Each level I and level II PICU must endeavor to meet the needs of other hospitals less well-equipped to handle certain types of care. Such knowledge is a vital component in improving patient care techniques and therapies, thereby decreasing morbidity and mortality. Pediatric Intensive Care Unit Dosing Guidelines ANALGESICS/SEDATIVES Aspirin (for anti-platelet dosing) AGE DOSE FREQUENCY < 3 kg 40.5 mg Twice a Week ≥ 3 kg - < 5 kg 40.5 mg M, W, F ≥ 5 kg - < 10 kg 40.5 mg Daily ≥ 10 kg 81 mg Daily Clonidine -25 mcg/kg/DAY initial 5 Note: TTS-1 = 0.1 mg/day, change Q7Days Program content should match the diverse needs of each unit's patient population. Programs providing subspecialty training in pediatric critical care medicine must possess approval by the Residency Review Committee of the Accreditation Council on Graduate Medical Education. Medical directors must achieve certification within 5 years of their initial acceptance into the certification process and must maintain active certification in critical care medicine. The level I PICU should provide care to the most severely ill patient population. Such policies shall govern matters including but not limited to safety procedures, nosocomial infection, patient isolation, visitation, traffic control, admission and discharge criteria, patient monitoring, equipment maintenance, patient record keeping, family care management (including family meetings, support groups, and sibling support), and bereavement care. Blood gas values must be available within 15 minutes. A manual of these policies will be available for reference in the PICU. Within these guidelines, the scope of pediatric critical care services is discussed, including organizational and administrative structure, hospital facilities and services, personnel, drugs and equipment, quality monitoring, and training and continuing education. Certain small equipment appropriately sized for pediatric patients must be immediately available at all times. Kyle UG, Lucas LA, Mackey G, Silva JC, Lusk J, Orellana R, Shekerdemian LS, Coss-Bu JA. All monitors must be maintained and tested routinely. This is essential for level I PICUs and desirable for level II PICUs. This report represents the consensus of the 3 aforementioned groups and presents those elements of hospital care that are necessary to provide high-quality pediatric critical care. Portable equipment will include an emergency (“code” or “crash”) cart; a procedure lamp; pediatric-sized blood pressure cuffs for systemic arterial pressure determination; a Doppler ultrasonography device; an electrocardiograph; a defibrillator or cardioverter with pediatric paddles and preferably with pacing capabilities; thermometers with a range sufficient to identify extremes of hypothermia and hyperthermia; an automated blood pressure apparatus; transthoracic pacer with pediatric pads; devices for accurately measuring body weight; cribs and beds with head access; infant warmers; heating and cooling devices; lights for photograph therapy; temporary pacemakers; a blood-warming apparatus; and a transport monitor. 4–8 At certain times of the day, the attending physician in the PICU may delegate the care of patients to a physician of at least the postgraduate year 2 level (in a level I PICU, this physician must be assigned to the PICU, and in a level II PICU, this physician must be available to the PICU) or to … An appropriately trained and qualified clinical pharmacist should be assigned to the level I PICU; this is desirable for the level II PICU. It is imperative that the same standards of quality care be applied to patients managed in level II PICUs and level I PICUs. Space will be allocated for a medication station (including a refrigerator and a narcotics locker), a nourishment station, counters, and cabinets. 2003 Mar;31(3):986-7. doi: 10.1097/01.CCM.0000055377.24657.A8. Access to the medical and nursing directors will be improved by having their offices located near the PICU. The department of surgery in hospitals with a level I or level II PICU will have at least 1 operating room available within 30 minutes, 24 hours per day, and a second room available within 45 minutes. Epub 2018 Jan 28. USA.gov. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. These drugs should be available in accordance with advanced cardiac life support and PALS guidelines and should include all those necessary to support the patient population that the PICU serves. It is desirable for level I PICU personnel to participate in regional pediatric critical care education for EMS providers, for emergency department and transport personnel, and for the general public. Physicians that work at public o private pediatric intensive care units in Argentina during at least 24 hours per week were invited to participate. J Pediatr Intensive Care. Please enable it to take advantage of the complete set of features! The practice of pediatric critical care medicine has matured dramatically during the past decade. A catheterization laboratory or angiography suite equipped to perform studies in pediatric patients should be present in hospitals with level I PICUs and is optional in hospitals with level II PICUs. 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