Pediatric Intensive Care Unit (PICU)
Critical care facilities at LPCH include a 24-bed PICU, 20-bed CVICU, and 40-bed Level III NICU. The PICU averages 1,600-1,800 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/Resuscitations 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, critical care nurses led by a nurse manager with three assistants, a clinical nurse specialist are integral members of the PICU team, which also includes social workers, chaplaincy, child life, rehabilitation services, dieticians, and case managers. Quality and process improvement in the PICU are conducted via a multidisciplinary Local Improvement Team (LIT) which includes, in addition to 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 18-26 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.
The footprint of the PICU will expand in 2017 with the opening of the new hospital. This will house 24 PICU beds at the outset, with expected expansion up to 36 beds in state-of-the-art-designed space.