Title page -- Copyright page -- Contents -- List of Contributors -- Acknowledgements -- Section 1: Introduction to Paediatric Intensive Care Nursing -- Chapter 1: Introduction to Children's Intensive Care -- Introduction and background -- The organisation of PICU care -- Differentiating paediatric intensive care -- Commissioning auditing and costing -- Standards for staffing and skill mix -- Developing roles in PICU -- Education in PICU -- Higher education and professional body partnerships -- New ways of learning in PICU -- Conclusion -- References -- Chapter 2: Assessment and Management of the Critically Ill Child/Resuscitation -- Introduction -- The priority -- Second-level priorities -- Fluids and drugs -- Calorie requirement and nutrition -- Potential impact on development and disability -- Indicators of brain injury -- Essential nursing care -- Skin assessment -- Bowel and bladder care in the PICU -- Oral hygiene -- Eye care -- Passive limb physiotherapy -- Resuscitation in the PICU -- Drugs used in resuscitation -- Adrenaline -- Amiodarone -- Atropine -- Sodium bicarbonate -- Dextrose -- Electrolytes (magnesium and calcium) -- Parents present during resuscitation -- Advance directives, personal resuscitation plans, end-of-life instructions -- Not for resuscitation -- Withdrawing and withholding intervention -- Conclusion -- References -- Chapter 3: Physiological Monitoring of Infants and Children in the Intensive Care Unit -- Introduction -- General safety and preparation before use -- Electrocardiographic (ECG) monitoring -- Five-electrode limb leads plus one precordial lead combination -- Troubleshooting ECG monitoring (Table ) -- Twelve-lead ECG recording (Figure ) -- Atrial wire ECG recordings -- Invasive pressure monitoring -- Maintaining line patency -- Arterial lines and monitoring.

Physiology of the arterial pressure-pulse wave (arterial waveform) (Figure ) -- Central venous pressure (CVP) monitoring -- Pulse oximetry -- Capnography and ETCO2 monitoring -- Near-infrared spectroscopy -- Conclusion -- References -- Section 2: Systems Approach -- Chapter 4: Care of an Infant or Child with a Respiratory Illness and/or the Need for Respiratory Support -- Introduction -- Embryology -- Transition to extra-uterine respiratory function -- Brief overview of respiratory physiology -- The role of surfactant -- Gas exchange -- Gas transport -- Control of respiration -- Central chemoreceptors -- Peripheral chemoreceptors -- Lung stretch receptors -- Joint and muscle receptors -- Irritant receptors -- J receptors (juxtacapillary receptors) -- Ventilation perfusion ratio and mismatch -- Pulmonary volumes and capacities -- Respiratory assessment -- Physical inspection -- Cyanosis -- Palpation -- Crepitus -- Pleural friction rub -- Percussion -- The respiratory rate and rhythm -- Auscultation -- The chest X-ray -- Blood gas analysis -- Buffering system -- Compensatory mechanisms -- Electrolytes and acid base balance -- Normal blood gas values -- Blood gas interpretation -- Systemic effects of a respiratory acidosis -- Cardiovascular -- Pulmonary vasculature -- Cerebral vasculature -- Peripheral vasculature -- Assessment of the non-intubated child or the child with a tracheostomy -- Assessment of the intubated child or child with a tracheostomy receiving mechanical ventilation -- Respiratory support and airway protection -- Non-invasive respiratory support - continuous positive airway pressure (CPAP) -- Airway adjuncts -- Oropharyngeal airway -- Nasopharyngeal (NP) airways -- Laryngeal mask airway -- Intubation -- Preparation for intubation -- Rapid sequence induction (RSI) -- Fibreoptic bronchoscope intubation -- Intubation risks.

Intubation medications -- Depolarisation versus non-depolarising agents -- Intubation procedure -- Tracheostomies -- Principles of ventilation -- Types of ventilation -- Negative-pressure ventilation -- Positive-pressure ventilation (PPV) -- Non-invasive PPV (NIPPV) -- Invasive positive-pressure ventilation -- High frequency oscillatory (oscillation) ventilation (HFOV) -- Principles of HFOV (Table ) -- Ventilator-associated pneumonia -- Clinical indicators of VAP -- Interventions to minimise the incidence of VAP -- Extracorporeal membrane oxygenation -- Examples of ECMO indications -- Suctioning the artificial airway -- Weaning and extubation -- Preparation for extubation -- Upper airway conditions -- Croup -- Bacterial tracheitis -- Retropharyngeal abscess -- Epiglottitis -- Subglottic stenosis -- Other causes of stridor -- Lower respiratory tract conditions -- Bronchiolitis -- RSV infection -- Clinical assessment findings -- Asthma and status asthmaticus -- Cardiovascular effects -- Metabolic effects -- Pneumonia -- Aspiration pneumonia -- Acute respiratory distress syndrome -- Near-drowning -- Smoke inhalation -- Persistent pulmonary hypertension of the newborn (PPHN) -- Congenital diaphragmatic hernia -- Tracheomalacia/Bronchomalacia -- Intercostal drain insertion -- Conclusion -- References -- Chapter 5: Care of an Infant or Child with a Cardiac Condition or Disease -- Introduction -- Cardiac embryology -- Foetal circulation -- Brief overview of cardiac anatomy and physiology (Figure ) -- External structure of the heart -- The cardiac cycle -- Innervation of the heart -- Structure and function of cardiac muscle fibres -- Cardiac action potentials -- Regulation of cardiac action potentials -- Atrial systole (ventricular diastole) -- Isovolumetric contraction (first heart sound) -- Ejection (R-S-T).

