Detecting and managing deterioration in children

Abstract

32 Paediatric Nursing vol 17 no 1 February 2005 In the past, paediatric intensive care units (PICUs) were perceived by many as ivory towers. They often had poor relationships with other departments probably caused by them working in isolation, by poor communication and lack of admission and discharge planning. Similar issues in adult critical care resulted in the Department of Health recommending a hospitalwide approach to the identification and referral of critically ill adults (DoH 2000). This led to the development of critical care outreach teams in adult services and an improvement in interdepartmental working. The function of these outreach teams is to improve the provision of critical care prior to admission to intensive care and following discharge. Across the UK, adult critical care services have been setting up teams under various titles such as emergency medical team or emergency outreach team. Despite the various titles the teams have three shared aims: ❘❚❘ early detection of patients at risk of deterioration ❘❚❘ support and education of ward staff in caring for patients at risk of deterioration ❘❚❘ improved discharge and follow up after intensive care. This article summarises the process of setting up a paediatric critical care outreach team at Brighton and describes the development of a paediatric early warning Alan Monaghan describes how the introduction of a critical care outreach service and a Paediatric Early Warning Score improved management of acutely ill children