What are the indications for advanced paediatric life support interventions in primary care settings?

In primary care settings, advanced paediatric life support (APLS) interventions are indicated when a child presents with symptoms or signs suggestive of an immediately life-threatening illness requiring urgent emergency medical care. This includes children with any 'red' features indicating severe illness or those with clinical signs of life-threatening conditions who need immediate referral and intervention, typically via emergency ambulance services.

Specifically, children with 'red' features but not immediately life-threatening illness should be urgently assessed by a paediatric specialist, while those with amber features require careful monitoring and safety-netting advice. The presence of life-threatening features mandates immediate emergency response and initiation of advanced life support measures as appropriate.

In addition, children with life-limiting conditions who are approaching the end of life and are cared for at home may require advanced interventions such as oxygen therapy, enteral nutrition, and subcutaneous or intravenous therapies, including parenteral drug administration (e.g., continuous subcutaneous opioid or anticonvulsant infusions). These interventions should be supported by specialist paediatric palliative care advice and services available 24/7.