Isovolumetric relaxation (end of T-wave to beginning of P-wave) -- Rapid filling phase (end of T-wave to beginning of P-wave) -- Diastasis (slow filling phase) -- Cardiac output -- Heart Rate -- Stroke Volume -- Cardiac assessment -- Physical inspection -- Auscultation -- Palpation -- Blood pressure assessment -- Additional assessment points -- Congenital heart disease -- Diagnosis of congenital heart disease -- Categorising cardiac lesions -- Common management strategies -- Prostaglandin -- Modified Blalock-Taussig (BT) shunt -- Glenn procedure -- Total caval pulmonary connection (TCPC) (Fontan procedure) -- Cardiopulmonary bypass -- Postoperative management of the child after open cardiac surgery -- Cardiovascular system -- Pulmonary hypertension -- Acyanotic heart lesions -- Atrial septal defect (ASD) -- Ventricular septal defect (VSD) -- Persistent ductus arteriosus (PDA) -- Atrio-ventricular septal defect (AVSD) -- Coarctation of the aorta -- Post-ductal and juxta-ductal coarctation of the aorta -- Aortic stenosis -- Cyanotic heart lesions -- Tetralogy of Fallot -- Tricuspid atresia -- Transposition of the great arteries (D-TGA) -- Truncus arteriosus -- Total anomalous pulmonary venous drainage (TAPVD) -- Hypoplastic left heart syndrome (HLHS) -- Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) -- ECLS for cardiac support -- Cardiovascular considerations -- Weaning from ECLS -- Rhythm disturbances and temporary pacing -- ECG (Figure ) -- Bradyarrhythmias -- Tachyarrhythmias -- Types of pacing mode -- Acquired heart disease -- Acute myocarditis -- Cardiomyopathy -- Hypertrophic cardiomyopathy (HCM) -- Restrictive cardiomyopathy -- Kawasaki disease -- Pharmacology (Appendix 1) -- Vasoactive drugs -- Volume and diuretics -- Anti-arrhythmic medications -- Circulatory failure -- Shock -- Compensatory mechanisms.

Uncompensated shock -- Cardiogenic shock -- Sepsis and multi-organ dysfunction -- Common causes of sepsis in children -- Myocardial dysfunction -- Endothelial injury and increased vascular permeability/capillary leak -- Disseminated intravascular coagulation -- Meningococcal disease -- Management of sepsis -- Current research studies -- Use of steroids -- Hyperglycaemic control -- Conclusion -- Appendix 5.1 A summary of vasoactive drugs, the adrenergic receptor stimulated the physiological response and side-effects -- References -- Chapter 6: Care of the Infant or Child in Renal Failure -- Introduction -- Terminology -- Anatomy and physiology of the kidney -- Renal pathology (Table ) -- Prerenal -- Intrinsic -- Postrenal (obstructive) -- Signs of acute kidney injury and useful tests in children -- Acute treatment (Table ) -- Restoration of circulating volume -- Prevention of complications -- Renal protection measures -- Drug metabolism and excretion -- Practical drug dosing -- Long-term follow-up -- Specific renal diseases that may present in PICU -- Haemolytic uraemic syndrome (HUS) -- Nephrotic syndrome -- Hepatorenal syndrome -- Tumour lysis syndrome (TLS) -- Transplant -- Renal replacement therapies -- Acronyms -- Peritoneal dialysis -- Continuous venous-venous filtration and haemodialysis (CVVH and CVVHDF) (Figure and Figure ) -- Intermittent haemodialysis -- Conclusion -- References -- Chapter 7: Care of the Infant or Child with Acute Neurological Dysfunction -- Introduction -- Embryological development of the neurological system -- Brief overview of neuroanatomy and physiology -- The meninges -- Spinal anaesthesia -- Epidural anaesthesia -- The ventricles -- Cerebrospinal fluid (CSF) -- Cranial nerves -- The brain -- The blood-brain barrier -- Neurological assessment -- Central nervous system infections -- Bacterial meningitis.

Viral meningitis.