What is the PICU?
The area of the hospital where unwell children receive the best possible medical attention is called the Pediatric Intensive Care Unit (PICU). Other areas of the hospital, such as the general medical floors, are different from it. Children get careful monitoring of their heart rate, respiration, and blood pressure as well as extensive nurse care in the PICU.
Additionally, the PICU enables medical personnel to administer treatments that would not be offered in other areas of the hospital. Breathing equipment (ventilators) and medications that should only be used under careful medical supervision can be examples of these.
Who’s sent to the PICU?
Children who require intense care and have urgent medical demands that cannot be fulfilled on the hospital’s main medical floors are admitted to the pediatric intensive care unit (PICU). This can include children who have severe asthmatic breathing issues, life-threatening illnesses, certain diabetic complications, or who have been in terrible car accidents or have come dangerously close to drowning.
When children grow more seriously unwell, they may occasionally be transferred from the medical-surgical floors of the hospital to the PICU. Many kids get treatment in the PICU for several days following major surgery.
The state of the child determines how long they remain in the PICU. While some would just remain for a day, others might stay for several weeks or even months. If you have any questions, as usual, ask the doctor or nurse who is attending to your kid.
Who Takes Care of Kids in the PICU?
Many highly trained individuals work in the PICU providing care for children. But at first, it might be difficult and a little daunting to not know who everyone is and what they do. Most personnel will make an introduction and explain their role in your child’s care. Feel free to inquire if they don’t. You should always feel free to ask the physicians and nurses anything about your kid and the care they are receiving.
The nurses who staff the PICU have expertise tending to the hospital’s sickest kids. They are the ones most intimately involved with the day-to-day upkeep of the children. In comparison to other areas of the hospital, the PICU frequently has a larger nurse-to-patient ratio (in other words, each nurse cares for fewer patients, which gives them more time with your child).
Your kid may get treatment from several doctors, but the attending doctors are in control. A pediatric intensivist could look after your youngster. This doctor completed a 3-year pediatric residency after completing medical school, and then underwent further 3-year intensive care specialist fellowship training.
Residents, who have graduated from medical school and are pursuing pediatrician training, and PICU fellows may be a part of the PICU team (pediatricians training to be attending intensivists).
Depending on your child’s needs, several more subspecialists may be engaged, including cardiologists (heart physicians) and neurosurgeons (brain surgeons). The management of PICU patients with breathing issues frequently involves respiratory therapists who are skilled with ventilators and other breathing apparatus. Additionally, pharmacists, dietitians, occupational therapists, physical therapists, and others could help with your child’s treatment.
You could also run into social counsellors who assist families in navigating the emotional challenges of caring for a seriously ill kid. When your kid is prepared to return home, they may organize discharge planning, assist with insurance concerns, and set up temporary lodging for families (via groups like Ronald McDonald House).
If the hospital employs child life specialists, you might wish to find out. They assist youngsters in understanding and coping with being in the hospital since they have training in developmental, educational, psychological, and counselling sectors. For instance, they may listen to a youngster who needs to chat, allay concerns about what is happening, or offer entertainment such as books and games.
Each day, the medical staff gathers in the morning to thoroughly discuss each patient’s situation. Rounds are the name given to these debates. As they arrange the medical care for each patient, a group of medical professionals — including physicians, nurses, and others — may be seen moving from one to another. You could be instructed to remain in your child’s room during rounds or to avoid entering or leaving the PICU altogether. This is done to safeguard the patient’s privacy.
The PICU may provide patient care that is family-centered. If so, you will be requested to participate in your child’s daily rounds. The attending physician will discuss the daily goals for your kid with you over the phone or in person if you can’t make it to rounds or don’t want to participate.
What Should Kids Expect While in the PICU?
The medical supplies being utilized to take care of your child may surprise you. The machines are noisy and bright, and they feature alarms and display screens.
The PICU stay for your kid might involve:
IVs: Nearly all children in the PICU have an intravenous catheter (or IV) for fluids and medications; these are often placed in the hands or arms, but can also occasionally be placed in the feet, legs, or even the scalp. A tiny needle is used to put an IV, which is a thin, flexible tube, into the vein. The soft plastic tubing is left behind after the needle has been withdrawn from the vein.
