Centralisation of specialist services, such as paediatric critical care, major trauma, cardiac surgery or neurosurgery, improves outcomes. For the critically ill child, accessing specialist critical care services may require transfer, either primarily by a ‘front line’ ambulance (bypassing non-specialist centres) or secondarily by hospital teams after initial resuscitation and stabilisation in a non-specialist centre.

This chapter describes the principles and practice of stabilisation and transport of the critically ill child between centres.

As a nurse caring for paediatric patients, it is important to develop the ability to recognise and respond to a sick infant or child. This is so important that a variety of projects have been undertaken, both internationally and throughout Australia and New Zealand, to ensure that nurses working with paediatric patients are able to recognise, respond promptly to and appropriately manage sick and deteriorating infants and children. Paediatric early warning tools help clinicians to recognise a deteriorating infant or child, and trigger an escalation in care to prevent further deterioration and achieve favourable outcomes. This chapter provides a basic understanding and knowledge so you will be able to recognise and respond to a sick and deteriorating child.