Pediatric intensive care unit
A pediatric intensive care unit (also paediatric), usually abbreviated to PICU //, is an area within a hospital specializing in the care of critically ill infants, children, and teenagers. A PICU is typically directed by one or more pediatric intensivists or PICU consultants and staffed by doctors, nurses, and respiratory therapists who are specially trained and experienced in pediatric intensive care. The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, child life specialists, and clerks on staff although this varies widely depending on geographic location. The ratio of professionals to patients is generally higher than in other areas of the hospital, reflecting the acuity of PICU patients and the risk of life-threatening complications. Complex technology and equipment is often in use, particularly mechanical ventilators and patient monitoring systems. Consequently, PICUs have a larger operating budget than many other departments within the hospital.
Goran Haglund established the first pediatric intensive care unit, which he called a "pediatric emergency ward", in 1955.
Infants were first kept intubated for long periods in the early 1960s. Breathing tubes made out of polyvinyl chloride (PVC) allowed clinicians to avoid performing tracheostomy (surgically inserting a tube into the windpipe) in more children who required prolonged mechanical ventilation.
Levels of care
Level I PICUs are variable in size, personnel, physical characteristics, and equipment, and that they differ in the types of specialized care (ie, care following transplantation or cardiac surgery) that they provide. Nurse-to-patient ratios range from 2 nurses to 1 patient to 1 nurse to 3 patients. Registered respiratory therapists are required to be assigned primarily to the Level I PICU in-house 24 hours per day.
Level II PICUs are smaller than level I PICUs and are able to care for less critical patients.
- Frankel, Lorry R; DiCarlo, Joseph V (2003). "Pediatric Intensive Care". In Bernstein, Daniel; Shelov, Steven P. Pediatrics for Medical Students (2nd ed.). Philadelphia: Lippincott illiams & Wilkins. p. 541. ISBN 978-0-7817-2941-3.
- Pronovost, PJ; Dang, D; Dorman, T; et al. (September 2001). "Intensive Care Unit Nurse Staffing and the Risk for Complications after Abdominal Aortic Surgery". Effective Clinical Practice (American College of Physicians–American Society of Internal Medicine) 4 (5): 199–206. PMID 11685977. Retrieved 2009-01-08.
- Moerer O; Plock E; Mgbor U; et al. (June 2007). "A German national prevalence study on the cost of intensive care: an evaluation from 51 intensive care units". Critical Care (BioMed Central) 11 (3): R69. doi:10.1186/cc5952. PMC 2206435. PMID 17594475.
- Morton, Neil S (1997). Paediatric Intensive Care. Oxford University Press. ISBN 978-0-19-262511-3.
- Morton 1997: 3
- Duke, Trevor; Kissoon, Niranjan;Van Der Voort, Edwin (2008). "Pediatric Intensive Care: a Global Perspective". In David G Nichols. Roger's Textbook of Pediatric Intensive Care (4th ed.). PA: Lippincott Williams & Wilkins. pp. 18–23. ISBN 978-0-7817-8275-3.
- "Guidelines and levels of care for pediatric intensive care units. Committee on Hospital Care of the American Academy of Pediatrics and Pediatric Section of the Society of Critical Care Medicine". Pediatrics 92 (1): 166–75. July 1993. PMID 8516070.