The 36-bed PICU averages 1600-1800 medical and surgical admissions annually and provides a full range of critical care services, including high-frequency ventilation, continuous renal replacement therapy, inhaled nitric oxide, and extra-corporeal life support. The PICU supports all subspecialty services at LPCH, directs the 24/7 Transport Team and Transfer Center, the Palliative Care program, as well as the Rapid Response/Resuscitation programs at LPCH. Services particularly active in the PICU include neurosurgery, ENT, liver, kidney and stem cell transplantation, pediatric surgery and the Level 1 Trauma Center at LPCH. The PICU team includes critical care fellows, nurse practitioners, and pediatric residents, which provides family-centered care to all PICU patients. Critically ill or injured children are admitted from communities throughout Northern California, together with selected referrals from Nevada, Oregon, and other states, particularly for organ transplantation and advanced neurosurgical services.
Dedicated pharmacists, respiratory therapists and critical care nurses are led by a nurse manager with four nurse practitioners. Members of the PICU team also include social workers, chaplaincy, child life, rehabilitation services, dieticians, and case managers. Quality and process improvement in the PICU is conducted via a multidisciplinary Local Improvement Team (LIT) which includes physician and nursing leads, a family advisory council member, a quality manager, performance improvement/analytics support, infection control, and the patient safety officer. Most medical patients are admitted to the PICU with acute respiratory failure, septic shock, or acute neurologic deterioration. In recent months, the average daily census of the PICU has ranged from 18-36 patients, with a mean of 22. During periods of high census, the PICU has the ability to ‘flex’ and overflow to the CVICU with primary physician coverage provided by the PICU team.