The PICU: Lifesaving Care For Kids

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Pediatrics

Parents want the best for their children—especially when their child is sick or injured.

For children with the most serious illnesses and conditions, there’s no better place to heal than the Pediatric Intensive Care Unit (PICU) at Miller Children’s Hospital Long Beach—a nationally recognized leader in pediatric critical care.

“We care for the sickest of the sick—children who are medically unstable, have life-threatening conditions and require constant, specialized monitoring,” says Tracy Ladbury, R.N., certified nurse practitioner and PICU clinical nurse specialist. Among the most common conditions treated in the PICU are respiratory failure, congenital heart disease, traumatic injuries, complications from diabetes and severe infections such as sepsis or pneumonia.

A Critical Resource

The 20-bed PICU is staffed around-the-clock by board-certified intensive care specialists, critical care nurses and specially trained respiratory therapists. “Our medical team is on-site, not just on call, which gives us the ability to respond instantly to any critical care need,” says Tracy. Social workers, dietitians, occupational therapists, physical therapists and other staff are also part of the PICU team.

More than 1,300 patients are treated in the PICU each year, including cases admitted from the Miller Children’s emergency department—the region’s only county-designated pediatric emergency room and trauma center. Many children also arrive from much farther away. “At least half our patients are transfers from other area hospitals that don’t have the special capabilities necessary to treat critically ill or injured children,” says Tracy.

To make sure these vulnerable patients are transferred safely, Miller Children’s has a dedicated PICU transport team, which includes a board-certified pediatric intensivist, as well as a pediatric critical care nurse and respiratory therapist. “Our PICU transport team is available at a moment’s notice, around the clock, ” says Tracy. “They bring their specialized training and equipment with them, and manage the patient’s care throughout the transport back to our facility.”

Nationally Recognized

The PICU at Miller Children’s is nationally recognized for its expertise in treating some of the most medically complex pediatric conditions, particularly head traumas and respiratory disorders. “Head trauma can cause swelling of the brain—a key concern because this can lead to permanent damage and loss of function,” says Tracy. “Children with these types of injuries require comprehensive assessment and constant monitoring.”

Treatment of severe respiratory disorders also requires highly specialized capabilities. The PICU offers the latest advances in respiratory care, including extra-corporeal membrane oxygenation, a special heart-lung bypass machine for children suffering severe breathing problems or cardiac failure. Other less invasive techniques for children in respiratory distress are high-frequency ventilation, a method that provides “breaths” at a much faster rate than normal, and ventilation, which supplies breathing support through an endotracheal tube (breathing tube).

Rigorous Standards

A key priority for the PICU care team is protecting fragile young patients from hospital-acquired infections. Thanks to rigorous infection-control procedures, the Miller Children’s PICU has been recognized by the National Association of Children’s Hospitals and Related Institutions for being in the top 10th percentile nationwide in preventing the most common hospital-acquired infections. These include catheter-associated urinary tract infection, catheter-associated blood stream infection and ventilator-associated pneumonias.

The PICU has also been recognized by the Institute for Healthcare Improvement as a “national mentor”—a resource for other hospitals—for its pediatric rapid response team. Led by PICU physicians, the team is immediately available to assess patients anywhere in the hospital. “If a nurse or staff member in any unit in the hospital has concerns about a child’s condition, he or she can page the rapid response team and a PICU physician will be there in minutes,” says Tracy.

But what really sets the PICU at Miller Children’s apart from other hospitals, says Tracy, is its patient-and-family-centered approach. “We have a wonderful Child Life Program that helps children cope with being hospitalized,” she says. “We also recognize that when you care for children, you also care for the family. Parents know their child better than anyone else, so they’re a key part of the treatment team.”

For more information visit PICU at Miller Children’s Hospital.