COVID-19 - guidance for acute settings

This page signposts to guidance and other resources to support members working in acute paediatric services during the current remobilisation phase of the COVID-19 pandemic in the UK.
Last modified
2 December 2020

Clinical management of COVID-19 in children in acute settings

  • Guidance has been produced with the British Paediatric Respiratory Society and the British Paediatric Allergy, Immunity and Infection Group on the clinical management of children admitted to hospital with suspected COVID-19. It is aimed at general paediatricians treating children during the COVID-19 pandemic. It covers medical management of paediatric patients, including advice on use of antiviral treatments.
  • NICE has published a range of guidance on COVID-19
  • Experts at the RCPCH have produced a  statement on anti-inflammatory medicines and COVID-19 This recommends that parents treat symptoms of fever or pain related to COVID-19 with either paracetamol or ibuprofen as there is currently insufficient evidence to establish a link between the use of ibuprofen and contracting or worsening of COVID-19.
  • This data collection guidance provides advice for paediatricians and health professionals on how to accurately collect and record data on patients with suspected or confirmed cases of COVID-19 using existing surveillance and data collection sources.

Paediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19 (PIMS-TS)

RCPCH has published guidance on paediatric multisystem inflammatory syndrome temporally associated with COVID-19. This document for clinicians, which has been developed after expert review of the cases, includes a case definition and approach to clinical management.

Critical care and intensive care

The Paediatric Critical Care Society provides a range of resources for critical care and intensive care.

The Faculty of Intensive Care Medicine, Intensive Care Society, Association of Anaesthetists and Royal College of Anaesthetists have developed a website to provide information, guidance and resources on understanding of and management of COVID-19 for the UK intensive care and anaesthetic community.

Resuscitation Guidance

This guidance produced with Resuscitation Council UK describes general principles and action to be taken for paediatric resuscitation during the COVID-19 pandemic. FAQs linked to specific situations are also discussed.

Paediatric resuscitation scenarios are described here

Specialty guidance

Many specialty groups have issued advice and guidance around COVID-19: 

Ethics framework for acute paediatric services

This ethical framework – for situations where there is extremely high demand and limited critical care capacity - is a modification of guidance developed for treatment decisions relating to adults. The principles relating to decisions for children in the setting of the pandemic are the same as those for adults. The framework emphasises that decisions should be ethically consistent and apply to patients both with COVID-related and non-COVID related illness.

Recovery of elective surgery in children

The College has published national guidance to support the recovery of paediatric elective surgery.

Management of children with bronchiolitis and lower respiratory tract infections during COVID-19

The College has published recommendations on the management of children with bronchiolitis and lower respiratory tract infections in hospital settings during COVID-19. This guidance is for clinicians to support winter planning in partnership with local infection control prevention teams.

Management of children with tracheostomies and those on long-term ventilation during COVID-19

The British Paediatric Respiratory Society (BPRS) has issued clinical and operational guidance, supported by RCPCH, for clinical teams managing paediatric patients who are:

  • On long-term ventilation (LTV) both at home some of whom are supported by a home-based care package and also those awaiting discharge on long term ventilation units.  
  • Children with tracheostomies who do not require ventilation some of whom may have care packages.

The College has worked with BPRS to develop this advice and guidance. It is aimed at clinicians and others involved in the care of these patient groups during the COVID-19 pandemic. It is based on good practice, experience and PHE infection prevention and control advice for healthcare settings. It provides advice on access to schools, respite and outpatient departments when the child is well without any suspicion of COVID-19. 

We note that these children may be cared for in a range of different locations/settings, and that other guidance and advice has been published for specific settings and circumstances across the UK. Our advice is offered to support management decisions for this group of patients, and their individual risk assessments during periods of health (when at home and at school) and also when children are unwell, and when they require acute admission.  

Winter pressures - good practice resources for Emergency Departments

Winter pressures in emergency departments are familiar. The prospect of delivering emergency care through a winter season during the COVID-19 pandemic presents an extra challenge. These resources outline a range of good practice ideas that may help and support members tackling these issues this winter. 

Further guidance is available from the Royal College of Emergency Medicine.

Children and young people who are clinically extremely vulnerable

The College has worked with specialty groups to develop guidance on those paediatric patient groups who are clinically extremely vulnerable and at very high risk of severe illness from coming into contact with COVID-19. The guidance identifies those children and young people most at risk.  

Further resources

Infection prevention and control: UK-wide guidance on infection prevention and control for remobilisation of services has been issued jointly by the Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS)/National Services Scotland, Public Health England (PHE) and NHS England as official guidance.

Latest updates to this page

Updates in this version (20 November 2020)

  • Section added on Management of children with tracheostomies and those on long-term ventilation during COVID-19. 

Updates in version 27 October 2020

  • Information updated to reflect the current remobilisation phase of the COVID-19 pandemic in the UK

Updates in version 18 June 2020

Updates in version published 4 May:

  • Added link to Health Protection Scotland checklist designed for the control of incidents and outbreak in healthcare settings 
  • Updated link to NHS England reference guide for emergency care settings