Criteria for admission of children to a regional hospital ICU or a Paediatric ward HDU
- Infants with acute viral bronchiolitis needing humidified high flow or bubble-CPAP who are too sick for the paediatric ward. These will be the majority of the patients. Follow the Respiratory Distress Score (below), escalate if RDS>12.
- Asthma needing more bronchodilators than the general paediatric wards can manage
- Adolescent patients with other conditions that can be managed in an adult ICU (such as overdose)
- Suspected sepsis with the rapid ICU admission criteria (see below): also discuss with RCH PICU / PETS urgently
- Acute respiratory infection exacerbations in children with chronic neuromuscular / neurological conditions. Many such patients could be managed with non-invasive respiratory support in a regional hospital ICU. Important that the child’s paediatrician is involved, and escalation plans or advanced directives discussed.
- Back-transfers from RCH PICU when children are stable.
Any child fulfilling the PIPER PAEDIATRIC GO NOW criteria should be discussed urgently with a PIPER consultant.
Most of these children will need to come to RCH PICU, but some will be stabilised in the regional ICU that has a paediatric intensive care section.