If your child needs an intensive care stay, he may go directly from the operating room to the Pediatric Intensive Care Unit (PICU) or the Cardiac Critical Care Unit (CICU) — or, depending on his age, the Newborn/Infant Intensive Care Unit (N/IICU). Children who have had certain types of major surgery — such as heart operations, organ transplants or neurosurgery — need intensive care. Children who require close or specialized monitoring after surgery will also spend time in the ICU. In the Intensive Care Unit, your child will be closely watched 24 hours a day. Here are few things to expect when your child needs intensive care.
What kind of equipment might your child need?
Intensive Care Units (ICUs) are designed for children's unique needs; they're equipped with complex machines and monitoring devices. While some of this equipment may look intimidating, it's all designed to help the healthcare team take good care of your child. Knowing what the equipment is and what it does can help ease your fears.
A cardiorespiratory or heart monitor continuously displays your child's heart and respiratory rate. Wires from the monitor are attached to adhesive patches on the skin of your child's chest and abdomen.
A blood pressure monitor measures your child's blood pressure with a cuff placed on her arm or leg. The monitor periodically pumps up the cuff and measures blood pressure. If your child needs continuous blood pressure monitoring, it can be done with a small catheter (small tube) in one of her arteries.
A pulse oximeter measures — through the skin — the amount of oxygen in your child's blood. A tiny light is taped to his finger, ear or toe. A wire connects the light to the monitor, where it displays the amount of oxygen in your child's red blood cells.
The transcutaneous oxygen/carbon dioxide monitor measures the amount of oxygen and carbon dioxide in your child's skin. A small, circular pad is attached to her skin, most often on the chest or abdomen. The pad warms a small area of skin underneath and measures oxygen, carbon dioxide, or both. A wire connects the pad to the monitor and displays the levels. Because the transcutaneous monitor heats the skin, it must be moved to different places on the skin every few hours. The heating may leave a temporary red spot on the skin.
Your child's healthcare team may bring a portable X-ray machine to her bedside in the ICU. Your child's doctor may order X-rays for a number of reasons:
- To check the placement of catheters and tubes
- To look for signs of lung problems
- To check for signs of bowel abnormalities
An endotracheal (ET) tube, which is placed through your child's mouth and into his trachea (windpipe), is held in place with tape and is connected with flexible tubing to a mechanical ventilator (breathing machine). Your child will be unable to speak or cry while he has an ET tube, because the vocal cords can't vibrate and make sounds when the tube is in place. This is temporary, and your child will regain his voice after the tube is removed.
A respirator or mechanical ventilator helps children who are unable to breathe on their own, or who need help taking bigger or more effective breaths. Ventilators can also deliver extra oxygen, if your child needs it.
Intravenous (IV) pumps give your child fluids and medications, in very accurate amounts, directly into his bloodstream through a needle placed in a vein.
Who will be caring for your child?
The surgeon may ask other specialized physicians to help manage your child's care while she's in the ICU. These specialists may include (but aren't limited to):
- Critical care medicine physicians to help coordinate your child's care when many physicians are involved, and to observe for complications that might occur after surgery
- Neonatologists, who are critical care medicine specialists for infants
- Anesthesiologists to help manage your child's pain
What should you know about visiting the ICU?
Ask someone on your child's healthcare team, when you first arrive, about visiting hours and policies. We may need to limit the number of visitors your child has, and may also request that other children not visit. As a parent or legal guardian, you are welcome to stay with your child 24 hours a day. You may also want to ask about other services available for parents, such as laundry, showers and sleeping facilities. More information about services for families can be found on our For Patients and Visitors site.
What can you do for your child in the ICU?
If your child needs to be in the intensive care unit, you may be feeling very frightened, upset and helpless. The good news is that even if your child is receiving medication to control pain or help her sleep, she still needs to know you are there to support her.
You can play an active role in your child's recovery by finding ways to comfort her. The healthcare team will be happy to suggest ways that you can support your child. In return, they'll welcome suggestions from you about how to make your child feel more comfortable and secure. One of the hospital's child life specialists can also be a great resource for teaching you and your child relaxation and pain management skills.
Here are some things you may want to try:
- Touch your child and talk to him in soft, soothing, reassuring tones.
- Bring your child's favorite music from home.
- Record your family reading your child's favorite story on a tape recorder.
- Place pictures of your family, child's friends or family pets where your child can see them.
- Bring an item or two from home that helps your child feel secure, such as a favorite stuffed animal, a soft blanket, a special cup to drink out of, or a pacifier.