Everything you need to know about the Paediatric Intensive Care Unit


Contents

Introduction

About Paediatric Intensive Care Unit (PICU)

Leaving PICU

Introduction

We hope this booklet can provide answers to some of the questions you may have during your stay in the Paediatric Intensive Care Unit (PICU). We understand this is an unfamiliar environment for you and that there may be questions you would Iike to ask. Please feel free to talk to our friendly doctors or nurses if you have any questions or concerns.

PICU is a special ward in the hospital that provides critically ill children with comprehensive care and treatment.

About Paediatric Intensive Care Unit (PICU)

What is PICU?

PICU is a special ward in the hospital. In addition to the intensive care given by doctors and nurses in here, medical equipment will also be used to assist you in the recovery process.

Why am I here?

You require intensive care here in PICU because doctors and nurses need to closely monitor your health condition. You were either transferred from a different ward in this hospital, or from another hospital. You will be able to leave PICU once your health condition becomes stable.

How long will I stay in PICU?

The length of PICU stay depends on your health condition, it can range from a few hours to several months, usually no more than a week in most cases.

Who are the people taking care of me?

You will meet a lot of people in PICU. Let's get to know the medical team that will be taking care of you. Doctor, nurse, physiotherapist, dietitian, occupational therapist, speech therapist, pharmacist, social worker, clinical psychologist, radiographer.

What will happen following PICU admission?

After arriving at PICU, doctors and nurses need some time to settle you down and stabilise your condition. Therefore, the medical team will usually invite your parents to wait outside the ward.

They may attach some devices to your body. There is nothing to worry about, as these devices and medical equipment are used to monitor your health condition.

The medical team will I deliver the appropriate treatment according to your condition. Sometimes they would give you medication to relieve pain or discomfort, and these medications can make you feel sleepy and drowsy.

What are the machines surrounding me?

Your room can be noisy at times due to the noises caused by the machines and monitors at the bedside. You may often hear beeps and other sounds as the devices attached on your body are monitoring your physical condition. These sounds are completely normal but feel free to ask our medical team if you have any concerns or questions. Please do not touch the surrounding machines and monitors, they include:

  1. Monitoring device
    This small screen that looks like a mini TV is placed near your bed, with lots of numbers and lines on the display. It shows the doctors the condition of your body, for example, how fast your heart is beating, your breathing rate, and the level of your blood oxygen etc.
  2. Medication pump
    This machine delivers medications into your body.
  3. Breathing machine (Mechanical ventilator)
    This is a machine that helps you breathe.
  4. Computer
    Doctors and nurses use this computer to record your medical data.

What are the tubes inserted into my body?

Different tubes serve different purposes. It depends on where they are placed in your body.

  1. Intravenous line (IV)
    The venous catheter (tube) is inserted into the vein and serves as a doorway into the bloodstream. It is usually inserted into the back of the hand or the lower part of the arm. Nurses use this catheter to deliver medicine, fluids or nutrient solutions into the blood.
  2. Feeding tube
    Those who have trouble eating or cannot eat by mouth can be fed using a feeding tube. It can be inserted through the nose and brings nutrition directly to the stomach.
  3. Urinary catheter
    In order to measure the amount of urine produced, doctor may use the urinary catheter to collect the urine into a drainage bag.

Common medical test

In order to make a diagnosis and determine the necessary treatment, doctors need to assess your overall health condition more accurately by performing the following tests.

  1. Blood test
  2. Urinalysis
  3. Medical imaging examination
  4. Medical imaging can show internal body structures, which is an important part of the examination. They include:

Frequently Asked Questions (FAQs)

  1. Why am I not allowed to eat?
    To help you recover more quickly, doctors may suggest that you should not eat for a short period of time, for example before or after surgery, or when you are seriously ill. Doctors may give you nutrition using other methods such as Total Parenteral Nutrition (TPN), where fluids and nutrition are given through the vein.
  2. When can I see my parents/carer?
    We understand you may feel lonely or scared at this time of separation from your parents/carer, but please be reassured that they can visit you during visiting hours. Our friendly team is also on hand if there's anything you need to feel more comfortable.
  3. How long will I stay in PICU?
    The length of stay depends on your health condition. You will be able to transfer to a general ward or go home once your health improves. At this point, it means you no longer require close monitoring and intensive care by doctors and nurses. Congratulations!
  4. How can I get help?
    Whenever you need help such as going to the toilet, getting a drink etc, please feel free to ask our nurses for help, as they are more than happy to help.

