Psychological Aspects of Care of the Critically Ill Child

Recent improvements in mortality rates in pediatric intensive care have led to an increasing focus on the physical and psychological morbidity of pediatric patients. In this review, guidance on the acute psychological management of children, during and shortly after their intensive care treatment, is provided. This is informed by the current state of knowledge regarding the nature of children's experiences of intensive care and the expanding literature on their subsequent psychological symptoms. The relevance to pediatric settings of the current debate about the significance of delirium, and other recent research and guidance regarding the management of psychological issues in adult intensive care settings, is considered. The importance of distinguishing between children's self-report and parents' proxy report is also discussed in relation to establishing the causes of the child's distress in this situation and suggestions are made of ways to help children better understand what has happened to them.