Retrieval service
Why retrieval?
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.
Guidance for transferring children with acute neurosurgical emergencies
Team
Ou
r 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 CEN compliant ambulance, with a team of 5 drivers to provide a 24 hour per day service. We retrieve around 120 - 140 children each year.
Outreach education
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.
Stabilisation days I and II
We aim to run two multi-disciplinary courses for staff involved in the care and stabilisation of critically ill children, concentrating on management beyond the initial resuscitation of children and prior to the arrival of the retrieval team. The courses are practically based with as much hands-on teaching as possible. There are two separate days, with sample timetables shown here - link to pdf of timetable.
We run one one of each day in East Wales and one of each in West Wales annually. The courses are free, and feedback from staff that have attended has been very positive.
However, we are not clear whether HCW are going to continue funding the sessions. For information on how to secure a placement contact Alison Oliver
National Stabilisation of the Critically Ill Child course
Now in its second year, this course is aimed at consultant and senior registrar staff in anaesthetics, paediatrics and accident and emergency to deal with medical management of children 'beyond APLS' while awaiting the arrival of a retrieval team. The format is lectures, scenarios and small group discussions, and has a very practical emphasis. Feedback following the first course was very positive. Places are limited to 30 delegates.
Medical secondments
We are able to accommod
ate 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
Nurse education
Alison Oliver is our Regional Education and liaison nurse.
Internal education
Link to registrars teaching programme
Link to nurses education programme
