Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Introduction
- Differences
- Clinical Assessment
- Introduction
- Scoring Systems and Quality Metrics in PICU
- Paediatric Intensive Care Transport Services
- Changing Patterns of PICU
- Relevance to the Intensivist
- How Widespread Is Child Abuse?
- Types of Abuse
- The Safeguarding Process – Roles, Responsibilities and Processes
- Respiratory Anatomy and Physiology in Children
- Upper Airway Obstruction
- Intubating the Child with Upper Airway Obstruction
- Paediatric Acute Respiratory Distress Syndrome
- Diseases of the Lower Airway
- High-Flow Nasal Cannulae
- Continuous Positive Airway Pressure
- Mechanical Ventilation
- High-Frequency Oscillatory Ventilation
- Extracorporeal Membrane Oxygenation
- Definition and Recognition of Sepsis
- Patterns of Sepsis Presentation
- Haemodynamics of Paediatric Septic Shock
- Protocolised Management of Sepsis
- Current Controversies
- Outcomes in Sepsis and Septic Shock
- Introduction
- Status Epilepticus
- Coma
- Neurosurgical Emergencies
- Introduction
- Initial Management
- Sudden Unexpected Death in Infancy and Sudden Infant Death Syndrome
- Introduction
- Presentation in Infancy
- Diagnosis and Management of Infants with Suspected Congenital Heart Disease
- Norwood Stage 1, Glenn or Fontan
- Acute Presentations
- Introduction
- The Primary Survey
- Head Injury
- Cervical Spine Injury
- Introduction
- Acute Liver Failure
- Inborn Errors of Metabolism
- Diabetic Ketoacidosis
- Introduction
- Analgesic Agents
- Sedative Agents
- 9.1 Assessment and Management of the Sick Child
- 9.2 Organisation of Paediatric Intensive Care and Paediatric Intensive Care Transport Services in the UK
- 9.3 Safeguarding and Non-accidental Injury
- 9.4 Respiratory Failure
- 9.5 Paediatric Sepsis
- 9.6 Acute Neurological Disorders
- 9.7 The Collapsed Infant
- 9.8 Congenital Heart Disease
- 9.9 Trauma
- 9.10 Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
- 9.11 Analgesia and Sedation in the Paediatric Intensive Care Unit
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
9.6 - Acute Neurological Disorders
from Section 9 - Paediatric Care
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Introduction
- Differences
- Clinical Assessment
- Introduction
- Scoring Systems and Quality Metrics in PICU
- Paediatric Intensive Care Transport Services
- Changing Patterns of PICU
- Relevance to the Intensivist
- How Widespread Is Child Abuse?
- Types of Abuse
- The Safeguarding Process – Roles, Responsibilities and Processes
- Respiratory Anatomy and Physiology in Children
- Upper Airway Obstruction
- Intubating the Child with Upper Airway Obstruction
- Paediatric Acute Respiratory Distress Syndrome
- Diseases of the Lower Airway
- High-Flow Nasal Cannulae
- Continuous Positive Airway Pressure
- Mechanical Ventilation
- High-Frequency Oscillatory Ventilation
- Extracorporeal Membrane Oxygenation
- Definition and Recognition of Sepsis
- Patterns of Sepsis Presentation
- Haemodynamics of Paediatric Septic Shock
- Protocolised Management of Sepsis
- Current Controversies
- Outcomes in Sepsis and Septic Shock
- Introduction
- Status Epilepticus
- Coma
- Neurosurgical Emergencies
- Introduction
- Initial Management
- Sudden Unexpected Death in Infancy and Sudden Infant Death Syndrome
- Introduction
- Presentation in Infancy
- Diagnosis and Management of Infants with Suspected Congenital Heart Disease
- Norwood Stage 1, Glenn or Fontan
- Acute Presentations
- Introduction
- The Primary Survey
- Head Injury
- Cervical Spine Injury
- Introduction
- Acute Liver Failure
- Inborn Errors of Metabolism
- Diabetic Ketoacidosis
- Introduction
- Analgesic Agents
- Sedative Agents
- 9.1 Assessment and Management of the Sick Child
- 9.2 Organisation of Paediatric Intensive Care and Paediatric Intensive Care Transport Services in the UK
- 9.3 Safeguarding and Non-accidental Injury
- 9.4 Respiratory Failure
- 9.5 Paediatric Sepsis
- 9.6 Acute Neurological Disorders
- 9.7 The Collapsed Infant
- 9.8 Congenital Heart Disease
- 9.9 Trauma
- 9.10 Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
- 9.11 Analgesia and Sedation in the Paediatric Intensive Care Unit
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Children with an acute neurological problem requiring intensive care will broadly present with seizures or decreased consciousness (or both).
2. The advanced paediatric life support (APLS) guidelines are regularly updated and provide guidance on treatment of status epilepticus.
3. It may be appropriate to extubate some children with seizures in the local hospital and avoid the need for transport to a paediatric intensive care unit.
4. It is not necessary to perform a lumbar puncture acutely.
5. Children requiring urgent neurosurgery are usually transported by the local team (rather than waiting for a specialist transport service).
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 708 - 710Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Advanced Life Support Group, Samuels, M, Wieteska, S (eds). The child with a decreased conscious level. In: Advanced Life Support Group, Samuels, M, Wieteska, S (eds). Advanced Paediatric Life Support, 6th edn. Chichester: Wiley Blackwell; 2016. pp. 89–98.CrossRefGoogle Scholar
Advanced Life Support Group, Samuels, M, Wieteska, S (eds). The convulsing child. In: Advanced Life Support Group, Samuels, M, Wieteska, S (eds). Advanced Paediatric Life Support, 6th edn. Chichester: Wiley Blackwell; 2016. pp. 99–106.CrossRefGoogle Scholar
Chin, RF, Neville, BG, Peckham, C, Bedford, H, Wade, A, Scott, RC; NLSTEPSS Collaborative Group. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet 2006;368:222–9.CrossRefGoogle ScholarPubMed
Mangat, HS, Patel, C, Rodrigues, D. Fifteen-minute consultation: assessment of a child with suspected shunt problems. Arch Dis Child Educ Pract Ed 2017;102:170–4.CrossRefGoogle ScholarPubMed
PICANet. 2017. PICANet annual report 2017. Paediatric Intensive Care Audit Network. www.picanet.org.uk/Audit/Annual-Reporting/Annual-Report-Archive/Google Scholar
Reynolds, S, Marikar, D, Roland, D. Management of children and young people with an acute decrease in conscious level (RCPCH guideline update 2015). Arch Dis Child Educ Pract Ed 2018;103:146–51.CrossRefGoogle Scholar