The pediatric intensive care unit is the hospital department used to house critically-ill newborns, children, pre-teens, teenagers and certain young adults. Because of this patient base, it has different requirements from other intensive care units like neonatal intensive care or the intensive care unit, which is exclusively for adults. 

What makes a pediatric ICU unique, though? And what are these requirements? We look to answer these questions and more, such as the benefits of using hospital computer systems.

What Does PICU Mean?

The pediatric intensive care unit, or PICU, is the section of the hospital providing the highest level of medical care to children. “Children” in this case range from critically ill infants, pre-teens, teenagers, to young adults between 18 to 21 years old. Many times the latter is done due to the policy of the hospital; example: “adult” may be 17 in one facility while it’s 21 in another. 

PICUs in the US come in two levels. A level I PICU cares for the most critically ill child. Specialists are onboard 24 hours per day, 7 days a week. 

Children in a level II PICU do not meet the criteria for level I. They will have less complex acuity and be more stable. 

PICU vs ICU

The PICU is similar to the ICU (intensive care unit) where adult patients (minimum 18 years old) receive intensive care medicine. PICU medical staff, though, are specialized to handle their children’s different physiologies and conditions. 

Older children (18 – 21) may find themselves placed in either unit depending on the policy of that particular healthcare organization. 

PICU vs NICU

NICU stands for Neonatal Intensive Care Unit. It specializes solely in the treatment of newborns too ill for PICU. They’re usually premature (born before 37 weeks of pregnancy), have low birth weight (less than 5.5 pounds) and have a medical condition that requires highly specialized care (Example: gastroschisis or when the baby’s organs are found outside of their body). 

Patients in PICU

Diagnosis that may get children admitted to the PICU include: 

  • Severe respiratory issues
  • Apnea
  • Sepsis
  • Shock
  • Trauma 
  • Altered mental status
  • Congenital heart defects
  • Diabetic ketoacidosis complications
  • Cancer / chemotherapy
  • Organ transplants
  • Poisoning 

Interesting fact The first PICUs 

The very first PICU was established in 1955at Queen Silvia Children’s Hospital of Goteborg in Sweden. 

The Children’s Hospital of Philadelphia is considered the first PICU in the US. Established in 1967, it was developed due to advancements in pediatric general surgery, cardiac surgery, and anesthesiology. The young patients required more extensive postoperative monitoring which could not be done in ICU or even the regular pediatric unit. 

Staffing of PICU

All of the staff members who work in the PICU specialize in children’s intensive care. 

PICU attending: This is the provider who oversees the department. They have had specialized training in both pediatrics and intensive care. 

PICU residents: Residents are MDs. Those in the PICU are usually training to become pediatricians. 

PICU fellows: Pediatricians receiving further training to become pediatric intensivists.

PICU nurses: The most common medical staff seen in the unit. PICU RNs usually have fewer patients to care for at one time than nurses in other departments. This allows them to spend more time with each child. 

Other medical personnel and support staff found in PICU include cardiologists; neurologists; pulmonologists; physical and occupational therapists; and social workers. 

PICU Devices and Equipment 

Providers in PICU use machines and devices to monitor and help keep their young patients stable as they’re recovering. 

  • Intravenous catheters (IVs) and central lines. IVs deliver medication and fluid straight into the patient’s body. A central line is similar but it supplies more volume. A foley, or indwelling catheter, drains urine.
  • Monitoring devices. These help medical staff keep a close eye on the patient’s heart rate, breathing, and blood pressure. A pulse oximeter for example measures the level of oxygen in the blood. An inflatable cuff on the arm or leg takes blood pressure readings which is then sent to a blood pressure monitor. 
  • Breathing devices. When patients need extra help breathing, they may be given an oxygen mask or a nasal cannula to deliver extra oxygen. Other breathing devices include ventilators (which breathe for the patient) or “trach” tube, which is a breathing tube that goes straight into the windpipe.  

Testing equipment like X-rays, MRIs, and ultrasounds may also be found in the PICU. 

Medical Computers

Medical computers in the PICU are used mainly for electronic health record usage, patient monitoring software, or both. This is similar to the ones found in the ICU and NICU. Vital for the patient’s survival, PCs in the PICU should be:

Medical Grade: As discussed in Medical Grade Vs Hospital Grade, the medical grade computer has been tested against hazards like fire, ignition from flammable anesthetics, electrical shock, mechanical impact, excessive electrical energy output, and radiation. It has been 60601-1 certified that it won’t interfere with potentially nearby life-sustaining or saving medical devices which are found in abundance in PICU.

Antibacterial / Fanless Design/ IP65 Rated: Patients in PICU are critically ill and could already be fighting another infection like pneumonia or COVID-19. Medical computers, medical grade monitors, and even medical tablets have been designed with antimicrobial properties so that bacteria don’t grow on their surfaces. This frees the PICU personnel to focus on their patients instead of keeping their computers sterile.

Those mentioned medical PCs should have fanless design, which keep cool without blowing air-borne pathogens in the air, and are IP65 rated. This last bit means the screens are sealed against dust and blasts from water jets. Staff can use harsh hospital grade cleansers without worrying about damaging the PC’s delicate interior.  

Industrial Grade / Low Failure Rate: Finally, hospitals should verify PCs for PICU are made with industrial grade parts. These ensure they can withstand being active 24 hours a day, 7 days a week for months on end. A glitch in any of them can be a life-or-death matter for a patient no matter how temporary. The manufacturers’ failure rates of their products should also be reviewed for the same reason.  

Closing Comments

The pediatric intensive care unit specializes in the treatment of critically ill children whose ages range from newborn to 21 years of age. Medical devices and equipment like medical computers in the unit are used similarly like those found in the ICU and NICU. If your healthcare group is interested in figuring out the best PCs, tablets, and monitors for your PICU, contact a representative from Cybernet. 

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