Paediatric Critical Care/Emergency Care: What Information Must A Good Strategy Contain?

Abstract

This write up on critical care and emergency care of children: What must a good strategy
contain? surrounds issues of what a critical care package should be even in resource poor
settings. Paediatric critical care consists of identification of children at risk of dying or
having adverse outcomes, and in need of intensive monitoring and provision of appropriate
interventions. Emergency care is defined by the World Health Organization (WHO) as care
for the acutely ill and injured delivered by frontline providers who manage medical, surgical,
and obstetric emergencies, relying on early recognition and resuscitation.
In developing countries, majority of mortalities occur due to infectious diseases which are
treatable and have potential for full recovery if appropriate definitive care as well as intensive
care is given to those who come critically ill. In Cameroon, maternal, child and adolescent
related diseases account for 18.3% of the burden of disease and 14.4% of deaths. Some of
these deaths could be prevented if there are adequate paeditric critical care facilities to handle
the critically ill children. However, paediatric critical care services are largely unavailable
in most developing countries 23. The objectives of this seminar are to describe the nursing
strategies used in the critical and emergency care of children, outline parent’s expectations of
the critical care/emergency care of their children by nurses and lastly to describe healthcare
managers’ responsibilities in critical care/emergency care of children. It has been observed
that nursing strategies include monitoring, assessment, vital sign monitoring, ventilatory
management, medication administration, intravenous insertion and infusion, central line
care, catheters care, maintenance of a running record of the patient’s status, performance
of cardiopulmonary resuscitation and other lifesaving techniques. Parent’s expectations
include guidance, reassurance and timely and comprehensive information on the progress
and prognosis of critically ill children; open visitation policy and involvement in their child’s
care 8, while healthcare managers’ responsibilities were found to be ensuring adequate skill
and knowledge among emergency services providers, and availability of pediatric critical care
medications, equipment, and supplies. The results can be used to implement good critical care
strategies and hence better care outcomes.