Pgi Chandigarh Picu Protocols4/10/2021
Level II PICUs may be necessary to provide stabilization of critically ill children before transfer to another center or to avoid long-distance transfers for disorders of less complexity or lower acuity.Michele Moss Find this author on Google Scholar Find this author on PubMed Search for this author on this site.
Pgi Chandigarh Picu Protocols Update The ExistingThese guidelines are presented to update the existing guidelines published in 1993.Pediatric critical care services are provided in level I and level II units.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. Knowledge of the pathophysiology of life-threatening processes and the technologic capacity to monitor and treat pediatric patients suffering from them has advanced rapidly during this period. Along with the scientific and technical advances has come the evolution of the pediatric intensive care unit (PICU), in which special needs of critically ill or injured children and their families can be met by pediatric specialists. All critically ill infants and children cared for in hospitals, regardless of the physical setting, are entitled to receive the same quality of care. In 1985, the American Board of Pediatrics recognized the subspecialty of pediatric critical care medicine and set criteria for subspecialty certification. The American Boards of Medicine, Surgery, and Anesthesiology gave similar recognition to the subspecialty. In 1990, the Residency Review Committee of the Accreditation Council for Graduate Medical Education completed its first accreditation of pediatric critical care medicine training programs. In 1986, the American Association of Critical Care Nurses developed a certification program for pediatric critical care, and in 1999, a certification program for clinical nurse specialists in pediatric critical care was initiated. In view of recent developments, the Pediatric Section of the Society of Critical Care Medicine and the Section on Critical Care Medicine and Committee on Hospital Care of the American Academy of Pediatrics believe that the original guidelines for levels of PICU care from 1993 1 should be updated. 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. The concept of level I and level II PICUs as established in the guidelines set forth in 1993 will be continued in this report. Individual states may have PICU guidelines, and it is not the intent of this report to supersede already established state rules, regulations, or guidelines; however, these guidelines represent the consensus report of critical care experts. Pediatric critical care is ideally provided by a PICU that meets level I specifications. The level I PICU must provide multidisciplinary definitive care for a wide range of complex, progressive, and rapidly changing medical, surgical, and traumatic disorders occurring in pediatric patients of all ages, excluding premature newborns. Most, but not all, level I PICUs should be located in major medical centers or within childrens hospitals. It is also recognized that in the appropriate clinical setting and as a result of many forces including but not limited to the presence of managed care, the insufficient supply of trained pediatric intensivists, and geographic and transport limitations, level II PICUs may be an appropriate alternative to the transfer of all critically ill children to a level I PICU. ![]() Specifications for level I PICUs are discussed in detail in the text and are summarized in Table 1. Level I PICUs will vary in size, personnel, physical characteristics, and equipment, and they may differ in the types of specialized care that are provided (eg, transplantation or cardiac surgery). Pgi Chandigarh Picu Protocols Full Complement OfPhysicians and specialized services may differ between levels, such that level I PICUs will have a full complement of medical and surgical subspecialists including pediatric intensivists. Each level I and level II PICU should be able to address the physical, psychosocial, emotional, and spiritual needs of patients with life-threatening conditions and their families. Minimum Guidelines and Levels of Care for PICUs Some pediatric patients with moderate severity of illness can be managed in level II PICUs.
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