Common Questions about the PCCU

Healthcare providers visit patient rooms one by one to discuss problems and treatment plans. This series of room visits is known as a "round."

The critical care team, which includes doctors, nurse practitioners, nurses, pharmacists, case managers, and other specialty team members, will round on your child each morning, usually between 8 a.m. and 11 a.m.

The rounding team will meet at the doorway of your child's room. Your family is welcome to listen and participate. The team will review your child's medical history and discuss the plan of care for the day. At the end of rounds, you may ask questions and discuss any concerns you have about your child's condition.

Typical conditions that may require a stay in the PCCU are severe breathing problems from asthma, serious infections, certain heart defects, and some complications of diabetes. Many children stay in the PCCU for several days after major surgery. Critical care includes trauma care for children who are severely injured in accidents such as falls, burns, or car crashes.

Critical care refers to the treatment of patients who are suffering from serious illness or injuries. In the Emergency Department, physicians and nurses stabilize patients and transport them to one of the critical care units or another hospital area for further treatment. The critical care team provides long-term management of critically ill and injured patients.

Your pediatrician is an important link between the critical care team and your child and family. Your family physician has your child's complete medical history. He or she is often a trusted friend of the family who understands your values, attitudes, and healthcare preferences.

Critical care teams often work closely with the pediatrician or family physician to determine pre-existing illness, allergies, use of medications, and other factors that may influence your child's health.

Critical care physicians are doctors who are specially trained to treat patients in the critical care unit. They do not act as general pediatricians or family physicians.

You may visit our online Find a Doctor directory to locate a pediatrician at Vanderbilt or in your community.

The medical equipment and testing in the PCCU can seem overwhelming. Your child's stay in the unit may include:

IVs

Patients in the PCCU often have an intravenous catheter (or IV) in place for fluids and medications. An IV is a thin, flexible tube inserted into the vein with a small needle. The needle is then removed, leaving just the soft plastic tube.

Medications

Certain medications can have serious side effects. Children given these medications receive closer monitoring in the PCCU than on a standard hospital floor. Some of these medicines, given continuously through the IV, are known as IV drips. These medications, such as epinephrine, dopamine, and morphine, can help with heart function, blood pressure, or pain relief.

Monitors

Your child's condition may be monitored with chest leads, which are painless stickers connected by wires to a machine that tracks heart rate and breathing rate. They may also be connected to a pulse oximetry (pulse-ox) machine, which is a painless device attached to the fingers or toes to check blood oxygen levels. Patients usually have a blood pressure cuff in place as well.

Tests

Your child may receive many different types of tests to check their condition. Blood and urine are often tested. Sometimes, cerebrospinal fluid surrounding the brain and spinal cord are tested. X-rays, ultrasound, computed tomography (also called a CT or CAT scan), and magnetic resonance imaging (MRI) may be used to get pictures or images of different parts of the body.

Ventilators

Patients in the PCCU may need to breathe through a mask on the face or tube in the nose. Some children who are having difficulty breathing on their own may be connected to a ventilator (breathing machine). This is done with an endotracheal tube (a plastic tube placed into the windpipe through the mouth or nose) or a tracheostomy (a plastic tube inserted directly through the skin into the windpipe) connected to a ventilator. The type of ventilator your child is on will depend on their specific condition.

You know your child better than anyone else and can provide us with helpful information. Here is what you can do.

• Participate in your child's care. When appropriate, wash, feed, or hold your child (always ask your child's nurse first if this is okay).
• Be aware of daily and long-term goals to help your child's health improve. Understand the core goals and "big picture" events that affect your child's stay in the PCCU. The recovery process may be unpredictable. Each child recovers differently, even from similar illnesses.
• Ask questions to stay informed. Feel free to ask them as many times as you need. Your care providers realize that you are under a great deal of stress and may not remember everything the first time you hear it. Write down the names of your care team members and their roles. If you think of questions when the doctors are not around, ask your nurse or write them down to ask later.
• Bring in pictures of your child or family. This helps your care team see your child the way you do and personalizes your child's care.
• Bring in your child's favorite toys, blankets, books, movies, or music. Familiar objects comfort children. Playing with familiar items can help your child stay calm and recover more quickly.
• Learn more about your child's illness. Doctors and nurses are trained to explain conditions and treatments in a way you can understand. They can also give you printed materials and website links to help you learn.
• Your child may enjoy receiving mail from family and friends. Your child's nurse can give you the mailing address of the PCCU.

Our PCCU team members take breaks from the tiring work of caring for your child. You need to take breaks, too. Here are some suggestions:

• Eat healthy meals.
• Get enough sleep.
• Exercise or stretch your limbs periodically.
• Accept the help and support of family and friends.
• Keep a positive attitude.
• Keep a journal of thoughts and feelings, or of your child's progress.
• Read inspirational material.
• Appoint a family member or close friend to take messages or to be a spokesperson for you.
• Ask someone to look after your home and pets, and check your mail and phone messages.

The illness of a sibling can affect other children in your family. Here are some things to look for.

• Children may feel responsible for sibling's illness because they wished him or her ill in the past.
• Children may feel ignored or that you are favoring the sick child by spending so much time at the hospital.
• Children may act out or regress (for example, losing bladder control).
• Children may do poorly in school due to prolonged disruption in family life.
• It is often helpful to address these issues yourself or with the help of a specially trained psychologist or child-life specialist. Many families find family therapy helpful in resolving these issues.
• Take some time to be with the rest of your family and to restore balance to your own life.