Critical illness in specific populations
Paediatric emergencies
Paediatric emergencies represent a significant challenge for intensivists, as they require prompt recognition and intervention to improve patient outcomes and reduce morbidity and mortality. These emergencies may be due to various causes, including respiratory, cardiovascular, neurological, metabolic, or infectious disorders, and their management often requires a multidisciplinary approach.
Paediatric life support
Paediatric Life Support 2025
European Resuscitation Council Guidelines 2025 Paediatric Life Support
Jana Djakow et al., Resuscitation (2025)
What’s inside
The 2025 ERC Paediatric Life Support Guidelines provide evidence-based recommendations for the prevention, recognition, and management of cardiac arrest in infants, children, and adolescents (0–18 years). The guidelines cover basic and advanced life support, post-resuscitation care, special circumstances, and system-level implementation, emphasizing early intervention, high-quality CPR, and tailored approaches for diverse healthcare settings.
Why it’s relevant
Paediatric cardiac arrest, though rare, has devastating consequences and requires rapid, effective intervention. These guidelines standardize best practices for healthcare providers and the public, aiming to improve survival rates and neurological outcomes. They address unique paediatric needs, such as age-specific techniques, reversible causes, and post-discharge care, ensuring comprehensive, up-to-date care for critically ill children.
Key focus
- Early recognition of critical illness using tools like the BBB-tool and ABCDE approach
- Age-specific CPR techniques, including two-thumb encircling for infants and two-hand for adolescents
- Use of adrenaline and amiodarone in shockable and non-shockable rhythms
- Special considerations for trauma, drowning, anaphylaxis, and metabolic derangements
- Post-resuscitation care targeting normoxaemia, normocapnia, and blood pressure above the 10th percentile
Advanced Paediatric Life Support
Advanced Paediatric Life Support: A Practical Approach to Emergencies, 7th Edition
Advanced Life Support Group (ALSG), Wiley (2023)
What’s inside
The 7th edition of Advanced Paediatric Life Support provides evidence-based, structured guidance for the recognition and management of both common and uncommon paediatric emergencies during the critical first hours after presentation. It integrates the latest ILCOR 2021 resuscitation guidelines and emphasizes non-technical skills, teamwork, and communication.
Why it’s relevant
Early, effective intervention is vital in paediatric emergencies, where rapid deterioration can lead to poor outcomes. This guideline supports critical care professionals with standardized, practical protocols for stabilizing and managing seriously ill or injured children, improving survival and reducing morbidity.
Key focus
- Structured ABCDE approach to paediatric emergencies
- Latest ILCOR 2021 resuscitation guidelines
- Comprehensive management of airway, breathing, circulation, and disability
- Emergency treatment of trauma, seizures, and exposure
- Emphasis on teamwork, communication, and human factors
Mechanical ventilation in paediatric patients
Mechanical ventilation in critically ill children
Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)
Kneyber, M. C. J. et al., Intensive Care Medicine (2017)
What’s inside
This guideline provides evidence-based recommendations for mechanical ventilation in critically ill children, addressing diverse conditions such as obstructive, restrictive, and mixed lung diseases, as well as cardiac patients and those with lung hypoplasia. It aims to standardize clinical practice and research by harmonizing approaches to ventilation strategies, monitoring, and supportive measures.
Why it’s relevant
Mechanical ventilation in children is often based on adult or neonatal practices due to limited pediatric evidence. These recommendations help bridge this gap, offering a standardized approach to improve outcomes and guide future research in pediatric critical care.
Key focus
- Standardizing ventilation modes and settings for various lung diseases
- Emphasizing patient-ventilator synchrony and monitoring
- Addressing supportive measures like humidification and positioning
- Highlighting the importance of weaning and extubation readiness
- Providing guidance for specific populations, including cardiac and chronically ventilated children
Status epilepticus
Please read the guidelines on the management of status epilepticus here.