Understanding the PICU

Whether your time in the pediatric intensive care unit (PICU) at Miller Children’s Hospital Long Beach is planned or the result of a sudden urgent need, having your child admitted to the PICU can be difficult. The physical, psychological and social needs are assessed on admission, as well as continuously during the patients hospital stay and the unit is designed to enable all patients and their families have visual accessibility of a nurse at all times.

Below are some of the terms you may hear or procedures you may be told of during your child’s stay.  If at any point there is something that is not clear, please don’t hesitate to ask.  It is important to us that you understand and are comfortable with the care your child is receiving.

Terms you may hear

Alarms: Alarms will sound for many reasons. Monitor alarms will sound when heart rate, respiratory rate or oxygen saturations fall outside an acceptable range. Medication pump alarms will sound to notify staff that a treatment or infusion is complete. Ventilator alarms will sound to notify the staff of a disruption in the circuit or a change in the delivered support. Staff in the PICU set alarms to go off at the slightest change. This causes some false alarms but allows us to observe your child closely. Alarms also may be observed from the nursing station or another patient's room.

Arterial Line: A flexible catheter that is inserted into an artery to allow the continuous monitering of blood pressure and the sampling of arterial blood to ensure adequacy of oxygen levels and carbon dioxide levels.

Bag, Ambu-bag, CPAP-bag: A hard plastic or inflatable bag connected to oxygen that allows a physician, nurse or respiratory therapist to help your child breath.

Call Light: Each room is equipped with a call light. The controls for the television also have a button to ring for the nurse.

Chest Tube: Sterile flexible tubing inserted by the physician into the chest to allow unwanted fluids or air to drain.

Emergency Cart: Rolling cart that contains supplies and medications needed to treat a child during a crisis.

ET Tube: A flexible plastic tube placed into a child's airway, through the nose or mouth, to help him or her breath.

Heart Rate: The number of times a minute your child's heart is beating. The green top line on the monitor will also be watched to observe the rhythm of the heartbeat.

Intubation: Placement of a breathing tube into the patient’s body.

Isolation: Used to prevent transfer of illness to the patient or to the visitor. May include one or all of the following: gown, gloves, mask, special isolation room or limited visitors.

IV: Intravenous. A flexible catheter that is inserted into a blood vessel to provide fluids, medications, blood products and or nutrition. These may be peripheral (inserted into a small vein in the hand, foot, or arm) or central lines (inserted into a larger vein via the neck, groin or chest).

Monitor: The large screen located above your child's bed that shows heart rhythm and rate, blood pressure and saturations. Other numbers may also be seen if your child's conditions indicates use of other treatments.

NG: Nasogastric Tube. A flexible tube that is inserted through the patient's nose into the stomach to drain unwanted fluids that can build up.

Postural Drainage: This procedure is used to assist in getting mucous and secretions out of your child's lung. The respiratory therapists will use their hands in a cuplike fashion or use a machine to gently vibrate on your child's chest.

Pulse Ox Probe: A "red light" usually taped to your child's finger or toe connected by a wire to the pulse oximeter. Measures the oxygen saturation in your child's blood.

Respiratory Rate: How fast your child is breathing. Measured by the monitor from abdominal "belly" movement and chest movement. The monitor can count movement by your child as breathing so this number is not always accurate. The health care team will also watch, look and listen to your child's breathing.

Restraints: Some children require soft Velcro holders on their arms and/or legs to prevent them from removing or pulling at equipment, IV's and tubes important to their recovery.

Saturation: A measurement of how well oxygen is being carried in the bloodstream.

Suctioning: May be needed for mouths and noses. If your child has an ET tube in place, he or she may need assistance clearing secretions. In this case, the ET tube will be suctioned and a staff member will assist your child's breathing using a bag connected to oxygen.

Ventilator: Assists with patient's breathing.

Warming Lights: A large metal frame that fits over a crib. Provides warmth to infants when they must be kept uncovered because of their illness or condition.