It can be frightening whenever kids are in the hospital — and even more so when they're admitted to the pediatric intensive care unit (PICU). But a basic understanding of the people and equipment in the PICU can help you feel less scared and better prepared to help your child recover.
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, in that the PICU allows intensive nursing care and continuous monitoring of things like heart rate, breathing, and blood pressure.
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 (breathing machines) and certain medicines that can be given only under close medical supervision.
Any child who's seriously ill and needs intensive care and whose medical needs can't be met on the hospital's main medical floors goes to the PICU.
Kids in the PICU might include those with severe breathing problems from asthma, serious infections, certain heart conditions, some complications of diabetes, or those involved in a serious automobile accident or near-drowning.
Some kids may have been stable enough to initially be cared for on the hospital's medical-surgical floors, 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.
How long kids will be in the PICU depends on their condition — some 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 questions.
The PICU has many highly skilled people who care for kids. 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 tell you how they're involved in your child's care, but if they don't, feel free to ask. At all times, you should feel comfortable asking the doctors and nurses questions about your child and the care being given.
The nurses who work in the PICU are experienced in caring for the sickest children in the hospital. They're the people most closely involved with the minute-to-minute care of the kids. The PICU also tends to have a higher nurse-to-patient ratio than other parts of the hospital (in other words, each nurse cares for fewer patients, which gives them more time with your child).
Numerous physicians may care for your child, but the attending physicians are in charge. Your child might be cared for by a pediatric intensivist, who is a doctor who did a 3-year residency in pediatrics after medical school, followed by 3 more years of subspecialty fellowship training in intensive care.
The PICU team may include residents (doctors who've completed medical school and are training to be pediatricians) and PICU fellows (pediatricians training to be attending intensivists).
Many other subspecialists, such as cardiologists (heart doctors) or neurosurgeons (brain surgeons), might be involved, depending on your child's needs. Respiratory therapists are experienced with ventilators and other breathing equipment, and are often involved in the care of PICU patients with breathing problems. Also, physical therapists, occupational therapists, nutritionists, and pharmacists may play a role in your child's care.
You also might meet social workers who help families cope with the emotional burdens of having a critically ill child. They can help to arrange temporary housing for families (through organizations like Ronald McDonald House), assist with insurance issues, or coordinate discharge planning when your child is ready to go home.
You may want to ask whether the hospital has child life specialists. Trained in fields like development, education, psychology, and counseling, they help kids understand and manage being in the hospital. For example, they'll listen when a child needs to talk, calm fears about what's happening, or provide distractions like books and games.
The medical team meets every day, usually in the morning, to discuss each patient's case 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 patient. During rounds, you may be asked to stay in your child's room or instructed to not enter or exit the PICU. This is to protect the privacy of other patients.
Family-centered patient care might be practiced in the PICU. If this is the case, you'll be asked to participate in your child's daily rounds. If you're not present for rounds or don't want to participate, the attending physician will inform you of the daily goals for your child by phone or in person.
By understanding everyone's role and how each contributes, you may find the group of people caring for your child less intimidating.
Possibly the most alarming aspect of the PICU environment is the medical equipment that may be attached to your child. The machines have alarms and display panels, and the noise and lights can be overwhelming.
Your child's stay in the PICU might include:
In the PICU, all of your child's physical needs will be met by the staff. You, as a parent, are there to provide emotional support, love, and a familiar voice or touch. However, you shouldn't feel as if you have to stay at your child's bedside every minute of the day. Getting away from the commotion of the PICU briefly or even leaving the hospital grounds can help you gather your thoughts.
Staying around the clock with a child who's in the PICU for more than a few days can be both physically and emotionally draining. Although some hospitals let parents spend the night with their child, some do not. Often, hospital staff will encourage parents to go home, get a good night's rest, and return to the PICU refreshed in the morning, which can help them be even more of a comfort to their child.
If the hospital allows parents to spend the night, the decision whether to stay in your child's room is yours. Either way, the PICU staff will support you and reassure you that your child will be well cared for. Whatever you do, make sure you get enough rest to be able to support your child throughout the PICU stay.
While some patients are sent home directly from the PICU, many are transferred to a regular floor of the hospital for further, less-intense monitoring and follow-up care. Still, discharge from the PICU is a significant milestone on the road to recovery. It means that a child no longer needs such an intensive level of monitoring, therapy, and/or nursing care.
