CONSENSUS GUIDELINES FOR PICU

While detailed discussion on this set-up is beyond the scope of this book, some important aspects are discussed here:

• Size: PICU should constitute at least ~15% of total bed strength in pediatric ward of a referral center, as per National medical commission guidelines.

• Area: Each PICU bed should have ~200 sq. feet of area, along with adequate space for placement and storage of equipment, emergency movements of medical personnel and central monitoring station. Generally, the total area of PICU should be three times of the size calculated for beds alone.

• Staff: Each PICU should be supervised by a trained intensivist, supported by round the clock availability of trained medical/paramedical personal. The ideal Nurse-patient ratio for PICU is 1:1, with a minimum of 1:3.

• Equipment: Each PICU should be equipped with enough numbers of state-of-art monitoring, resuscitation and treatment-delivery equipments, as well as round-the-clock facility for laboratory and radiological investigations.

• AdmissionZdiseharge protocol: In order to optimize resource utilization, each IPCU should have a written standard admission as well as discharge/transfer criteria, discussed later.

• Treatment protocols: Although each patient in PICU presents with unique problems, it is advisable to have written standard management protocols for common problems in intensive care to assist quick and rational decision-making by on-site staff.

• Infection control policy: Nosocomial infections are major killers in PICU set-ups. Each PICU should have a written infection-control policy, with special reference to hand washing, cleaning/sterilization procedures and antibiotic usage.

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