To administer bigger amounts of fluids and medications, larger IVs are occasionally required. Because they are put into the chest, neck, or groin’s bigger, more central veins, these are known as central lines. Despite being extremely similar to IVs, arterial lines are often used to monitor blood pressure and oxygen levels in the blood rather than to provide medication. They are put in arteries rather than veins.
Medicines: Certain medications may have harmful side effects. These are exclusively provided to kids who are being closely watched in the PICU. Some medications are administered constantly, numerous IV drops at a time, and are referred to as drips rather than every few hours. These drugs, such as epinephrine, dopamine, and morphine, may be prescribed by doctors to aid with blood pressure control, pain management, or cardiac function.
Monitors: The PICU has monitors linked to the children. Chest leads, which are little, painless stickers attached to cables, are used to bind them to the body. These leads are capable of measuring a child’s breathing and heart rates. In order to monitor blood oxygen levels, many children are additionally attached to a pulse oximetry (pulse-ox) device. This equipment, which produces a gentle red light and is harmless, is connected to the fingers or toes like a little bandage. Kids often wear a blood pressure cuff around their arm or leg unless their blood pressure is being directly monitored using an arterial catheter.
Tests: To gather further information, doctors may request a range of tests, including blood and urine testing. Cerebrospinal fluid (CSF), which surrounds the brain and spinal cord, may occasionally be tested. Additionally, images or photographs of various bodily areas may be captured using an X-ray, ultrasound, computed tomography (commonly known as a CT or CAT scan), and magnetic resonance imaging (MRI).
Ventilators: Sometimes children in the PICU require more assistance breathing. This can entail using a face mask or nasal tube to inhale more oxygen. However, there are situations when a youngster need a ventilator connection (or breathing machine). The ventilator is attached to the opposite end of an endotracheal tube (a plastic tube that is introduced into the windpipe via the mouth or nose) or a tracheostomy (a plastic tube that is inserted directly into the windpipe through the skin). Although there are several types of ventilators, they all assist a youngster breathe. While the breathing tube is in their windpipe, a youngster will get sedatives and painkillers.
Taking Care of Yourself
The professionals at the PICU will take care of your child’s physical requirements. Parents are there to love you, support you emotionally, and provide a comforting voice or touch. However, you shouldn’t feel obligated to spend every waking hour at your child’s bedside. You may find it helpful to collect your thoughts if you momentarily leave the chaos of the PICU or even leave the hospital premises.
It can be physically and emotionally taxing to stay awake all night with a kid who has been in the PICU for more than a few days. Hospitals may or may not allow parents to spend the night with their children. Frequently, medical professionals will advise parents to leave the hospital, get a full night’s sleep, and then come back to the PICU rested the following morning. This will enable parents to console their infant even more.
You can choose to spend the night in your child’s room if the hospital allows parents to do so. In any case, the PICU personnel will assist you and give you comfort knowing that your kid is in good hands. Whatever you do, be careful to get enough sleep so that you can assist your kid while they are in the PICU.
reference: https://kidshealth.org/en/parents/picu.html
When Kids Leave the PICU
Some youngsters leave the PICU and head home immediately. However, many patients go to a standard hospital unit for further, less rigorous monitoring and follow-up treatment. Nevertheless, leaving the PICU is a significant step toward recovery. It indicates that a youngster doesn’t require as much close supervision, treatment, and/or nursing care.
However, leaving the PICU could also make you nervous. Parents of children who were in the PICU frequently consider, “He was really ill. Even if he is feeling better, shouldn’t he remain here until he is fully recovered?” However, before a child is ready and stable, the PICU’s medical staff will not transfer them. Additionally, the staff on the hospital’s main floor is equipped with the tools necessary to continue directing your child’s rehabilitation.
It might be difficult to provide for a child who is seriously unwell. Work with the PICU care staff and ask any questions you may have. This will assist you in supporting your child and preparing for the time when everyone will be together at home again.
