Paediatric Nursing (PAED)
ADMISSION OF A SERIOUSLY ILL CHILD
This is the process of admitting a critically ill child who requires immediate medical attention and intensive care.
Purpose
- Provide immediate life-saving interventions
- Stabilize child's condition
- Establish monitoring and support systems
- Support anxious family members
- Coordinate multidisciplinary care
Indications
- Child requiring urgent/critical care admission
Equipment
- Resuscitation equipment and crash cart
- Cardiac monitor and defibrillator
- Oxygen source and delivery systems
- Suction apparatus
- IV cannulas and infusion pumps
- Emergency medications
- Ventilator equipment
- Vital signs monitoring equipment
Preparation
- Prepare resuscitation area/equipment
- Ensure all emergency equipment is functional
- Alert relevant team members
- Prepare isolation if infectious disease suspected
Procedure steps
- Receive child in emergency/treatment area
- Quickly introduce self to accompanying persons
- Obtain brief handover from referring personnel/parents
- Assess ABCDE (Airway, Breathing, Circulation, Disability, Exposure)
- Initiate resuscitation if needed
- Attach cardiac monitor and pulse oximeter
- Administer oxygen as indicated
- Establish IV/IO access urgently
- Draw blood for urgent investigations
- Administer emergency medications as prescribed
- Insert urinary catheter if indicated
- Insert nasogastric tube if indicated
- Prepare for possible intubation
- Obtain focused history from parents
- Provide emotional support to family
- Complete essential admission documentation
- Transfer to ICU/PICU when stable
Precautions
- Use standard precautions throughout
- Verify identity before any procedure
- Calculate medication doses carefully
- Monitor for complications continuously
Aftercare
- Continue close monitoring
- Reassess frequently
- Update family on condition
- Ensure all lines and tubes are secure
Nursing considerations
- Prioritize interventions based on urgency
- Delegate tasks appropriately
- Maintain calm demeanor to reduce family anxiety
- Consider need for interpreter services
Patient education
- Provide simple explanations to child if conscious
- Keep family informed of procedures
- Explain equipment and monitors
- Address family questions when possible
Documentation
- Record time of arrival and initial condition
- Document all interventions with times
- Record vital signs and monitoring data
- Note medications administered with doses
- Document communication with family
- Complete admission forms when stable
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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