The psychological impact (second victim effect) of in-theatre critical incidents is increasingly recognised. Different styles of psychological support programme have recently been published, including some utilising ‘near in time’ peer support. Most of these programmes either target their support to individuals, or focus on one vocational group rather than the multidisciplinary team. However, the in-theatre team consists of different craft groups who nonetheless function as a single team and are therefore ‘peers’. This paper sets out the design and implementation of a critical incident peer response programme at Waikato Hospital, New Zealand, which provides peer-led group psychological first aid to full theatre teams. The programme is administered by trained representatives from multiple in-theatre craft groups including nurses, midwives, anaesthetic technicians, recovery room nurses, surgeons and anaesthetists. It emphasises team education and peer support, and has a wholly welfare focus. The programme has voluntary participation but mandatory activation triggers so that individuals do not need to seek support actively at a time when they may not recognise the need to do so. The programme is becoming embedded in the Waikato Hospital theatre culture so that participating in psychological support is normalised following a critical event. This framework is shared in the hope that it will assist other hospitals to develop welfare interventions to support full theatre teams.

We present the case of a 5-year-old boy who developed a delayed onset intractable hyperventilation following endoscopic third ventriculostomy. The proposed aetiology of this exceptionally rare phenomenon is discussed. To our knowledge, previous cases have only been reported in the adult population.