In Alberta, the following common skills required in our PICU are not within the scope of practice of LPNs:
IV drug administration (particularly cytotoxics and anaesthetic agents)
short-term central line care
arterial and intracardiac line care
care of the patient with an open sternum
administration and monitoring of vasoactive drugs
monitoring and care of the patient on ECMO
endotracheal tube suctioning and maintenance
monitoring and care of intraventricular drains
monitoring and care of intracranial pressure monitoring devices
small bowel feeding tube placement
and probably several others I can't think of off the top of my head.
Assessment skills are also extremely important. The depth of assessment taught to LPNs just isn't the same.
Many of these skills are not acquired in nursing school
but through a lengthy orientation to PICU. There are courses available across the continent for nurses wishing to learn the theoretical and practical skills required to care for the critically ill child, but the individual will still require an orientation and gradual introduction to more complex skills.