When Your Child Is in the Intensive Care Unit

The intensive care unit (ICU) is an area in the hospital where your child can receive close monitoring, help with breathing, or specialized medical procedures. It's also called the critical care unit. Hospitals may also have specialized ICUs for certain age groups. If your child is in the ICU, it means they need special care and attention from a team of specially trained doctors.

Each of the doctors caring for your child has special knowledge and skills. You may see the following staff in the ICU:

• Doctors oversee your child's care.
• Nurses do much of your child's hands-on care and monitoring.
• Physician assistants (PAs) and nurse practitioners (NPs) are trained to do many of the same tasks as primary doctors under a doctor's supervision.
• Physical and occupational therapists will work with your child if they have been under prolonged sedation or bed rest. They help your child to regain their strength and baseline functionality.
• Respiratory therapists help assess and improve your child's breathing.
• Speech-language pathologists help with speech and communication issues.
• Dietitians give advice about special eating concerns and nutrition.
• Pharmacists make sure your child receives the right medicine in the correct amount and on schedule.
• Child life specialists help your child learn what to expect in the hospital and how to cope with their experience.
• Social workers and case managers help you deal with money concerns, resources, and insurance.
• Other support staff help with tasks such as drawing blood or serving meals.

The ICU is a busy place. It can be set up as an open bay or there may be separate patient rooms. Your child may stay in the ICU for a day, a week, or longer. You'll see lots of wires, tubes, and equipment, including:

• Monitors. These may be in place to check your child's heart rate, respiratory rate, and blood pressure. They may have alarms that beep and signal staff when something needs to be checked. Alarms aren't always a cause for concern. Sometimes even a slight movement from your child sounds an alarm.
• Oxygen. Most children in the ICU need extra oxygen. It's given through a thin plastic tube in the nose (nasal cannula), a face mask, or a machine that helps with breathing (ventilator).
• I.V. (intravenous) lines and tubes. Your child will have one or more I.V. lines and tubes in place. All lines and tubes are closely monitored. I.V. lines usually provide medicine or nutrients. Tubes help drain or suction unneeded fluids or air from your child's body.
• Pulse oximeter. This device measures the level of oxygen in your child's blood. It has a red light and is connected to a long cable. It's usually clipped to a finger, toe, or ear lobe, but it can be placed in other spots as well.
• Restraints. As a last resort, your child's hands or legs may need to be restrained. This prevents them from pulling out tubes or wires. Restraints may be removed during your visits if you watch carefully that your child doesn't pull on any tubes.

These include:

• Many hospitals allow you to stay with your child in the ICU. The exact rules vary with each hospital. Your child's condition is also a factor.
• Wash your hands with soap and water before entering the ICU and after helping care for your child.
• Turn off all electronic devices, including cellphones. Ask an ICU staff member before bringing any other electronic equipment into the ICU.
• Items such as plants, flowers, food, balloons, or toys may not be allowed in the ICU. This depends on the hospital rules.
• You may be asked to leave the ICU during rounds. These are the times when your child's care team checks and examines your child. They need to do so without any distractions.
• Your child may have a condition that requires isolation. In this case, you'll be asked to wear protective clothing, gloves, or a face mask.
• In most cases, you can spend the night in the hospital if you want to. This will likely be in a waiting room or a hospital room outside the ICU.

Most children are discharged from the ICU when they:

• Have stable vital signs.
• Can breathe without help from a machine or tube.
• No longer need specific medicines or treatments that can only be given in the ICU.

Your child will then be moved to a regular hospital room. In rare cases, your child is discharged from the ICU to go home.

Here are some ways to help your child in the ICU:

• Stay with your child as much as you can. Ask your child's doctors if you can be present during treatments and procedures.
• Learn all you can about your child's health problem. Your child can pick up on your fears and worries. By staying positive and upbeat, you can help ease some of your child's anxieties and discomfort.
• Comfort your child by touching and holding them often. Stroke your child's hair or hold their hand.
• Ask a member of your child's care team if it's okay to bring in items from home. These include your child's favorite blanket, stuffed animal, or book.