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Review
Parallel planning and the paediatric critical care patient
  1. Peter Sidgwick1,
  2. James Fraser2,
  3. Peter-Marc Fortune3,
  4. Renee McCulloch4
  1. 1 Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK
  2. 2 Paediatric Intensive Care Unit, Bristol Children’s Hospital, Bristol, UK
  3. 3 Paediatric Intensive Care Unit, Royal Manchester Children’s Hospital, Manchester, UK
  4. 4 Louis Dundas Centre for Children’s Palliative Care, Great Ormond Street Hospital, London, UK
  1. Correspondence to Dr Peter Sidgwick, Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, WC1N 3JH, UK; petersidgwick{at}hotmail.com

Abstract

A growing number of children with life-limiting conditions (LLCs) are being cared for in paediatric critical care (PCC) settings. Children with LLCs admitted to PCC are at a high risk of developing complications and many die after prolonged admissions. Relatively few of these patients and their parents or carers have had documented discussions about their wishes for care in the event of a serious clinical deterioration before admission to PCC. There is a need for improved understanding of (1) how parents arrive at decisions regarding what is best for their child at times of critical illness and (2) the role of parallel planning and advance care plans in that process. This review examines the complexities of decision-making in children with LLCs who are admitted to PCC settings.

  • intensive care
  • multidisciplinary team-care
  • palliative care

https://doi.org/10.1136/archdischild-2018-315222

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    Footnotes

    • Contributors PS initiated and wrote the first draft. All authors contributed to and edited subsequent drafts. The finalised text was agreed by all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.