Respiratory Surge in Children - elearning for healthcare
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This programme is in partnership with...
  • Health Education England_New logo 2021
  • NHSI-partner
  • Paediatric Critical Care Society
  • London Transformation and Learning Collaborative

About the Respiratory Surge in Children programme

Our aim
The Respiratory Surge in Children Programme is designed to support the cross-skilling of the NHS workforce to manage:

  • existing demand in children
  • potential future spikes in paediatric demand as a result of respiratory syncytial virus (RSV) and other respiratory illnesses in children
  • longer-term increasing paediatric acuity and demand in children

The resources are aimed at healthcare staff working in the various settings where a child will present with respiratory illness, including home, primary and community care, and across the acute hospital environment. Within the skills matrix (below) and educational resources on this page, the term child is used to represent infant, child and young person.

Update on the Respiratory Surge in Children Programme – Webinar

This 40 minute webinar, recorded on the 17 November 2021, provides an overview of the key updates to the Respiratory Surge in Children programme since its launch in September 2021. It includes a showcase of new resources, plans for the skills matrix and an audience Q&A. You can also download the slides as a PDF (8,750KB).

  • Alignment to paediatric standards and competencies
  • Our approach

    The programme is led by users, with both the systems and future learners actively involved in every stage, from development to delivery. We are working with Paediatric Critical Care Society (PCCS) and the Paediatric Critcal Care Operational Delivery Networks (ODNs) to ensure we are responsive to different needs across the nation.

    Respiratory Surge in Children programme approach

    Our aim will be achieved through 4 key phases, supported by robust governance and assurance:

    1. Understand
      – Care standards and competency frameworks (e.g. RCPCH, RCN / NMC)
    2. Develop
      – Co-development of an interprofessional skills matrix that summarises key skills required for different levels of care, with mapped educational resources
      – Curation of existing educational resources for learners, trainers and systems onto this elfh microsite, for different levels of care and settings where children are cared for
      – Co-design of a national digital skills passport
    3. Deliver
      – Dissemination of educational resources and digital skills passport at a national level
    4. Refine
      – Implementation of a feedback mechanism, to enable continued refinement

How to use the Respiratory Surge in Children programme:

Step 1: Explore the multimedia resources by using:

Step 2: Complete learning at your own pace

Step 3: Tell your colleagues about the programme with this downloadable poster / PDF

Step 4: Feedback and tell us what you think of the programme by completing this short evaluation survey

Or scan the QR code

  • Current updates in progress

    Completed in update 17 November 2021:

    • New Pulse Oximetry resources added in Domain 1
    • New Rapid Access Lists launched for quick, guided access to resources
    • New Simulation Training video for physiotherapists
    • New CPAP competencies added to Educator Resources

    Current updates in progress / ongoing work includes:

    • Refinement of existing resources
    • Development of pharmacy specific resources
    • We are still seeking further input to develop learning objectives for community settings
    • Ongoing review of the matrix by colleagues from various professional areas, including AHPs, ODPs, pharmacists and community teams and decisions about how to utilise the matrix effectively.
  • Add this programme to your phone home screen for quick access

    You can add this programme page on your phone by accessing your browser settings or share settings and selecting “Add to Home Screen”. Please note steps vary between devices. On an iPhone tap the “share” icon  and then “Add to home screen”.

Searchable index for Respiratory Surge in Children resources

The searchable index has been developed by mapping the Respiratory Surge programme’s educational content to learning objectives and skills, by domain and by level of paediatric care.

Its searchable functionality allows users to quickly find and access relevant content on the programme by:

  • Keywords, resource titles and topics
  • Duration
  • Content types (e.g. text, video, audio)
  • Future updates

    This tool is currently under active development and additional functionalities will be added in the coming weeks to allow users to filter by:

    • Learning objective
    • Staff role
    • Care level

    Users will also have the ability to save and sort their filtered lists.

    If you have any suggestions or feedback about the skills matrix, please email:

  • Add the searchable index to your phone home screen for quick access

    You can add the searchable index web app to your phone home screen by opening it on your phone, accessing browser settings/share settings and selecting “Add to Home Screen”. Please note steps vary between devices and browsers. On an iPhone tap the “share” icon  and then “Add to home screen”.

Rapid Access Resource lists

These lists have been designed as quick introductions to the content in the Respiratory Surge in Children programme. Each list is designed to take no longer than 2 hours to complete, and some also have additional “Extension learning” should you feel you want to push yourself further. They are PDFs with hyperlinks to resources on the elfh Hub, so you will need to be logged in to access them. If you have not already registered on elfh, you can find guidance on how to do so at the bottom of this page. In addition to these available lists, we have further lists in development. If you have suggestions for further rapid access lists, or have created ones of your own you would like to share with others, please contact the team on

Overarching resources

This section includes:

  • Resources addressing topics which are relevant across the 6 domains listed below. Examples include infection prevent control (IPC)
  • Resources that address multiple domain topics and provide context as to why they are important. Examples include the RCPCH special webinar on bronchiolitis

1. Recognition, management and escalation: care of the sick child

This domain provides resources that enable healthcare providers and carers across all settings to use a systematic approach to identify deteriorating infants and children. Children with respiratory or circulatory failure become hypoxic and acidotic. Early recognition and treatment of respiratory and circulatory failure can prevent progression to severe illness.

