you are trained to deal with the potential consequences of their illness, including intubation, ventilation, seizure management, cardiac arrest and a whole host of other unpleasant situations. It is scary, and not nearly as much fun as it sounds. Lastly, the gold standard for transfer for PICU/PHDU is by retrieval team, unless the transfer is time-critical (associated intracerebral bleed requiring urgent neurosurgery, for example). This is either available to you or it isn't -- so I'm going to take the opportunity to big-up the fabulous NEWTS team . Having spent the last three months working (and training) alongside these guys, I can see why this standard exists; not only are they highly skilled in looking after sick kids, they also set up infusions etc. in the way they will run in PICU, making transfer of care much smoother. They are brilliant; but don't call NEWTS (unless you are working in the North West/North Wales); find out about your local service and use them. OK, got it! So what now? Well, you've got the basics of "gold standard care". But what is your department actually doing? How are your ED team performing? It's a perfect time to get out there and audit; identify the weaknesses and take steps to fortify them. And from NICE? Look out for more quality standards coming your way ; of interest to the ED: upper GI bleeding, asthma, and just for Dan -- thromboembolic disease. I can hardly wait! Share this: This is great as it