When Your Child Is in the Intensive Care Unit
The intensive care unit (ICU) is an area in the hospital where your child can receive close monitoring, assistance with breathing, or specialized medical procedures. It’s often referred to as the critical care unit. Hospitals may also have specialized intensive care units for specific age groups. If your child is in the ICU, it means that he or she needs special care and attention that can be given only by a team of specially trained healthcare providers.
The ICU staff
Each of the healthcare providers caring for your child has special knowledge and skills. You may see the following staff in the ICU:
Healthcare providers oversee your child’s care.
Nurses do much of the hands-on care and monitoring.
Physician assistants (PAs) and nurse practitioners (NPs) are trained to do many of the same tasks as primary healthcare providers under a healthcare provider's supervision.
Therapists help assess and improve your child’s breathing, speech, strength, and movement.
Dietitians give advice about special eating concerns and nutrition.
Pharmacists make sure your child receives the right medicine in the correct amount and on schedule.
Child life specialists help your child learn what to expect in the hospital and cope with their experience.
Social workers and case managers help you deal with financial concerns, resources, and insurance.
Other support staff help with tasks such as drawing blood or serving meals.
Physical and occupation therapists will work with your child if they have been under prolonged sedation or bed rest to regain their strength and baseline functionality.
Inside the ICU
The ICU is a busy place. It can be set up as an open bay or consist of individual rooms. Your child may stay in the ICU for a day, a week, or longer. Be prepared to see lots of wires, tubes, and equipment, such as the following:
Monitors. These may be in place to check your child’s heart rate, respiratory rate, and blood pressure. They may have alarms that beep and signal staff when something needs to be checked. Alarms aren’t always a cause for concern. Sometimes even a slight movement from your child sounds an alarm.
Oxygen. Most children in the ICU need extra oxygen. It’s given through a nasal cannula (thin plastic tube that sends oxygen through the nose), a facemask, or a ventilator (machine that helps with breathing).
Intravenous (IV) lines and tubes. Your child will have one or more IV lines and tubes in place. All lines and tubes are closely monitored. IV lines usually provide medicine or give nutrition. Tubes help drain or suction unneeded fluids or air from your child’s body. They can also be used to give nutrition.
Pulse oximeter. This device measures the level of oxygen in your child’s blood. It has a red light and is connected to a long cable. It’s usually clipped to a finger, toe, or ear lobe, but it can be placed in other spots as well.
Restraints. Your child’s hands or legs may need to be restrained. This prevents him or her from pulling out tubes or wires. Restraints may be removed during your visits if you watch carefully that your child doesn’t pull on any tubes.
Important things to know
Many hospitals allow you to stay with your child in the ICU. The exact rules vary with each hospital. Your child’s condition is also a factor.
Wash your hands with soap and water before entering the ICU and after helping care for your child.
Turn off all cell phones and beepers. Ask an ICU staff member before bringing any other electronic equipment into the ICU.
Items such as plants, flowers, food, balloons, or toys may not be allowed in the ICU depending on the hospital rules.
You may be asked to leave the ICU during rounds. These are the times when your child’s healthcare team checks and examines your child. They need to do so with no distractions.
Your child may have a condition that requires isolation. In this case, you’ll be asked to wear protective clothing, gloves, or a facemask.
In most cases, you can spend the night in the hospital if you want to. This will likely be in a waiting room or a hospital room outside the ICU.
Discharge from the ICU
Most children are discharged from the ICU when they:
Have stable vital signs.
Can breathe without assistance from a machine or tube.
No longer need specific medicines or treatments that can only be given in the ICU.
Your child will then be moved to a regular hospital room. In rare cases, your child is discharged from the ICU to go home.
Helping your child
Following are ways to help your child in the ICU:
Stay with your child as much as you can. Ask your child’s healthcare providers if you can be present during treatments and procedures.
Learn all you can about your child’s health problem. Your child can pick up on your fears and worries. By staying positive and upbeat, you can help relieve some of your child’s anxieties and discomfort.
Comfort your child by touching and holding him or her often. Stroke your child’s hair or hold his or her hand.
Ask a member of your child’s healthcare team whether it’s OK to bring in items from home, such as your child’s favorite blanket, stuffed animal, or book.
April 21, 2018
Pulse Oximetry in Pediatric Practice. Fouzas, S. PEDIATRICS 2011; 128(4); p740-752
Adler, Liora C., MD,Bass, Pat F. III, MD, MPH