2. The care and management of the child with respiratory illness

This domain outlines the pathophysiology, signs and symptoms, and recommended treatment for children with respiratory disease being cared for in various settings including viral bronchiolitis. Most cases of viral bronchiolitis are due to respiratory syncytial virus (RSV). While self-limiting, bronchiolitis can be life-threatening in infants who were premature or have underlying respiratory, cardiac, neuromuscular or immunological conditions.

3. High flow / High velocity oxygen therapy

High flow / High velocity heated and humidified oxygen therapy is being increasingly used as treatment for children with respiratory illness. This therapy delivers oxygen through the nasal passages at higher rates than is achieved through standard nasal oxygen. This domain provides information on the theory, existing evidence, and practice of using high flow / high velocity oxygen therapy. It also includes videos describing set up of 3 high flow delivery systems.

There are multiple, widely used abbreviations for High Flow Therapy or High Velocity Therapy, with little consensus. For clarification, the Respiratory Surge in Children programme refers to these devices as “High Flow/ High Velocity Therapy” to encompass the wide range including specialist devices and ventilators that can provide this support. All can be used with or without oxygen. You may also see these devices referred to as Heated Humidified High Flow therapy (HHHFT), High Flow Oxygen Therapy (HFOT), High Flow Nasal Cannula (HFNC) or simply High Flow. These are all referring to same devices, unless otherwise stated.

EQUIPMENT GUIDES: We are in the process of adding high flow / high velocity oxygen to our LTLC Equipment Guide (requires elfh Hub login to view). This mobile friendly web app allows the user to rapidly access quick guides, manuals, and training videos for most of the equipment used in critical care units. Please explore it and let us know of any equipment we should add by emailing

  • Resources

    We are continuing to build this site and more resources will be added in the coming days and weeks (please share any relevant content you have with

    Each resource title includes its duration to complete, and we have split resources into a ‘At a glance’ (≤5 mins), ‘Bitesize learning’ (5-30 mins) and ‘Time to think’ (>30 mins).

4. Medicines management and differences between child and adult

This domain provides guides to support safe management of medications for sick children, including opportunities to practice calculations. This is relevant for both paediatric and adult trained staff across a variety of settings.

It also includes essential information on physical and psychological differences between adults and children, and critical variations in physiology which are important to understand in all contexts, including when prescribing.

5. Family centred care

Family centred care is central to the provision of healthcare for any child in the UK. This domain describes how family centred care is practiced, what this means for those providing care, and essential communication techniques when working with a hospitalised child and their family. This section also explores key information about safely discharging patients, safety netting and approaching conversations about the COVID-19 vaccination in pregnancy.

6. Emergency advanced stabilisation and transfer

All children’s acute care providers must be able to appropriately assess, treat, stabilise and escalate all critically ill children, including those requiring transfer, to a level 3 unit internally or externally. This domain includes resources to support safe delivery of advanced stabilisation of the critically ill child, covering recognition, monitoring, treatment, escalation and use of transfer equipment.

7. Wellbeing and Staff Recovery Resources

During patient surges staff may need to flex to support different areas. We have learnt from other surges that the better prepared staff are in advance, the easier this is physically, emotionally and mentally.

It is important we check in with each other regularly, so these resources are designed to help us all have honest conversations, de-fuse and connect with colleagues. Not all people approach wellbeing by the same means; these resources acknowledge those differences and cover a variety of approaches.

Staff Recovery Resources page

The Royal College of Paediatrics and Child Health (RCPCH) have collated wellbeing materials from across the country which can be accessed here.

Educator Resources

This domain provides resources for educators and trainers to use in the local workplace. These include competency documents, guidelines, simulation scenarios, and presentation slide decks. They cover a wide variety of topics relating to the respiratory surge in children programme. Feel free to use them as they are or to inform and inspire your own resources. N.B. it is good practice and polite to retain the acknowledgements of the original authors who have shared these with us, so please do so.

We are still collating and creating resources and would appreciate you sharing any relevant resources; feedback on the resources already available is also most welcome (please see the ‘How to give your feedback’ section below).

Share your resources and feedback

Your feedback will help us to better understand and address the needs and demands of the NHS workforce during the respiratory surge. Please complete our short evaluation survey. This should take around 5-10 minutes to complete, with the option to provide further feedback at the end.

  • How your feedback will be used

    This is an anonymous questionnaire and all responses will be stored securely by Health Education England. We are not collecting personal data, and this questionnaire is not linked to your elfh profile so you will not be able to be identified. By submitting the evaluation form, you are consenting to HEE elfh using your feedback to inform the development of its elearning programmes.

  • Other comments, feedback and resource suggestions

    If you have any paediatric educational resources that would benefit other colleagues accessing the programme, please email Author recognition will be given.

    We also welcome any additional comments or feedback to improve the programme.

How to access

In order to access the Respiratory Surge in Children programme, you will need an elfh account. If you do not have one, then you can register by selecting the Register button below.

Register >

To view the Respiratory Surge in Children programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

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Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Respiratory Surge in Children programme, please contact elfh directly.

More information

Please select the following link for more information on how to use the elfh Hub.

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