These clinical paediatric palliative care guidelines were developed by the Shaping the Future of Paediatric Palliative Care Project, PaPCANZ in partnership with New Zealand Paediatric Palliative Care Clinical Network (PSNZ). They have been adapted with approval from the PSNZ New Zealand Paediatric Palliative Care Clinical Network Clinical Guidelines.

They are written for health care professionals who provide care to children with life-limiting diagnoses. They are intended to inform clinical practice through concise best practice advice. Please contact your Paediatric Palliative Care Service for further advice.Please read our disclaimer

The guidelines focus on three areas that present the greatest difficulties in paediatric palliative care:

Agitation – management in the palliative paediatric patient

Agitation or irritability is used to describe unpleasant psychological and physical arousal, often in circumstances in which the underlying aetiology remains unclear. It refers to a complex set of symptoms and signs that are distressing to the patient, their family and caregivers. Agitation and irritability may consist of psychological symptoms, physical symptoms and autonomic changes.  Click here to read

Breathlessness – management in the palliative paediatric patient

Breathlessness is described as the subjective feeling of disturbed or difficulty with breathing. It can also be called dyspnoea or shortness of breath and is relatively common in children with life-limiting conditions. This symptom frequently occurs alongside other symptoms and is commonly associated with anxiety for the child and family. It often requires rapid and assertive management. Click here to read

Sharing significant news about end of life in paediatrics

Significant news about end of life is information which seriously impacts the family/child’s understanding of their future. It is shared with the family and, where appropriate, the child, to support them to explore care options and make decisions with the care team.  Click here to read

Each section provides immediately applicable guidelines that work across diverse healthcare settings.

Information contained in the clinical guidelines include: 

• Goals of management  
• Practice principles 
• Causes and provoking factors 
• Clinical features 
• Recommendations pharmacological management  
• Non-pharmacological management 
• Dosing information