ABSTRACT
This chapter focuses on initial management and stabilisation of critically ill children, using the ABCDE format likely to be used when stabilising children for transfer. The ABCDE are airway, breathing, circulation, disability, drugs, and exposure. In the UK, as in most European countries, children are usually nursed in dedicated paediatric intensive care units, as this improves survival. Paediatric admissions to adult intensive care units are rare, but when they occur is usually brief, with the aim of stabilising for transfer. Meningitis can cause long-term health complications, especially hearing loss, so survivors should be followed up by paediatric services. Meningitis usually causes photophobia, so children should be nursed in a dark room. Like all patients, children should be thoroughly examined for any other signs of injury; in children this may include non-accidental injury. Children usually become pyrexial owing to infection; antipyretics do not prevent convulsions, so should only be given if the child is distressed.