But leaving the PICU might also cause some anxiety. It's not unusual for parents of kids who were in the PICU to think, "He was so sick and now he's better. But shouldn't he stay here until he's completely back to normal?" But the doctors and nurses in the PICU won't transfer kids before they think they're ready and stable, and the team on the hospital's regular floor will have the resources necessary to continue guiding your child's recovery.
Caring for a critically ill child is always stressful and difficult. But understanding the people and things in the PICU can help ease your family's stress — leaving you better able to support your child and plan for when the entire family is home together again.
Reviewed by: Adalberto Torres Jr., MD
Date reviewed: September 2015
|Family Voices This website brings together families who have children with special health needs.|
|American Medical Association (AMA) The AMA has made a commitment to medicine by making doctors more accessible to their patients. Contact the AMA at: American Medical Association|
515 N. State St.
Chicago, IL 60610
|Centers for Disease Control and Prevention (CDC) The CDC (the national public health institute of the United States) promotes health and quality of life by preventing and controlling disease, injury, and disability.|
|Consolidated Credit Counseling Services This group's mission is to assist families throughout the United States in ending financial crisis and to solve money-management problems through education and professional counseling.|
|Ronald McDonald House Charities Ronald McDonald House Charities provides comfort and care to families with children in the hospital.|
|KidNeeds.com This website is for children with special needs, their parents, and other caregivers and contains information and health supplies.|
|InsureKidsNow.gov InsureKidsNow.gov provides information about Medicaid and CHIP services for families who need health insurance coverage.|
|The Health Insurance Marketplace Consumers can learn about, compare, buy, and enroll in health insurance at HealthCare.gov, the official site for the Health Insurance Marketplace.|
|Word! Intensive Care Unit The intensive care unit, or ICU, is a special place in the hospital where people can recover from very serious illnesses, accidents, or operations.|
|Going to the Hospital It may seem scary to go to a hospital, but doctors and nurses are there to help people who are sick or hurt feel better. Read our article for kids to find out what happens inside a hospital.|
|Anesthesia - What to Expect Here's a quick look at what may happen before, during, and after on the day of your child's operation or procedure.|
|What's It Like to Stay in the Hospital? Scheduled for a hospital stay? Knowing what to expect can make it a little easier.|
|Knowing Your Child's Medical History In an emergency, health care professionals will have many questions about a patient's medical history. It's easy to compile this information now, and it could save critical minutes later.|
|What Happens in the Operating Room? Surgeries and operations happen in the operating room, sometimes called the OR. Find out more in this article for kids.|
|What's It Like to Have Surgery? Knowing what to expect with surgery before you get to the hospital can make you less anxious about your surgical experience - and less stress helps a person recover faster.|
|When a Sibling Is Seriously Ill When your sibling has a serious illness, you may find yourself juggling some pretty intense and confusing emotions. Here are some ways to take care of yourself during this stressful time.|
|Relaxation Techniques for Children With Serious Illness Help ease your child's pain and anxiety with these exercises, complete with step-by-step instructions.|
|What You Need to Know in an Emergency In an emergency, it's hard to think clearly about your kids' health information. Here's what important medical information you should have handy, just in case.|
|Preparing Your Child for Anesthesia If your child needs to have an operation, you probably have plenty of questions, many of them about anesthesia.|
|Preparing Your Child for Surgery Good preparation can help your child feel less anxious about getting surgery. Kids of all ages cope much better if they have an idea of what's going to happen and why.|
|Caring for a Seriously Ill Child Taking care of a chronically ill child is one of the most draining and difficult tasks a parent can face. But support groups, social workers, and family friends often can help.|
|Managing Home Health Care When kids need intensive health care after they're discharged from the hospital, it's important that family and caregivers learn about the devices, equipment, and support they'll need.|
|Taking Care of You: Support for Caregivers It's common to put your own needs last when caring for a child you love. But to be the best you can be, you need to take care of yourself, too. Here are some tips to help you recharge.|
|Financial Management During Crisis Although the emotional price of raising a seriously ill child can be devastating, it's only part of the picture. Even during this difficult time, you have to consider the financial implications.|
|Balancing Academics and Serious Illness When your child has a serious or chronic illness, it's hard to think beyond the next treatment. But with planning and communication, you can help your child balance treatment and academics.|
|Caring for Siblings of Seriously Ill Children By being aware of what healthy siblings are going through and taking a few steps to make things a little easier for them, parents can help kids cope.|
|When Your Baby's in the NICU The neonatal intensive care unit may seem like a foreign place, but understanding what goes on there can help reduce your fears. Here's how to familiarize yourself with the NICU.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.