised to have a procedure in place to enable them to undertake these transfers.
Our retrievals are carried out by consultant paediatric intensivists who have received training, and are experienced in transporting sick children, and by experienced nursing staff who have undergone specific competency-assessed training in transporting sick children.
We have a dedicated ambulance, with a team of 5 drivers to provide a 24 hour per day service. We retrieve around 120 - 140 children each year.
Regional feedback meetings
These are organised annually in each of the hospitals we retrieve patients from. They are multi-disciplinary. The link consultant and a member of the nursing team will attend the meeting and present data relating to PICU activity, including external audit of our performance. Cases retrieved from the individual hospital will then be discussed and any learning points drawn.
These meetings are designed to be a two-way feedback process, and the aim is to permit an open discussion of any issues raised by particular cases, and the PICU service in general. The meetings are minuted by our departmental secretary.
We encourage all staff involved in the care of critically ill children to attend, particularly anaethetsists and A & E staff, not just the paediatric team.
Meetings are organised by the link staff at each hospital.
We are able to accommodate consultant anaesthetists from the regional hospitals we cover for 1 week secondments in paediatric anaesthesia/ PICU. These secondments are funded by HCW - i.e. free to participants and their trusts! The bulk of time is spent in paediatric anaesthesia lists and gives a good opportunity for anaesthetists who's practice is generally adult based to refresh their paediatric experience. All who have taken up these secondments so far have told us they found the experience very worthwhile.
For details on how to apply contact Helen Fardy
Alison Oliver is our Regional Education and liaison nurse.