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PAEDIATRIC ALTERED
CONSCIOUS LEVEL GUIDELINE |
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Round one
17. Good practice points
Statement 17a
During resuscitation and initial management of a child with a reduced conscious level, the parents / guardians should be allowed to stay with the child if they wish
|
%
Agree |
%
Disagree |
Result |
|
88.2% |
0% |
Included |
|
Position |
Comments |
|
PICU N |
However, a member of staff should be available to support them through this period |
|
Endo |
If consistently accompanied by a trained member of staff |
|
PICU |
and staff can support adequately |
Statement 17b
During resuscitation and initial management of a child with a reduced conscious level, the parents / guardians should be kept informed of the possible underlying diagnoses and treatments required
|
%
Agree |
%
Disagree |
Result |
|
91.4% |
0% |
Included |
|
Position |
Comments |
|
ED P |
During resus keep informed of progress and any treatments given and why but not the time to discuss in too much detail “possible” diagnosis and treatment |
|
Neuro |
not always possible to do this in great detail…- |
|
ED |
Strongly agree that in general parents should be given this information, but amount and timing related to what parents want to be told during resuscitation and initial management |
|
Neuro S |
Tailored to individual cases – some parents may be distressed at list of possible diagnoses and fact that doctors don’t have the answer yet |
Statement 17c
During resuscitation and initial management of a child with a reduced conscious level, the parents / guardians should be kept informed of the possible prognosis of their child if it is known
|
%
Agree |
%
Disagree |
Result |
|
88.2% |
2.9% |
Included |
|
Position |
Comments |
|
Metab |
If the prognosis is known |
|
ED P |
Within reason, sometimes better to talk about prognosis once the child stabilised |
|
ED |
Parents should be kept informed, timing of giving information dependent on nature of prognosis, whether parents are asking for this information during resuscitation & initial management, and general clinical context. |
|
Neuro |
not always possible |
|
PICU |
But difficult unless obvious cause is known |
|
PICU N |
not always appropriate |
|
Endo |
With caution ie difficult to be sure of prognosis at early stage |
|
Metab |
I am not in agreement fully with D/W them the issue of prognosis – too early during resus + initial management. – esp if only possible prognosis! |
|
Paed |
Doubt whether in practice this will be known |