My emotions and feelings

During this period in PICU, it is normal if you experience strong emotions that go up and down over time. Sometimes, you may feel sad, worried, overwhelmed, angry, and at other times you may feel calm. These emotions can even happen all at the same time.

Having emotions is a natural part of being human, other children in PICU often experience similar feelings. If you would like, you may share how you are feeling at this moment, either in your own words or from the list below:

Ways to relax and calm your mind

  1. Breathing exercise
    Relax by counting, breathe in while you count 1-2-3-4-5 and hold your breath for 5 seconds, make sure your belly expands at this point by checking with your hand. After 5 seconds, breathe out slowly while counting 1-2-3-4-5. Repeat this breath cycle for a few times.
  2. Communication
    Talk to your family and friends, share your feelings with them and don't be afraid to ask for their support.
  3. Meditation
    Close your eyes, meditate while you think about the things you like to do, or favorite places you would like to visit.
  4. Sleep and rest
  5. Listen to music
  6. Draw, sketch or scribble

Draw, Sketch or Scribble

Drawing or scribbling is a great way to express your emotions and feelings. Feel free to draw anything that is in your mind.

My Diary

PICU is a continuously busy place, operating 24 hours a day and a lot of things happen here.

You can record your personal experience by writing your own diary, for example what you have done each day, what the doctors have done for you, whom you have had conversation with, or who came to visit you etc.

Date:
Events:
My feelings and thoughts:

Leaving Paediatric Intensive Care Unit

PICU discharge

Well done on the achievement of leaving PICU, which is the beginning of your journey to recovery and you are one step closer to full recovery! Before hospital discharge, you are usually transferred to another ward for further observation.

Road to Recovery – rehabilitation

Most children are able to make a full recovery after being discharged from the hospital, but some children still require continued rehabilitation. Doctors and allied health professionals may ask you to come back regularly for appointments, following up on your recovery process and providing up-to-date treatment.

If you have been away from school for an extended period of time due to hospitalisation, our allied health team can also support you in the reintegration back into school life.

  1. PICU admission
  2. Receive treatment
  3. Rehabilitation
  4. Transfer to general ward
  5. Hospital discharge
  6. Back to school
  7. Follow-up clinic

Are you ready to go home?

It is normal if you are not able to recall everything that has happened to you in PICU.

You may have had a lot of dreams and experienced hallucinations, which could make you feel annoyed and confused. This is a common experience for children who are on the recovery journey, as such experiences may be caused by medicines or the disease itself. You may feel scared and worried, but do not be afraid or embarrassed by your experience, and feel free to share with our medical team or people you trust.

You may need some time to adjust and settle back into life outside hospital. As the day of hospital discharge is approaching, it is normal to feel overwhelmed at this point.

Sharing your feelings

It may not be easy to talk about the PICU experience with family and friends. Putting your feelings and thoughts down in words can be very helpful. Writing is a great way of expressing yourself, so feel free to share your PICU experience by writing a letter to your best friend!


Sponsor:

Labour and Welfare Bureau

Authors:

Dr Karen Ka Yan Leung
Associate Consultant, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital

Dr Ellis Kam Lun Hon
Honorary Consultant, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital

Ms Kelly Lee Yan Tung
Medical student, The Chinese University of Hong Kong

Ms Stephanie Tsang
Medical student, The Chinese University of Hong Kong

Special acknowledgement:

All staff and patients of the Hong Kong Children's Hospital Intensive Care Unit

February 2023