Pediatric intensive care medicine (intensive care medicine for children and adolescents) is a special branch within the field of pediatrics. It is responsiblefor the intensive medical care of critically ill children of all ages .
The field of neonatology (newborn medicine) is also part of pediatrics. It cares for newborns who also require intensive medical care in the event of illness or premature birth. Treatment is provided in specially equipped neonatal intensive care units and by appropriately trained doctors and nurses.
Neonatal intensive medical treatment/care is necessary in the following cases, among others
- low birth weight,
- Lung hypoplasia (immature lungs),
- growth disorders during pregnancy,
- congenital anomalies,
- oxygen deficiency occurring during birth.
The following conditions, among others, are frequently treated in pediatric intensive care units:
- Injuries caused by accidents or other violence of any kind (trauma),
- Cardiovascular failure, for example due to congenital heart defects,
- Sepsis (mostly bacterial blood poisoning),
- severe meningitis (inflammation of the meninges, also usually caused by bacteria),
- other serious infections (viral or bacterial),
- acute respiratory distress syndrome,
- Before and after organ transplants.
Intensive care pediatrics is an independent medical specialty. Here, children and adolescents of all ages are treated and cared for according to their age. Not every clinic has a pediatric intensive care unit. Existing pediatric intensive care units are usually responsible for a large catchment area.
Here, the distance between the ward and the operating room is also much shorter than in a "normal" pediatric ward if an operation is necessary.
Only specially trained specialist staff work in a pediatric intensive care unit. The treatment and care of critically ill children cannot be compared with the treatment of adults with the same clinical picture. In addition, children and newborns have their own clinical pictures that do not or only rarely occur in adults.
The smaller size of children and newborns also poses particular challenges for staff and technical equipment. The difference in weight compared to adults must also be taken into account when caring for and treating children and adolescents.
Dealing with children as patients requires special empathy © N Lawrenson/peopleimages.com | AdobeStock
Infants and small children in particular require special treatment that is adapted to the child's respective stage of development. A baby or toddler is not yet able to communicate sufficiently. For diagnosis and further treatment, doctors observe the clinical signs. In addition, a careful medical history and cooperation with the parents is also important.
During painful procedures (catheterization, blood sampling, etc.), the patient needs an understanding and empathetic contact person. In addition to their medical expertise, this person must know how to deal with such situations.
This is why doctors and nurses in a pediatric intensive care unit are usually also trained in pedagogy and psychology. This benefits not only the child but also you as parents: a child in intensive care also means an enormous psychological and organizational burden for parents.
If your child has to be treated in intensive care pediatrics, the first impression may be frightening. This is usually due to what is known as monitoring, i.e. the continuous monitoring of your child's vital functions. Monitoring is carried out using technical devices that are used for safe intensive care on this ward.
The basic equipment on a pediatric intensive care unit with an attached neonatology unit includes
- Special intensive care beds for the care of newborns,
- height-adjustable beds for infants,
- heat sources for premature and newborn babies,
- monitoring devices for monitoring vital functions and electronic connections for other devices,
- so-called perfusors for the intravenous administration of medication and nutrient solutions.
- Monitoring of vital functions: Respiration and cardiovascular function are among the most important vital functions. Your child will therefore first be connected to an appropriate device. Several ECG electrodes are attached to the chest area for this purpose. Nursing staff and doctors can read and interpret the functions in the form of a curve on the monitor.
- Measurement of body temperature: The body temperature is permanently monitored via a probe.
- Measurement of the oxygen content: The nurse attaches a reddish glowing electrode to the hand (sometimes also to the foot for newborns). It measures the oxygen content of the blood and also transmits the values to the monitor.
- Dual blood pressure monitoring: Blood pressure is also constantly monitored. The nurse puts a cuff on your child for this purpose. In addition, a small cannula in the crook of the arm or groin provides information about the arterial blood pressure. If necessary, additional blood can be taken at any time via this catheter.
- Ventilators: Appropriate ventilators are available for artificial (invasive and non-invasive) ventilation.
If artificial respiration is necessary, the doctor will insert a tube (breathing tube) through your child's nose or mouth into the windpipe. The tube is connected to a ventilator. If any irritating secretions form, they are suctioned out.
The child cannot eat or drink during artificial respiration. In this case, it is therefore given a feeding tube through which it is adequately nourished. A thin tube runs through the nose to the stomach.
In an acute emergency, you probably don't have much time to look for a pediatric intensive care unit. This is because the ambulance or emergency doctor will then take your child to the nearest hospital with a pediatric intensive care unit.
In most cases, intensive medical care is an emergency anyway. If you are considering a change of hospital for reasons relevant to you, it is essential that the condition of your child is taken into account.
You should therefore plan a transfer to another hospital with great care and discuss it with the doctors treating your child.
If your child has to be cared for in an intensive care pediatric unit, this is a major challenge in every respect. Nevertheless, your child is in the best of hands here. Specially trained doctors and nurses use state-of-the-art technology to look after your child 24 hours a day until he or she can leave the pediatric intensive care unit again.
