Criteria for admission of children to a regional hospital ICU or a Paediatric ward HDU

  1. 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.
  2. Asthma needing more bronchodilators than the general paediatric wards can manage
  3. Croup
  4. Adolescent patients with other conditions that can be managed in an adult ICU (such as overdose)
  5. Seizures
  6. Suspected sepsis with the rapid ICU admission criteria (see below): also discuss with RCH PICU / PETS urgently
  7. 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.
  8. 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.