Adolescent in icu

Specialties Critical

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What are the legal issues caring for a 16-17 yo in an adult icu in a hospital that does not have a pedi or children unit. (A unit for patients

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Specializes in OR, Nursing Professional Development.

At 16-17 years old, you most likely would not be following PALS anyway. Think about what they tell us with CPR- once there's evidence of onset of puberty, treat them like an adult in a situation where you would perform CPR. My facility frequently cares for patients who are 16-17 (and occasionally 15) years old in our adult trauma unit or ICU. We do not have a PiCU. In fact, some of them may indeed be getting better care than in a large city hospital with a PICU due to our experience with certain genetic disorders that we are very familiar with treating due to the prevalence in our one population subset.

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Specializes in Critical care.

Is this a homework question? Kind of sounds like it to me.

What do you think the legal issues would be and why? I'm not really seeing any, but I want to hear you're ideas before sharing mine.

Rose Queen is also right that at that age PALS wouldn't even apply to them anymore.

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Specializes in CVICU, MICU, Burn ICU.

You don't need PALS to treat patients > 14 or 15 years of age. I have always occasionally cared for older teens in general ICU settings. Patients of ALL ages are treated in many BICUs (even if there is an onsite PICU). In these settings where you can literally be caring for a 3 month old or a 76 year old, PALS is required. If you are certified in PALS and/or have ever cared for a critically ill older teen, you know drug calcs, ETT sizes, etc. are same as adult.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

In trauma, 15 and up is considered adult. Does that mean we stop using pediatric parameters? Not at all. But they may end up in an adult unit vs. our PICU depending on the patient and what our trauma surgeon and pediatric intensivist decide to do.

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Most 16-17 year old males are bigger than me. Physiologically speaking they are adults. Psychologically they are adolescents. That's where the big difference lies.

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Specializes in Critical care.

I didnt want to give away my original thoughts in case this was homework, but it's been long enough.

I don't see any differences from a legal standpoint between a minor (who can't give consent) and any other adult patient that can't give consent (for whatever reason- being sedated, dementia, etc). Both would have a designated person making the decisions and giving consent for treatment/procedures.

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15 and older come to my icu.

What kind of legal issues do you anticipate?

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