What is Paediatric Intensive Care Medicine (PICM)?
PICM involves caring for neonates, infants, children and young people from all types of paediatric specialties who are critically ill and in need of close observation, continuous monitoring. These patients also need frequent, often highly technical, interventions along with complex drug therapies and machines to provide support for failing organ systems. This activity is done in a special type of hospital ward called a Paediatric Intensive Care Unit (PICU). Patients requiring this type of care often need a nurse:patient ratio of 1:1 or 2:1 and the input of a large team of health professionals.
Paediatric Intensivists are hospital Consultants who co-ordinate and implement the management of children whilst they are in the Paediatric Intensive Care Unit (PICU), in collaboration with the specialty team that the child is admitted under. In PICUs, Intensivists work as part of a multidisciplinary team with colleagues in nursing, pharmacy, dietetics & nutrition, physiotherapy, cardiac physiology, medical imaging and bio-engineering.
Very accurate data is collected on children who receive intensive care in Britain and Ireland by the Paediatric Intensive Care Audit Network (PICANet). The following information is from PICANet’s 2015 report covering admissions of Scottish children from 2012-2014:
- 4,404 children under 16 years whose usual place of residence is Scotland were admitted to paediatric intensive care units in the UK and the Republic of Ireland between 1st January 2012 and 31st December 2014
- Age specific prevalence was 158 (95%CI: 154-163) admissions per 100,000 children
- this resulted in 25,386 bed-days being provided for Scottish children in paediatric intensive care
- nearly half of these were provided for children under one year of age.
- over half of admissions were for respiratory (lung, 28%) or cardiovascular (heart, 19%) reasons
- half of admissions were ‘planned - following surgery’.
- over half of children admitted to PICU need invasive ventilation to support their lungs.
- Most children stay in Paediatric Intensive Care for two days or less, but this varies from less than an hour to a year or longer in some cases. It is extremely rare for children to die in paediatric intensive care; over 97% of children leave this type of specialist care alive.
- Crude mortality for Scottish children in paediatric intensive care was 2.0% (compared to 3.7% in the UK and the Republic of Ireland) from 2012-2014. This had fallen slightly from 2.3% in 2009-2011.
We are a large Unit with almost 150 permanent staff. Paediatric Critical Care Medicine involves individuals from many professions and disciplines. At the heart of the PICU is our team of nurses, doctors (Intensivists), allied health professionals (Pharmacists, Dieticians, Physiotherapists), auxiliary nursing and housekeeping staff.
The PICU team operates an open model of care and we have close links with the specialty teams within the Chidren’s Hospital, in particular Cardiac Services, Medical Paediatrics, ENT Surgery, Renal Medicine, Neurosurgery, Neurology and Oncology.