The LEAST critically ill kid you've cared for in PICU :) - page 3

by marycarney | 14,000 Views | 28 Comments

So last night I admitted an eleven-month old fro the ED into a PICU bed for acute asthma. The floor doc declined him due to his 'instability' and 'acute distress'. The first HOUR this kid spent in the PICU was spent jumping... Read More


  1. 0
    Quote from MeganNYRN
    I worked in a PICU that took every pt that had a VP shunt not just malfunctions. If a pt coming in for an t+a or appendectomy etc had a VP shunt they had to stay in PICU through discharge. Apparently due to a sentinel event but it seemed silly to have kids who were fine hooked up to monitors all the time in a PICU bed.
    There's always that one event that ruins it for the rest of them. Never mind improving education for the floors and working to make the hospital stay better for the patient, nope just tie them to an ICU bed/monitor that their insurance probably won't pay for and hope that no traumas come in!
  2. 1
    I'm not PICU, but worked in Pediatric Level ! Trauma for years. I sent a teenager to the Burn Unit one night. Report was high temp flash burns to the face, 9% BSA all to the head, with airway involvement. He was sedated, paralyzed for transport, and coming by 'copter. I've got sterlie sheets on the bed, we're all gowned up and expecting, well .. a burned kid. The 'copter crew comes strolling through the doors, chatting to each other (tip off #1), I don't smell "that smell" (tip off #2).

    This kid gets over to the gurney and my attending and I just look at each other and at the same time say, "Where's the burn?". Literally. This guy had one single strip across his forehead that was red, one little bubble of blister, 1mm X 1mm at the left end. No airway involvement at all (and he had a full mustache, no singed hairs). He went up to Burn to let the Vecuronium and Versed wear off so he could be extubated and observed over night. He arrived in the ER at around 22:00, they were gone and driving home by 09:00 the next day.
    KelRN215 likes this.
  3. 0
    A suspected rocky mountain fever patient, transferred from a small rural hospital. Found to have a common virus (causing the fever) and bedbugs (causing the bites).
  4. 3
    We get all the scolis overnight on their surgery day. No biggie. Had a teenaged girl several months back who had a very long anesthesia time (like 13 hours). Needless to say, she was a wee bit loopy. She kept saying, "Wasn't that sweet of him to fix my back?"

    We assumed she was talking about the surgeon, agreed with her over and over. Mom calls us into the room about 2am- convulsed with laughter. She says, "Ask her WHO fixed her back." So we did.

    "Barack Obama - and he's a very busy man!" was the answer.

    Mom of course filmed this hilarious exchange, and I'm sure it'll be drug out at this girl's prom or graduation party.
    WoosahRN, HazelLPN, and JustBeachyNurse like this.
  5. 0
    An ingrown toenail surgery. It wasn't my patient and I have no idea why they were even admitted much less to PICU.

    Our neuro surgeons will not admit kids to the floor. They refuse. So we get everything including skull fractures with no bleeds (and not depressed fractures either). Basically we babysit them and discharge in the morning.
  6. 0
    Three of the sickest patients I ever took care of were Rocky Mountain Spotted Fever. Horrible deaths and very, very quick deterioration. One went from talking to starting ECMO within 8 hours and was taken off support 12 hours after that. Dead within 24 hours of admission. I can understand those PICU admissions.
  7. 3
    LOL -- I'm a floor nurse, but have enjoyed reading these. We have our fair share of "stupid" admissions... the best coming in July when the new residents hit the floor running. Last summer we admitted a kid with swimmers ear. Why? Because it was accompanied with dizziness.

    No ****, sherlock.
  8. 1
    One of my intensivists has a saying, "if they can walk, talk(scream), pee, poop and eat.... time to ship them out!" The other nurses and I know in our PICU if the other intensivist is on, all we have to do is keep the door open to the screaming childs room during rounds and magically, transfer orders are written ;-)
    meanmaryjean likes this.
  9. 2
    I'm not a PICU nurse, but a hospital I used to work at had the policy that any child w/ a trach was admitted to the PICU. Well this one night the PICU was full, so I had an overflow pt in my adult SICU. I don't remember his dx but he was 15 yrs old, rock stable, sitting up in his chair playing with his Xbox all evening. No pain, on room air, didn't even have secretions he needed me to suction. I think I gave him scheduled meds twice and checked on him hourly...otherwise I was going around practically begging my colleagues for things to help them with. This kid was my only pt; I had the admit bed w/ no admits. That was an extremely long 8 hours!!
    meanmaryjean and Christy1019 like this.


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