Question about ages in the NICU and PICU

  1. 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!!
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    16 Comments

  3. by   kstec
    I don't know about all hospitals, but my hospital only allows newborns that have never left the hospital to be admitted to NICU, all others have to go the PICU due to being "contaminated" by the outside world, even if they are only a day old and have left the hospital only to turn around and return.
  4. by   rnurse2b
    My old facility was the same as kstec, only the newborns in NICU and if the baby ever left the facility and turned around and was readmitted, then the baby went to the PICU.
  5. by   Gennaver
    Quote from 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!!
    Hello,
    There are a couple of Children's hospitals here that are "children" only and do not have a labor and delivery. All NICU children come from other places. I heard one nurse say that their ages are not cut and dry between PICU and NICU there.

    I really am not helpful, eh?
    Gen
  6. by   wooh
    Quote from Gennaver
    Hello,
    There are a couple of Children's hospitals here that are "children" only and do not have a labor and delivery. All NICU children come from other places. I heard one nurse say that their ages are not cut and dry between PICU and NICU there.

    I really am not helpful, eh?
    Gen
    But there's a difference between out in "the world" and just at another hospital. I would think that if they've gone home, then they're PICU, but if they're coming straight from another hospital, then they're NICU. Interesting question though, because with that being the difference, you could have much older babies in NICU than in PICU at times. I'm going to have to ask around the next time I'm at work.
  7. by   WSU_Ally_RN
    Although I do not work in either of these units, I have done soem PRN work in our ED where we get lots of kids in and out. I believe our determination here is their weight. Not all the stuff in the NICU is cut out for a big baby, so they go to PICU. I'm not sure what our cutoff is though. Our hosptial does not have L&D, so everyone is admitted either from an outside hospital or through the ED.
    Last edit by WSU_Ally_RN on Apr 5, '07 : Reason: added info
  8. by   pcicurn7
    Once that baby is discharged, any stays afterwards go to the PICU. Obviously Nursery to NICU or NICU to NICU transfers are not babies that have been discharged. Seems like this is the rule of thumb all around...
  9. by   JenICURN
    Quote from kstec
    ...but my hospital only allows newborns that have never left the hospital to be admitted to NICU, all others have to go the PICU due to being "contaminated" by the outside world
    Just out of curiousity, do you know what happens with babies that were born out of the hospital (homebirth, in the car on the way to hospital, etc)?
  10. by   Imafloat
    I work in a NICU at a Children's Hospital so every patient comes from somewhere else. If a baby comes to us right after birth we will keep them on our unit for a very long time if they need to be there. We have an IMCU and we try to get them in there once they are 4-6 months old, but that usually takes awhile, the IMCU is usually full.

    We take ER admits up to 28 days, but will sometimes take an older baby if it was a former NICU baby at another hospital. Our PICU has such a broad range of conditions, I think the facility feels like since there are newborn specialists in the hospital that newborns are better off in the NICU. If one of our former patients comes back through the ER with a problem not related to what we treated them for they either go to PICU or the general floor. If one of our chronics comes back after discharge they go to the PICU.
  11. by   Imafloat
    Quote from JenICURN
    Just out of curiousity, do you know what happens with babies that were born out of the hospital (homebirth, in the car on the way to hospital, etc)?
    Those babies usually go to a children's hospital if there is one in the area.
  12. by   lovemyjob
    we will get an older baby if he left our unit and it is with in a few days or so from D/C. We have gotten hyperbili/double exchange transusion who was 3-4 days old who had come from home (term, not our LD.) There is no across the bard rule. If PI is full, we may take bacj one ouf our older kids who went home and cam back.
  13. by   AliRae
    Babies born in the car or the Wawa parking lot come to our NICU. Anyone IN the NICU stays there until they NICU runs out of room. Then they get dumped on us. Kids from outside NICUs come to our PICU. The only ones born in-house who come straight to PICU are cardiac kids.
  14. by   TiffyRN
    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.

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