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Paediatric Critical Care Pearls are key points that should be remembered when treating the critical ill child, each summarised into a sentence. These are not all my own pearls and I have been collecting these throughout my career. This will be a multi-part series and I plan to release them in batches of 10. The pearls themselves below may not make much sense on their own and you will need to listen to the above podcast to fully understand them, but once you have listened to the podcast the below list will serve as a useful summary.

The Pearls

  1. Consider going straight for intraosseous access in crashing patients
  2. Use cefotaxime rather than ceftriaxone initially in septic shock
  3. Don’t exceed the adult maximum dose when using salbutamol infusions
  4. Don’t delay calling the ambulance in a patient needing time critical transfer
  5. When you see a collar think use a bougie
  6. Use a cuffed endotracheal tube in all critically ill children unless contraindicated
  7. Don’t insert upper circulation central lines in patients with hypokalaemia
  8. Use ultrasound to help insert arterial lines in children with weak or impalpable pulses
  9. Start prostaglandin infusions at a dose appropriate to the clinical situation
  10. Don’t try to lead and do at the same time

I’m always on the search for new pearls so if you have any please get in touch in the comments section to share yours and I’ll feature the best ones in a future podcast.

Useful Links

Video demonstrating the effectiveness of intraosseous access

Podcast – Should cuffed endotracheal tubes be used routinely in critically ill children?

Video demonstrating task fixation and why trying to lead and do at the same time doesn’t work

Video demonstrating effective leadership

Podcast

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