• History
• children
• emergencies
• developing countries

Few experiences in life match the exhilaration and terror

that accompany the emergency management of

a critically ill child.

The initial resuscitation usually occurs in a

tumultuous, chaotic and high charged atmosphere

in which there is little time to think or to deliberate

on the management options.

Success is dependent on a team approach

utilising well rehearsed, systematic

management protocols that can be implemented within

the golden hour of presentation

Editorial Team 1991

The Golden Hour

The Handbook of Advanced Paediatric Life Support

John Hopkin's Hospital1

At times of life-threatening crisis and great anxiety, the question of a parent or guardian is simple, yet the answer is so important: “Will my child live?”

It is not an easy question to ask and so it may be phrased differently—“Is he going to be OK?” “Is he alright?” or hope expressed in a statement pleading for confirmation “He will be OK won't he?”

I speak of the critically ill or injured child with a potentially life-threatening problem.

Let us look at what influences the answer to that heartfelt cry “will my child live” and the background to some of the medical interventions used and how as children's doctors we have developed a response to the critically ill child. Let us look at the child and how his background health and welfare may influence the outcome as well as the community's response and responsibility to a sick or injured child and how together we may respond to the challenge of very sick children and improve their outcome.

Resuscitation measures have been tried throughout history. They were logical within the understanding of that time, but to us now, they appear bizarre, sometimes frankly brutal and unlikely to succeed. The first recorded attempt at reviving a person was a child, and it was …