Children in a Pediatric Intensive Care Unit (PICU) are receiving intensive care. Parents can find the variety of machine and medical equipment used to provide that care overwhelming. Knowing what to expect and what all that equipment is for, can help. The caring team at The Woman’s Hospital of Texas Pediatric Center PICU can also address any questions or concerns you might have.
Be assured that your child’s condition is constantly monitored while in the PICU and staff are on hand 24 hours to make any adjustments to care need to keep the patient comfortable and on the road to improvement.
For more information our staff and facility, visit: Pediatric Intensive Care Unit.
IVs, Lines, Tubes and Catheters
Your child may need one or all of these lines, catheters and tubes when in the PICU. They may feel uncomfortable so, please help prevent your child from pulling on them. Gentle straps may be recommended for this purpose to ensure patient safety. We are experts at gently placing IVs, lines, tubes and catheters into even the youngest of our patients.
- IVs. IV or intravenous catheters are thin, soft, flexible tubes inserted into a vein to deliver fluids and medications. The small needle used to insert the catheter is removed once the catheter is in place. These are usually inserted into the hands, arms or feet of the patient. Once inserted, they should not cause the patient pain.
- Central Lines. Central lines are IVs placed in the larger, more central veins of the chest, neck or groin. They may be needed if the medication a patient needs is likely to damage smaller blood vessels or if the patient needs greater volumes of fluids and medications.
- Arterial Lines. Arterial lines resemble IVs, but are placed in arteries rather than veins. These generally are used to monitor blood pressure, oxygen levels and other gases in the patient’s blood.
- Nasal Cannula. This soft plastic tube has two prongs that are placed into the nostrils to deliver oxygen to the patient. The cannula causes no pain.
- Oxygen Mask. This is a small soft plastic mask worn over the nose and mouth to provide oxygen to the patient. It is totally painless.
- “Feeding” Tubes. These tubes can be used for delivering food and medicine to the patient’s stomach or keeping the stomach empty. We use four types in our PICU, all specially sized for children. An NG tube is placed through the nose into the stomach, while an ND tube goes through the nose down into the duodenum (the first section of the small intestine). Oral tubes are inserted through the mouth down into the stomach (OG tube) or duodenum (OG tube).
- Foley Catheter. This is a small, soft tube inserted into the bladder used for collecting and measuring urine.
- ET Tube. An “ET tube” is used to provide an artificial airway for your child. Placed in your child’s mouth or nose, it will help him or her breathe. This tube goes down the windpipe and through the voice box, so your child will not be able to talk while the ET tube is in. A pad and pencil may help them communicate during this time.
Sometimes simply providing direct oxygen to a patient through a nose canula or oxygen mask isn’t enough to help them breathe. In this situation, your child may need to be connected to a ventilator (breathing machine). There are different types of ventilators used for different situations. No matter which type of ventilator is used, they all help your child breathe.
Your child can be attached to the ventilator using either an endotracheal tube (most common) or tracheostomy.
- Endotracheal tube: One end of a plastic tube is inserted through the patient’s nose or mouth and down into the windpipe, while the other end is attached to the ventilator.
- Tracheostomy: One end of a plastic tube is inserted through the patient’s skin at the front of the neck to directly access the windpipe. The other end is attached to the ventilator. Tracheostomy is only used when patients need to be on ventilation for a long time, they are unable to clear mucus from their lungs by coughing or there is swelling or damage that prevent an endotracheal tube from being placed.
While either type of breathing tube is in your child’s windpipe, sedative and pain relief medications will be administered to keep him or her as comfortable as possible.
Doctors sometimes need to use medications that have dangerous side effects. Children receiving these types of strong medications must be closely monitored in the PICU. Often, these medications are administered slowly, but continuously, through an IV, drop by drop. These are known as IV drips. Examples of medications administered this way include epinephrine, dopamine, and morphine to help with heart function, blood pressure or pain relief.
Patients in the PICU are attached to various types of monitors. These devices provide a constant stream of information about patient vital signs for observation by the PICU medical staff.
- Heart Rate and Breathing Rate. Heart rate counts how many beats per minute the heart is contracting, while breathing rate counts how many breaths are taken per minute. Heart rate and breathing rate are both monitored by sensors (electrodes) secured to the patient’s chest with small stickers. These sensors are connected to the monitoring device (a bedside machine) using wires (called leads). The application of the electrodes as well as the monitoring process is completely painless to the patient.
- Pulse Oximetry. This device (pulse-ox) is attached to the patient’s fingers or toes like a small bandage and emits a soft red light. The pulse-ox measure blood oxygen levels and is painless.
- Blood Pressure. Most children will have a cuff on their arm or leg to monitor blood pressure. This device automatically turns on and off without having medical staff present as it intermittently measures blood pressure readings and relays results to medical staff electronically. While constricting, it should not cause pain.Blood pressure can also be monitored constantly using an Arterial Line (see IVs, Lines, Tubes and Catheters).
A variety of tests may be ordered by the patient’s doctor to obtain information about a patient’s medical condition. These tests may include lab work to analyze the child’s blood or urine, and sometimes the fluid that surrounds the brain and spinal cord called cerebrospinal fluid. We have our own on-site lab available to perform diagnostic analysis 24 hours a day.
Internal pictures of parts of the body may be obtained using different types of imaging devices. Our Pediatric Center has its own on-site imaging department where X-rays, ultrasound, CT or CAT scans (computer aided tomography) and MRIs (magnetic resonance imaging) can be performed 24/7. These tests are usually painless, but the patient needs to remain still during the imaging process, which can be lengthy. Sometimes it will be necessary for the patient to maintain an awkward position for these tests.
When an MRI is performed, patients should wear earplugs or headphones to protect their hearing from the loud noises the machine makes. Patients may request their favorite style of music be played over these headphones during the testing procedure.
Because children can’t always be still enough for an accurate test, or may become stressed or scared, The Woman’s Hospital of Texas Pediatric Center is able to complete MRI testing under anesthesia. Your child’s care team will discuss this option with you if needed.
Get more information about The Woman’s Center of Texas Pediatric Intensive Care Unit (PICU), including our staff, conditions treated and the admission process: Pediatric Intensive Care Unit.