Guidelines and Levels of Care for Pediatric Intensive Care Units

Abstract

ABSTRACT. The practice of pediatric critical care medicine has matured dramatically during the past decade. These guidelines are presented to update the existing guidelines published in 1993. Pediatric critical care services are provided in level I and level II units. Within these guidelines, the scope of pediatric critical care services is discussed, including organizational and administrative structure, hospital facilities and services, personnel, drugs and equipment, quality monitoring, and training and continuing education. Pediatrics 2004;114: 1114-1125; pediatric intensive care unit, PICU, critical care services.

The morbidity and mortality conference as an adverse event surveillance tool in a paediatric intensive care unit

“…The Johns Hopkins Children's Center PICU is a 36-bed, Level 1 unit18 accommodating ∼1700 admissions per year, of patients 0–21 years of age, and serves as a tertiary referral centre for many local and international centres. It is staffed by one to three paediatric critical care physicians and three fellows for 24 h each day divided into two 12-h shifts.…”

Comparison of chronic illness among children receiving mechanical ventilation in a cohort of children’s hospitals in 1991 and 2001

“…In fact, greater hospital capacity (bed availability) alone has been shown to increase utilization of health care services in a population of older adults. 22 However, given that the need for mechanical ventilation in an acutely ill pediatric patient is generally considered an absolute indication for intensive care admission and need, 8,9 our results suggest that expansion of PICU bed capacity and occupancy during the last decade may have been demand-driven.…”

“…8,9 We hypothesize that the prevalence of chronic illness in children receiving mechanical ventilation has increased over the previous decade, as has the incidence of mechanical ventilation in hospitalized children.…”

Pediatric Sedation: Using Secondary Data to Describe Registered Nurse Practice in Radiology

“…However, pediatric critical care experienced RNs do have the training and experience to care for patients who are severely ill. Pediatric Intensive Care Unit (PICU) RNs are required to have skills in drug administration, resuscitation, respiratory care, and the recognition and interpretation of various physiologic measures (Rosenberg & Moss, 2004). Thus, the PICU RN may be better equipped with the skills and experience to deliver sedation to children up to and including ASA III than a general pediatric or radiology nurse who receives less training and demonstrates competency in sedation care but may not have other intensive care skills and experience to manage underlying coexisting conditions.…”