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As many as three out of five children in the pediatric intensive care unit (PICU) develop delirium. Routine monitoring for delirium, pain, agitation, and withdrawal while instituting an interdisciplinary, multiprofessional model of care is vital to ensuring the best care and outcomes. The ICU Liberation Campaign is expanding to offer more resources for treating children and infants.
One of the pillars of these resources is the 2022 SCCM Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility (PANDEM).
The PANDEM guidelines for children and infants were published in the February 2022 issue of Pediatric Critical Care Medicine. Many of the concepts in the PANDEM guidelines reflect the goals of SCCM's ICU Liberation Campaign, including adequately treating pain, thoughtfully determining sedation medications, assessing for and treating delirium, promoting early mobility, and engaging families in the care of their loved one.
The guidelines contain 44 recommendations based on the best available evidence, featuring management strategies such as enhanced use of protocolized sedation and analgesia in addition to nonpharmacologic interventions and family involvement strategies to make the patient as comfortable as possible and improve outcomes.
 | Critcal Connections Blog: SCCM Releases PANDEM Guidelines for Critically Ill Children and Infants |
 | Pediatric Critical Care Medicine: Caring for Critically Ill Children With the ICU Liberation Bundle (ABCDEF): Results of the Pediatric Collaborative |
 | The ICU Liberation Bundle (A-F) for pediatric patients is included in Epic and Cerner electronic health records. |
Heidi A.B. Smith, MD, MSCI, shares insight into the PANDEM guidelines for children and infants and how recommendations relate to the ICU Liberation Campaign.
John W. Berkenbosch, MD, FAAP, FCCM, cochair of the guidelines committee, shares the top practices from the PANDEM guidelines for children and infants.
The ICU Liberation Implementation Toolkit provides adult and pediatric critical care teams with a variety of resources to champion and sustain bundle implementation. The toolkit contains:
