Essential Of Pediatric Intensive Care

Essentials of
Paediatric Intensive Care

Essentials of
Paediatric Intensive Care

C G Stack, FRCA
Director of Intensive Care
Sheffield Children’s Hospital
P Dobbs, FRCA
Consultant Anaesthetist
Royal Hallamshire Hospital, Sheffield

cambridge university press
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Cambridge University Press
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© Greenwich Medical Media Limited 2003
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without the written permission of Cambridge University Press.
First published in print format 2004
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0-511-16583-8 eBook (NetLibrary)

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978-1-841-10053-1 paperback
1-841-10053-6 paperback

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CONTENTS
Preface
Section 1
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter
Chapter
Chapter
Chapter
Chapter
Chapter

5
6
7
8
9
10

Section 2
Chapter 11
Chapter 12
Chapter
Chapter
Chapter
Chapter
Chapter
Chapter
ChapterChapter
Chapter
Chapter
Chapter

13
14
15
16
17
18
19
20
21
22
23

Section 3

Basic Principles of PICU
Differences between the child, the neonate
and the adult
Neonatal problems in the PICU
Resuscitation
The structured approach to the seriously
injured child
Airway and ventilation
Circulation and rhythm disturbances
Sedation and analgesia in PICU
Fluid, electrolytes andnutrition
Transport of the critically ill child
Death on the PICU

vii
1
3
10
14
20
24
37
43
50
61
65
69
71
83

Specific PICU Problems
Respiratory disease
Cardiac disease on the PICU
Monica Stokes – Birmingham Children’s Hospital
Dysrhythmias and myocardial disease
Neurological and neuro-muscular disease
Gastrointestinal and hepatic disorders
Renal disease
Haematologyand oncology
Endocrine disorders
Inborn errors of metabolism
Infection and related illness
Trauma
Poisoning
Neonatal and other surgical patients in PICU

95
106
122
129
134
138
143
146
155
171
176

Drugs Used in Paediatric Intensive Care

179

Bibliography
Index

222
223

PREFACE
The aim of this book is to be a practical handbook providing easily
accessibleinformation for medical and nursing staff who are involved
in looking after sick children. It is aimed at those who work for a short
time in paediatric intensive care or look after sick children for short
periods prior to retrieval to a paediatric intensive care unit. It is not
intended to be a complete guide but rather a synopsis of the most
salient points. With this in mind, we hope to havewritten it in an
easily readable form.
The book is in three sections. The first is about basic principles of
intensive care. The second section deals with specific conditions
through different systems.The final section is a section on drugs which
are commonly used in the critically ill child. We apologise for any
omissions.

PREFACE

We would like to thank Dr Monica Stokes from BirminghamChildren’s Hospital for the chapter on Cardiac Problems on the
PICU.We would also like to thank the editorial staff at GMM for their
infinite patience and persistence. Finally we would like to thank Judy
Needham for her secretarial assistance.
C G Stack
P Dobbs
October 2003

vii

Section 1
Basic Principles
of PICU

ESSENTIALS OF PAEDIATRIC INTENSIVE CARE

CHAPTER 1
DIFFERENCES...