Detecting and managing deterioration in children: Critical Care Outreach & Paediatric Early Warning Score

Alan Monaghan describes how the introduction of a critical care outreach service and a Paediatric Early Warning Score improved management of acutely ill children. In the past paediatric intensive care units (PICUs) were perceived by many as ivory towers. They often had poor relationships with other departments probably caused by them working in isolation, by poor communication and lack of admission and discharge planning. Similar issues in adult critical care resulted in the Department of Health recommending a hospital-wide approach to the identification and referral of critically ill adults (DoH 2000). This led to the development of critical care outreach teams in adult services and an improvement in interdepartmental working.