Table 2 Compliance with the UK Paediatric Intensive Care Society consensus guidelines

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