What is picu?

A PICU is full of special equipment to help care for your child and keep your child as safe and comfortable as possible. The PICU staff will answer your questions and tell you how these tools are helping your child.

Some machines will beep or display information all the time. Others have alarms on them for emergencies. Usually an alarm just means that something needs to be adjusted, and the care team may come in and check on it. Ask a member of the PICU staff if you are concerned about the information or alerts on any of the machines.

Breathing equipment

• A ventilator is a machine that breathes for a person who has trouble breathing. The tube is placed in the windpipe through the nose or mouth.
• A continuous positive airway pressure (CPAP) machine may be used when a ventilator isn't needed. It gently pushes oxygen or air into the lungs through a mask over the nose or mouth. Children can breathe on their own with this extra help.
• A nasal cannula is a device with two prongs. The prongs are placed in the nostrils when a child just needs more oxygen. The oxygen goes through the tubes and into the nostrils.
• Oxygen may also be given through a mask. Oxygen flows through a tube and into a mask that's placed over the nose and mouth.
• An oxygen tent or hood can also help your child or baby get enough oxygen.
• A tracheostomy or "trach" tube (say "trayk") is a breathing tube that goes straight into the windpipe. It's used when a person needs to be on a ventilator for a long time. It also helps remove mucus and fluid from the lungs. A surgeon will insert the trach tube.

Medicine, fluid, and nutrition

• An intravenous (I.V.) site gives access to a vein. It may be placed in the back of the hand. Or it may go in the foot, arm, leg, or scalp. One end of a tube is attached to the site. The other end may be attached to a medicine pump. It can also be used to take samples of blood for testing.
• A central vascular access device or central line is put through the skin into a vein and ends in a larger vein near the heart. It can stay in place longer than an I.V. It can deliver fluids or medicines quickly if needed. It can also deliver nutrition and can be used to monitor your child.
• A PICC line is a long, thin tube used to deliver medicines. It most often is put into the body in the arm and ends in a large vein in the chest. A PICC line is a type of central line.
• Medicine pumps deliver exactly the right amount of medicine at the right time. The medicine flows through an I.V. site or a central line. These pumps may beep a lot.
• Gastrostomy (G-tube) or nasogastric (NG-tube) feeding tubes deliver nutrients to a child who can't eat. A G-tube goes directly into the stomach. An NG-tube is put through the nose into the stomach. They can also remove excess fluids from the stomach and provide medicine.

Other equipment

• An inflatable cuff on the arm or leg takes blood pressure readings. It sends the data to a blood pressure monitor.
• Temperature probes keep track of the child's temperature.
• A heart monitor has a sensor that attaches to the chest to track the heart rate.
• A pulse oximeter is put on the earlobe or on the end of a toe or finger. For babies, it may be put on the palm or foot. It measures how much oxygen is in the blood.
• Extracorporeal membrane oxygenation (ECMO) is used for children who have very serious lung or heart problems. A special machine puts oxygen into the child's blood and takes carbon dioxide out of the blood.
• A Foley, or indwelling, catheter drains urine when a child can't go to the bathroom on their own.
• A dialysis machine helps adjust the level of fluids and waste products in the blood. This may be done if your child has kidney problems.
• Electrodes may be placed on your child's head to check electrical brain waves.

You will work closely with the staff in a PICU. The PICU staff has special training in intensive care. Here are some of the team members and what they do.

Providers

• Pediatric critical care medicine specialists: Medical doctors who focus on care for children who are in the PICU.
• Specialists: Doctors who focus on certain areas of medicine. For example, a pediatric cardiologist would help treat a heart problem.
• Nurse practitioners and physician assistants (PAs): Providers with advanced training in patient care. Some may specialize in certain areas of medicine.
• Resident doctors: Licensed doctors who are getting more training.

Nurses

• Nurses: Handle daily care and often are a main point of contact for a patient's support network. Nurses keep patients as comfortable as they can. They track vital signs and give medicines that the doctor has ordered.
• Certified nursing assistant (CNA): Cares for patients under a nurse's direction.

Therapists

• Respiratory therapist: Helps treat breathing problems. For instance, they may manage breathing equipment, such as a ventilator.
• Physical therapist: Works with patients on exercises to help them move better and relieve pain.
• Speech therapist: Helps with swallowing and speech problems.

Clinical roles

• Pharmacist: Prepares medicines and suggests the best and safest ones.
• Social worker: Helps children and their loved ones in the PICU. Social workers help you understand how the PICU works. And they handle discharge planning when it's time to go home. They can also help if you have concerns about any members of the PICU staff.
• Child life specialist: Helps children cope with having a serious medical problem.

Other team members

• Students: There may be many types. For example, some are nursing or medical students in training.
• Chaplain: Attends to your family's religious or spiritual needs. Most hospitals have a chaplain or spiritual advisor on call. You can ask for a spiritual advisor in your own tradition.
• Interpreter: Translates the words of a person speaking a different language—either orally or into sign language.
• Family advocate: Supports children and their loved ones in the PICU.
• PICU clerk: The assistant for the unit. They keep track of everything that goes on in the PICU. They can be a great contact for you.
• Technician: Handles some of the equipment in the PICU.
• Cleaning, maintenance, and food service staff: Have special training for the PICU.

Your role

The staff provides medical care. But children and their families have a support network too. Family and friends can give children the things they can give best: love, hugs, support, and more.

The staff on your child's care team knows that this is all new to you. They expect you to have questions. And they'll do their best to answer them.

You're an important part of the care team along with doctors, nurses, and specialists. You can help make decisions about what is best for your family. You can make sure that you have a voice in your child's care and be your child's advocate.

A pediatric intensive care unit (PICU) is a part of the hospital where children who are very sick get care. It could be a special unit for children with heart, breathing, or other serious medical problems. Children may go there to recover after surgery. Or they may get treatment for an injury or exposure to poison.

Over time, a child in the PICU may not need as much breathing support. As a child gets stronger, the doctor may move (or wean) the child from a ventilator to a CPAP machine. A child may then be moved to a mask or nasal cannula with oxygen, and finally to breathing without the need for help.

You may see tubes and wires attached to your child. This can be upsetting to see. But these things help the doctor treat your child.

The tubes supply air, fluid, and medicines to your child. The wires are attached to machines that help the doctor keep track of vital signs. These include temperature, blood pressure, breathing rate, and pulse rate.

Ventilators and other equipment have alarms that alert the care team to any sudden changes. Usually an alarm just means that something needs to be adjusted. The care team may come in and check on it. If you have questions about any alarms, you can ask a PICU staff member.

The PICU staff is highly trained to care for children who are very sick. They will do everything they can to help. If you need it, ask for support from friends and family. You can also ask the hospital staff about counseling and support.