Pediatric intensive care unit

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A child-intensive care unit (also child ), usually abbreviated as PICU ( ), is an area within the home illness specializing in care for critically ill infants, children, and adolescents. A PICU is usually directed by one or more pediatric intensivists or PICU consultants and is managed by respiratory doctors, nurses, and respirators who are specially trained and experienced in pediatric intensive care. The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, childcare specialists, and staff clerks, although this varies greatly depending on geographic location. Professional ratios for patients are generally higher than in other areas of the hospital, reflecting the PICU patient's acuteness and the risk of life-threatening complications. Complex technology and equipment are often used, especially mechanical ventilators and patient monitoring systems. As a result, PICU has a larger operating budget than many other departments in the hospital.

Video Pediatric intensive care unit

Sejarah PICU

Goran Haglund is credited with establishing the first pediatric ICU in 1955. The PICU is located at the Goteburg Children's Hospital in Sweden. The first PICUs in the United States were not developed until 12 years later. In 1967, John Downes founded the first PICU in North America at Children's Hospital of Philadelphia. The formation of these two units will eventually lead to hundreds of PICUs being developed in North America and Europe. This number is still increasing in the present.

There are various factors that lead to the development of PICU. John Downes identifies five drug specializations that are aided in development. These specializations include adult respiratory ICU, neonatal intensive care, general surgery of the child, child heart surgery, and child anesthesia.

Between 1930 and 1950 the epidemic of poliomyelitis has created a greater need for adult respiratory intensive care, including iron lung. There are times when children will be exposed to polio and should be treated in this ICU as well. This contributes to the need for units where critically ill children can be treated. Respiratory problems are also increased in children because the neonatal intensive care unit improves the baby's survival rate. This is due to the progress of mechanical ventilation. However, this results in children developing chronic lung disease, but there is no special unit to treat the disease.

Advances in general surgery, cardiac surgery, and anesthesiology are also driving factors in the development of PICUs. Surgery performed becomes more complicated and requires wider postoperative monitoring. This monitoring can not be performed on a regular pediatric unit, which led to the Philadelphia Child Development House of the first PICU. Advances in pediatric anesthesia resulted in an anesthesiologist treating pediatric patients outside the operating room. This causes pediatricians to gain skills in anesthesiology to make them better able to treat critically ill children. The pediatric anesthesiologist eventually develops and then runs the PICU.

Maps Pediatric intensive care unit

PICU Characteristics

There are various characteristics of PICU that enable healthcare providers to provide the most optimal care. The first of these characteristics is the physical environment of the PICU. The layout of the unit should allow staff to continue to observe the patients they are dealing with. Staff should also be able to respond quickly to patients if there is a change in the patient's clinical status.

Correct personnel is the next vital component for successful PICU. The nursing staff is very experienced in providing care to the most critical patients. The nurse's ratio to the patient should remain low, meaning that the nurse should only treat 1-2 patients depending on the patient's clinical status. If the patient's clinical status is so important, then they will need more monitoring and intervention than stable patients.

In many cases, nurses and doctors care for the same patient for long periods of time. This allows the provider to build relationships with patients, so that all the needs of the patient are met. Nurses and doctors should work together as a collaborative team to provide optimal care. Successful collaboration between nurses and doctors has resulted in lower mortality rates not only in PICU, but all intensive care units.

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Treatment level

As the drug has matured over time, the development of the pediatric intensive care unit has been expanded to maintain the level one and level two PICUs. Between these two different levels, they are able to provide critical care and stabilization for each child before transferring to different sharpness.

At the PICU level one, members of the health care team should be able to provide a range of treatments that typically involve intensive, rapidly changing, and progressive approaches. At PICU level two, patients will present with less complex sharpness and will be more stable. Conditions

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Requires PICU

Respiratory problems include acute respiratory distress syndrome (ARDS), asthma, apnea, sepsis, trauma (possibly including abuse), congenital heart defects, mechanical ventilation, and diabetic ketoacidosis complications. Gastrointestinal conditions include gastrointestinal perforation, cancer/chemotherapy, organ transplants (kidney, heart), seizures, and poisoning.

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PICU Nurse Skills and Certification

As a PICU nurse, broader knowledge and certification are required. Recognition and interpretation are two of the many skills required for a PICU nurse. This allows the nurse to be able to detect any changes in the patient's condition and to respond accordingly. Other skills may include route administration, resuscitation, respiratory and cardiac intervention, preparation and maintenance of patient monitors, and psycho-social skills to ensure patient and family comfort.

There are various certificates needed for registered nurses to obtain to work in PICU. One of these certifications is the Certificate of Registered Nursing Career Critical (pediatric). This certificate allows nurses to care for critically ill children in any setting, not just PICU. Other certificates include cardiopulmonary resuscitation, basic life support, and pediatric life support.

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Hospital Team

In PICU, it is important that all team members have a wide variety of training and experience to provide high quality care. Due to the different priorities between the professionals, the PICU care team includes many different roles. (physician, nurse, pharmacist, respiratory therapist, child's life, intensivist, cardiologist, physical therapist/worker, social worker) Every inter-professional team member is highly skilled and trained to provide the best care for every child. It is important for everyone to introduce themselves to the family and explain their role to hopefully extend the understanding to family members.

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Factors that Lead to Poor Results in PICU Patients

The patients at PICU are the most critically ill children in the hospital. There are times when these children do not have the best results, which can lead to a permanent deficit or even death. There are times when nothing else can be done to improve outcomes for these patients. However, there are times where the treatments can be different and the end result may be better.

There are various factors that cause poor results in PICU patients. The main factor causing inadequate care for PICU patients is an improper health assessment by health care providers. This may include not observing changes in patient clinical status, delayed resuscitation efforts, delayed decision making, or a combination of any of these factors. If any of these factors occur, it can cause a permanent deficit in the most critical patient.

Steps can be taken to prevent incorrect assessments from occurring. Proper education on how to conduct appropriate assessments and how to recognize critically ill children can improve patient outcomes. This includes being able to recognize signs of deteriorating clinical status and performing the right patient triage. This education is not only for PICU staff, but also for emergency medical services, emergency department staff, and pediatric unit staff.

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Challenges Working on PICU

The deaths of patients treated at the PICU can not be avoided, which can then lead to emotional stress and/or fatigue of staff work. For patients who leave the unit, often they are not free from any chronic or defective condition. There are other factors that cause stressful working conditions for PICU staff. Staff often work for long periods of time to stabilize the patient's most critically ill children. They should collaborate with other members of the health team to develop the best treatment plan. Once the maintenance plan is developed, the staff should communicate the plan with the patient's family to see if it is in accordance with their beliefs. If the treatment plan is not in accordance with the family belief, then it should be modified plans that cause more pressure on staff. All this causes the staff to be very stressed and every member of the unit must develop their own coping mechanisms to prevent blackout.

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See also

• Intensive care unit
• Intensive care medicine
• Neonatal intensive care unit
• Pediatrics

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References

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External links

• Virtual PICU

Source of the article : Wikipedia