Table 3 ‘Green lights’ for considering a child eligible for paediatric palliative care^a

- Child with a new life-threatening or life-limiting illness diagnosis

- Difficult pain management or other symptoms

- Three or more urgent hospitalisations for serious clinical crises over a period of 6 months

- Prolonged hospitalisation (over 3 weeks) without evidence of clinical improvement

- Prolonged admission to intensive care (over 1 week) without evidence of clinical improvement

- Fitting of invasive medical devices (e.g., tracheostomy)

- Child and/or family with complex psychosocial needs, limited social support or both

- Child assisted by more than three specialised services, with potential interdisciplinary communication difficulties

- Child with difficult and complex management of care handover between the hospital setting and the home

- Child and/or family obliged to make difficult and significant decisions

- Difficulties in achieving consensus between child, family and medical team on treatment and illness management goals (e.g., resuscitation actions, use of parenteral nutrition/IV hydration or continuation of chemotherapy in the terminal stages)

- Child and/or family experiencing difficulty making decisions concerning resuscitation actions

- Ethical debates about palliative care expressed by the child, family or medical team

- Needs for continuous medical support or medical devices or frequent laboratory services by home care services if these facilities are not readily available within the primary care territorial resources

- The prospect of complex outcomes in case of survival, such as a serious toxicity condition from long-term therapy

- The prospect of complex needs during the mourning period