Challenges in pediatric cardiac emergency care amid nursing and resource shortages in Germany

Abstract

Objectives: Pediatric cardiac emergency care in Germany faces critical challenges due to ICU bed shortages, rigid healthcare policies, and nursing workforce deficits. The strict adherence to the Paediatric Cardiac Surgery Directive (PCSD) often prevents critically ill children from receiving timely life-saving interventions, as policies restrict their admission to adult intensive care units (AICUs), even in urgent situations. Study design: comparative cross-national report. Methods: This study employs a comparative approach, analyzing pediatric cardiac care models in the United Kingdom, New Zealand, and Australia. These countries have implemented flexible, interdisciplinary strategies to address ICU capacity issues, ensuring critically ill children receive timely surgical and postoperative care. Literature from PubMed and national healthcare policy frameworks were reviewed to assess their applicability to Germany. Results: Findings indicate that integrating pediatric and adult intensive care services, along with flexible policy adaptations, can improve emergency care accessibility. International models emphasize interdisciplinary collaboration, specialized training for adult ICU staff, and structured transitional care for pediatric cardiac patients. Conclusions: Policy adaptations are required in the German healthcare system to enhance pediatric cardiac emergency care. Implementing flexible ICU admission protocols, cross-disciplinary training, and optimizing resource allocation can bridge critical gaps. A modernized, patient-centered approach is essential to ensuring equitable and timely access to life-saving pediatric cardiac interventions.