What kind of kids do you see in your PICU?

[sergel02]

Another pediatric question I was thinking about. I know every PICU is different and at a different level, but I was wondering what kind of kids you see in your unit. All I know is most PICU's have vented patients and open heart post-ops. I know at the 3 PICU's in my area, once a kid doesn't need the vent, they tend to get taken down to med surg.

Also, something I've been really curious about, is the age range you see. Mostly toddlers, under 8, adolescents, etc.? I have a friend precepting in a PICU and they get a lot of heart kids since there is a CVICU for peds, but since the hospital is also a major trauma center they get a lot of teens doing things they probably shouldn't have.

Thanks for any help :)

[LoveMyBugs, BSN, CNA, RN]

My PICU is in a children's hospital on a truamas center campus.

So pretty much anything you imagine gets admitted.

Just admitted an infant in acute renal failure do to dehydration related lack of breast milk infant was only being breastfed. Lost 2kg in 4 days Moms milk never came in.

Teens you have ODs, attempted strangulations, MVC,

Toddlers NATs and truamas, accidental OD.

Infants RSV, respiratory failure

DKA

Hearts

ECMO

Spinal rod placements

Taken care of post-op T&A in the PICU

If they are stable, but still needing the vent....new quads, they can go to the floor and are made intermediate as we don't have a step-down

[NicuGal, MSN, RN]

We are the peds trauma center and comprehensive care for

our area. I worked up in PICU today and we had:

2 long term care kids, trached

and PEGed in for pneumonia and sepsis. Both 18yo

1 brain tumor needing an external

shunt

2 MVA with multiple fractures and bolted, 10yo and 16yo

2 DKA new diabetics teens

1 dog attack (grandmas pug took on a 2 year old )

and one 2 year old with bad chickenpox kid, intubated with lesions in the airway.

One heroin overdose--14yo

Busy day!

[sergel02, BSN]

We are the peds trauma center and comprehensive care for

our area. I worked up in PICU today and we had:

2 long term care kids, trached

and PEGed in for pneumonia and sepsis. Both 18yo

1 brain tumor needing an external

shunt

2 MVA with multiple fractures and bolted, 10yo and 16yo

2 DKA new diabetics teens

1 dog attack (grandmas pug took on a 2 year old )

and one 2 year old with bad chickenpox kid, intubated with lesions in the airway.

One heroin overdose--14yo

Busy day!

That poor 2 year old

An ER nurse was telling me she started seeing more drug-related incidents in teens the last few years. For her it was more related to prescription drug abuse, but that's on her end.

Have you guys noticed any thing different on that front where you are?

[NotReady4PrimeTime, RN]

We see a handful of overdoses a year, often toddlers who got into grandma's purse and took her heart meds. Every once in awhile we'll have a cluster of methamphetamine ODs that usually have tragic outcomes. Tylenol ODs are infrequent but often enough that we stock Mucomyst in our Pyxis. I don't find street drugs to be a big concern for our unit.

[LoveMyBugs, BSN, CNA, RN]

We get dextromethphoran or known on the street as triple C. Recently we have gotten overdoses of 25C or 25B which is a synthetic acid, last pt the CK was over 30000.

There is also a synthetic marjunana that they are overdosing on as well.

Plus the good ol drunk teenagers sometimes get admitted to the PICU as they can not protect their airway.

[NicuGal, MSN, RN]

We are seeing an increase in heroin in our area. It is sad

[reisingrn]

Ah, Picu. Where you can have amazing days and the worst day of your life in the same week. There is no nurse smarter than a Picu nurse. Compared to adult icu, we know a lot about everything. There is a million things that can go wrong in every system/organ/cell in your body. We have to be able to manage all of it. My unit does everything except transplants. You can have barely"sick" patients up to coding patients. Last night I had a patient who is trached/vented, neurologically devastated and a sweet young laddie (also trached/vented) who's toughest time was figuring out what toy to play with and when. (Don't be fooled, those chronic kids are sick, true Picu patients). To explain how horrible it can be: a bit ago, I had a patient on crrt who started seizing. An hour later we were intubating her, putting an icp bolt in, slow coding her, placing extra central lines, opened her belly at the beside, and started compressions. She herniated. Yes we do have egos, but it's because we need to know how to do all of that without the time to look it up. Anything can happen at any time. Yes we deal with families and the education can be downright terrible. In the end, there is buying like being a Picu nurse. We are beasts.

[DarkEyed]

I did 2 years in PICU. I got so burnt out. I would see accidental overdoses, meningitis, hemophilia, pneumonia, car accidents, seizures, etc.

[Wolf at the Door, BSN]

Compared to adult icu, we know a lot about everything.

Seriously don't be foolish

[reisingrn]

Rereading what I wrote after a night shift,I realize how that is offensive. I can't seem to make it not sound offensive, so I'll go ahead and place my foot in my mouth. Think specialized ICU environments vs a general knowledge type. In all honesty, we all really should know a good amount of everything to safely perform in that environment. So there, foot in mouth.