N. J. Marsden, University Hospitals Birmingham, UK


The Queen Elizabeth Hospital Birmingham (QEHB) does not routinely see and treat paediatric patients, however staff may be required to support unwell paediatric patients that present to the Emergency Department or are incidentally on-site. Maintaining skills and training in paediatric emergencies is vital to ensure that trainees feel equipped to deal with scenarios that may present themselves when there is limited resources and experience in the management of paediatric emergencies.

In such instances, Anaesthetics and Intensive Care Medicine trainees form part of the emergency team required to respond. Following an incident in 2022, it transpired that these trainees may be the only team members with any recent paediatric experience. Anaesthetic stage 2 and 3 trainees will rotate through Birmingham Children’s Hospital for a minimum of three months, and have experience of managing sick children.

Using trainees who had recently completed their paediatric rotations, we designed a pilot half-day course of simulation training coupled with tutorials on the management of paediatric emergencies. The aim of the project being to reinforce knowledge and training within the trainee group most likely to respond to, and lead the team during, paediatric emergencies.



A half-day course designed for stage 2 and 3 Anaesthetic trainees without recent paediatric experience.


  1. Management of asthma/respiratory illness
  2. Management of sepsis
  3. Traumatic injury/haemorrhage
  4. Collapsed child/BLS/ALS

All scenarios used the quick reference handbook as a resource available throughout the scenario, along with electronic access to resuscitation council guidelines as appropriate.

The scenarios were debriefed by faculty who were experienced in appropriate techniques and who had undertaken formal debrief training.

Measuring impact:

Formal feedback from candidates about the structure and content of the course



The pilot course aimed to identify whether it was useful to run paediatric simulation in a centre that rarely sees paediatric patients.

100% of attendees felt that the course improves their understanding of paediatric emergencies.

100% of attendees felt that their confidence in managing paediatric patients was improved

90% of trainees feel that they would be comfortable leading a paediatric emergency in a non-paediatric centre

100% of attendees found the structure of the course suited their educational requirements


Although paediatric patients are not routinely encountered at QEHB, there have been instances where they require medical attention when on site. Running a course that uses simulated scenarios covering paediatric emergencies, with appropriately trained and experienced faculty, alongside resources that are intended for use in such scenarios, seems to provide an appropriate introduction to the management of paediatric emergencies. The use of trainees as trainers allowed for easier course design, however input from more experienced clinicians would be helpful in the future.

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