Any time children are admitted to the hospital, it can be a frightening experience - maybe even more so when they're admitted to the pediatric intensive care unit (PICU). But with some basic understanding of the people and equipment in the PICU, you can minimize your fears and be better prepared to help your child recover.
What's the PICU?
The PICU is the section of the hospital that provides sick children with the highest level of medical care. It differs from other parts of the hospital, like the general medical floors or the emergency department, in that the PICU allows close monitoring of bodily functions and conditions (heart rate, breathing, and blood pressure, for example). The PICU also allows medical staff to provide therapies that might not be available in other parts of the hospital. Some of these more intensive therapies include ventilators, or breathing machines, and certain medications that can be given only under close medical supervision.
Who's Sent to the PICU?
Any child who's seriously ill and needs intensive care and whose medical needs can't be met in the hospital's main medical floor goes to the PICU.
Some examples of patients in the PICU include those who may have severe breathing problems from asthma or pneumonia, meningitis, serious heart defects, certain complications of diabetes, or children who have been involved in a serious automobile accident or near-drowning. These children may have been stable enough to initially be cared for on the hospital's main medical floor, but may be transferred to the PICU if they become more acutely ill. Following major surgery, many children are cared for in the PICU for several days.
Kids are admitted to the PICU when they're at their sickest. Depending on the severity of the illness, the amount of time spent in the PICU is addressed on an individual basis - some children might stay a single day; others might need to stay for weeks or even months. As always, ask the doctor or nurse caring for your child if you have any questions.
Who Takes Care of Kids in the PICU?
One of the biggest advantages of the PICU is that there are many highly skilled people to closely care for your child. But not knowing who everyone is and what they do can be confusing and a little overwhelming at first. Most people will introduce themselves and indicate how they're involved in your child's care, but if they don't, feel free to ask.
The nurses who work in the PICU are experienced in caring for the sickest children in the hospital. They're the individuals most intimately involved with the minute-to-minute care of the child. At all times, you should feel comfortable asking the doctors and nurses questions about your child and the care that's being given. Another advantage of the PICU is that it tends to have a higher nurse-to-patient ratio than other parts of the hospital (in other words, there are more nurses to tend to your child).
There may be numerous physicians caring for your child, but the attending intensivist is the leader in the PICU. A pediatric intensivist is a doctor who did a 3-year residency in pediatrics after medical school, then furthered his or her training by doing additional years of subspecialty fellowship training in intensive care. Also part of the PICU team are residents (doctors who've completed medical school and are training to be pediatricians), as well as PICU fellows (pediatricians training to be attending intensivists).
Many other subspecialists such as cardiologists or neurosurgeons may also be involved, depending on the needs of your child. Respiratory therapists are experienced with ventilators and other breathing equipment, and are also often involved in the care of PICU patients. In addition, you may meet physical therapists, occupational therapists, nutritionists, and pharmacists who also may play a role in the care of your child.
You may also meet social workers who are available to assist in helping families cope with the emotional burdens of having a critically ill child. They may also help to arrange housing for families (through organizations like Ronald McDonald House), assist with insurance issues, or coordinate discharge planning for when the child is ready to go home.
Usually in the morning, the medical team meets as a group to individually discuss each child in detail; these discussions are known as rounds. You may see a group of doctors, nurses, and others walking from patient to patient, planning the medical care for each child. By knowing everyone's role, and understanding how everyone contributes, the number of people caring for your child will likely seem less intimidating.
