Going to the Pediatric Intensive Care Unit (PICU) is usually a sudden, unexpected, and frankly unwelcome experience, meaning that many parents do not have enough time to anticipate going to the PICU to do research on what to expect in the middle of a situation. Knowing what to expect before that reality ever arises can give you helpful context if a visit to the PICU should occur, and this knowledge could be helpful to you, a family member, or a friend someday.
What is the PICU, and what can you expect there?
The PICU is a unit within the hospital that is specifically designed to care for infants, children, and adolescents with severe and sometimes life-threatening illnesses, injuries, or medical conditions. If you haven’t been to a PICU before, it can be hard to know what to expect. The first thing you’ll probably notice is the number of people there: doctors, nurse practitioners, nurses, respiratory therapists, pharmacists, and all therapy support systems and allied health professionals. You may see a doctor you already know well – a surgeon, a cardiologist, a pulmonologist, an endocrinologist, etc. but, the doctors and nurse practitioners you will see the most often will be ones with particular training and expertise in caring for children who require the PICU. They are called intensivists. You will quickly learn their names because you will likely see them often. You will see them early in the morning, at bedside rounds, throughout the day, and late into the night. You will likely see a different doctor at night than you did during the day but know that they are all communicating with one another to ensure that your child gets the care they need. Some of the doctors will still be in training. The ones specifically training to become pediatric intensivists are called fellows, while the ones training to become pediatricians are called residents. All these doctors and nurse practitioners are talking with each other and with any other doctors and providers whose expertise is needed to care for your child while they are sick.
The next thing you’ll likely notice is the machines in the PICU. There will be many of them, and they all make noise. At nighttime, the various beeping noises can contribute to the weird sense that you are on a spaceship far, far away, rather than tethered firmly to the same building you came to from the attached garage. Unfortunately, many of the noises are meant to sound intrusive – alarming. And when the person attached to that alarming machine is your child, alarming can be terrifying. Most of the time, the alarms do not mean something terrible is happening. They are intended to draw attention to things that might be a problem if they are sustained over time, but transient beeping becomes the necessary go-along for all the vigilance. You will have a nurse assigned to your child who can answer most, if not all, of your questions about the sounds you hear. Other machines can be scary even without the noise – those are the machines that you know are there to support body functions that your child, for whatever reason, currently cannot do for themselves. These include IV pumps that deliver medicines to your child, ventilators that help them to breathe, and others, depending on your child’s condition. When your care team determines that your child needs one of those machines to get better, they will often talk to you about it before they need to get it started.
Sometimes emergencies occur, and at those times, the PICU is the right place for your child to be in order to manage those emergencies as quickly and efficiently as possible. What I hope you know in all those instances is that your care team will only use the types of support that they think are necessary, and they want to be able to get your child off the machines and back to their normal functioning as quickly and fully as possible. Doing that is the reason they decided to work in the PICU in the first place.
So, what is the PICU? It’s a special place in the hospital for the most severely ill kids. It’s a place that is complicated and technical and often frightening. But it’s a place where a team of professionals has come together to provide the best help they can for every kid and every family.