Pediatric Intensive Care Unit (PICU)

Rotation Guide & Goals

Orientation Materials

The ICU Rotation

S. Kache, MD

The Intensive Care Unit at LPCH is a 24-bed ICU providing care for both medical and surgical critically ill pediatric patients.  Diagnosis of patients admitted to the PICU include: trauma, sepsis, pneumonia, solid organ / bone marrow transplants, post-neurosurgery, post airway reconstruction, organ failure (kidney, liver, lung heart), patients with neurologic deterioration, and any other children with rapidly progressive critical illness.  Residents will be exposed to a broad range of diagnoses in the Intensive care unit and should learn the essentials of managing pediatric patients with critical illness.

There are two care teams in the PICU, each consists of the ICU attending, an ICU fellow, 2 pediatric residents, an EM resident or nurse practitioner and rotating, medical students.  In the PICU, all patients are covered by the residents and will be divided evenly between the various care providers covering the unit.  Some rotations may have medical students present.  The students can either be present for a single week as a portion of their general pediatrics rotation, or for an entire month for either a core clerkship or sub-internship rotation.  All patients cared for by the medical students must be co-followed by a resident.  

BEFORE YOU START, MAKE SURE YOU REVIEW THE ROTATION GUIDE AND THE GOALS AND OBJECTIVES FOR THIS ROTATION.  THE DETAILS OF YOUR ROLES AND RESPONSIBILITIES AS WELL AS THE GOALS FOR YOUR EDUCATION IN THIS CHALLENGING ENVIRONMENT ARE ALL THERE!!

Tips

  • PRIORTIZE: i.e. assure septic patient receives ABX within the hour of order being written; iontropes are started within 30 minutes of being written
  • COMMUNICATE: with bedside nurse about plan for patient; with fellow / attending regarding possible updates, thoughts
  • FOLLOW-UP: to assure that orders written are completed; on radiologic studies, on cultures, on consultant recommendations
  • ASK QUESTIONS: any questions, concerns, thoughts – ask
  • BE YOUR PATIENT’S DOCTOR: you are the primary doctor of all your patients
  • KEEP TRACK: keep track of daily labs, results of radiology studies, biopsy results, etc.
  • HANG OUT: the more you are in the unit, the more you see, the more you do, and the more the nurses will come to you with issues on your patients 

Orders in the PICU

  • Review orders entered during rounds at the end of the presentation to assure nothing is missed 
  • Communicate orders with the bedside nurse

Teaching Schedule

Monday 8am   Fellow-led lecture  (PICU Front Desk)
Tuesday 12pm   PICU fellow conference  (PICU Conf Rm.) 
Thursday 8am   Fellow-led lecture (PICU Front Desk)

Goals and Objectives

Orientation

1st Monday 3:00pm.  

Review Orientation Slides in advance.

educational tools

(SUnet Authorization Required)


Contacts

Administrative Contact
Sarah Salem
Email Sarah

Rotation Director
Courtenay Barlow, MD
Email Courtenay

Rotation Liaison
Caroline Thomas