Critical care for children in a district general hospital: a review of the caseload and outcomes

Intensivists and anaesthetists working in district general hospitals have an important role to play in the management of critically ill children. The ability to maintain the skills needed for paediatric resuscitation and stabilisation will partly depend upon clinical exposure to paediatric cases. However, the centralisation of paediatric services and the expansion of critical care services are likely to have reduced the paediatric caseload for many clinicians. We undertook a review of paediatric cases referred to the Department of Critical Care at the Queen Alexandra Hospital, Portsmouth to determine the caseload for both the service and individual consultants. The caseload for individual consultants was relatively low (an average of eight cases per consultant over 12 months) and highlights the challenge facing clinicians in district general hospitals who need to maintain their expertise in managing critically ill children.