This paper describes a Delphi study used to identify and improve areas of c
oncern in the planning of care for children in major incidents. The Delphi
was conducted over three rounds and used a multidisciplinary panel of 22 ex
perts. Experts were selected to include major incident, immediate care, eme
rgency medicine, and paediatric specialists. This paper presents a series o
f consensus statements that represent the Delphi group's opinion on the man
agement of children in major incidents. The statements cover all phases of
major incident planning and response. Paediatric services may play a vital
role in the preparation and response to a major incident involving children
. This paper represents a consensus view on how best to plan and respond to
major incidents involving children. An accompanying paper describes the pr
actical implementation of this guidance.