Question about ages in the NICU and PICU

[SoontobeAdrienneRN]

Hello Everyone!

I have a question regarding the NICU and PICU. I know that if a baby at complications during the delivery or has an abnormality at birth they are admitted to the NICU. But at what point is a newborn admitted into the PICU for a serious health matter? I mean is the NICU limited to just "new" newborns? At what point is the baby considered old enough for the PICU??

Thanks All!!

[TiffyRN, BSN, PhD]

Our NICU sounds like most. It will take homebirths though. Generally they go to the NICU at the Children's hospital that is next door to us. Because we have that Children's hospital right next door we can be pretty strict with the rule about once they've been home they must go to PICU. The Children's hospital has a separate NICU and PICU.

About the only time I remember transferring an infant to the PICU (not the NICU) next door was when we had an infant come down with a severe case of RSV and our census was really high.

If they have never gone home we will keep the infant here until discharge, I've seen kids as old as 8 months old. Most of us think it's not appropriate as the Children's hospital has better resources for these older babies. But apparently it would be considered some kind of patient dumping unless the infant had some medical need that couldn't be provided by our hospital. I hear back in the old days (20+ yrs ago) our unit had kids as old as 2 yrs old, running around in walkers (those aren't even used anymore are they?) dragging their oxygen tubing.

[tvccrn, ASN, RN]

NICU takes anything under 28 days or if they are a NICU grad anything that has been gone from there for under 14 days. Other than that it's PICU.

[SoontobeAdrienneRN]

Oh okay!! Thanks everyone it seems like every hospital varies in some way or another. Great answers to my question though

[sasha1224]

The children's where I worked it was pretty much outside world under 28 days, transfer from another NICU, no limit(though generally under six months). However, any patient requiring complex cardiac surgery(other than PDA or PA banding), was transferred and treated in the PICU. On occasion, if these pts were premature, once the heart surgeon cleared them, they went back to the NICU, otherwise went to the cardiac floor.

[LilPeanut, MSN, RN, NP]

Much like others, typically we only accept transfers (or the occasional precip from our Children's ER) though if someone has a "newborn issue", sometimes we'll take them. It just depends on the circumstances. Cardiac Kids usually go to CICU, which is in PICU, but sometimes we keep them, if they have other things going on. PICU has typically 1month+ kids. Or if they are RSV or something nasty like that.