Pediatrics Intensive Care protocall AIIMS

One of the most remarkable advances in the care of children in India has been the introduction of intensive care. Emergency rooms existed in all pediatric units where immediate care was provided to sick infants and children. However, it was realized that full ime in-ICU staffing and patient care will result in improved outcomes for critically ill pediatric patients. The first unit to be set up in this frontier area in India was at the All India Institute of Medical Sciences in Delhi in the 1980s. Initially the pediatric staff had to learr intubation from the anesthesiologists, but practice soon made them even more skillful in resuscitation procedures than their mentors. A review of the functioning of this intensive care unit a few months later effectively demonstrated that many more lives were saved which would otherwise have been lost. Experts abroad have argued that countries with under-5 mortality rates above 40 or so should spend more money on primary care to reduce infant and child mortality rather than establish intensive care units which admittedly are costly.I have always believed this argument to be fallacious, simply because every child who is ill deserves the best care that can be provided according to the local resources. Moreover, in the cities in India the infant mortality and under-5 mortality rates are sufficiently low that it is desirable to establish intensive care units It is well recognized that a protocol-based approach is of great help in improving the care of an acutely ill child. We at the Indian Journal of Pediatrics felt that it would be advantageous to present the protocols that had been evolved through years of experience and research at the AllMS. Professor Kabra and his colleagues have succeeded admirably in putting together the protocols used in Indian pediatric intensive care units. These have been designed to be used both as a source of readily accessible information and as a concise yet comprehensive summary of current knowledge and