Table 2.

Compliance with the UK Paediatric Intensive Care Society consensus guidelines

Recommendation from 2006 consensus guidelines	Compliance within the observed PICUs
Pain assessment should be performed regularly by using a pain scale appropriate for patient age	In 87 % of PICUs pain is formally assessed and scored
The level of sedation should be regularly assessed using a validated sedation assessment score e.g. COMFORT score	83 % of PICUs use a validated tool, but compliance with regular assessment is low. 8 % of PICUs use a protocol to titrate according to sedation score
The desired level of sedation should be identified for each patient and should be regularly reassessed
Dosage of sedatives should be titrated to produce the desired sedation level
The use of clinical guidelines for sedation is recommended	30 % of PICUs have sedation guidelines
The potential for opioid and benzodiazepine withdrawal syndrome should be considered after 7 days of continuous therapy. When subsequently discontinued the doses of these drugs may need to be tapered.	48 % of PICUs assess withdrawal syndrome
Whenever it is safe to do so, continuous infusions of neuromuscular blockade should be discontinued at least 24-hourly until spontaneous movement returns	22 % of the units very confident this was done daily, 95 % said they tried to do this daily

PICU Paediatric Intensive Care Unit