Behind the Scenes in the Texas Children's Hospital Pediatric Intensive Care Unit (PICU)



Dr. Lara Shekerdemian, chief of critical care at Texas Children’s Hospital, takes you behind the scenes of the largest pediatric intensive care unit (PICU) in the nation.

Learn more about Texas Children’s PICU

Learn more about Texas Children’s Kangaroo Crew – pediatric intensive care transport

Read more about Dr. Lara S. Shekerdemian

Learn more about Texas Children’s Neonatal Intensive Care Unit (NICU)

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Dr. Lara S. Shekerdemian, November 5, 2013

The Pediatric Intensive Care Unit (PICU) is a place where no parent would ever want to go. In fact, having a child in the ICU is every parent’s worst nightmare. It’s an intimidating place — noisy, crowded, alarms going off all around, beepers, bursts of action, teams of nurses, doctors, buzzing in and out of rooms speaking in a medical language that is foreign to the families. While we are buzzing, the parents are too…with an array of emotions and questions, fears and anxieties. These parents have to quickly become educated to the sounds of the monitors, the plethora of new words being spoken about their son or daughter and the general activity of the unit going on around them.

As the chief of the Texas Children’s PICU, I hope to lessen the fears and answer the many questions parents may have. Many parents say to me that they didn’t know that intensive care units existed for children until they have encountered this themselves. Texas Children’s is one of the busiest PICUs in the country. Every year, we admit more than 6000 children to our 88 intensive care beds. Many of these children are very sick, some come here for treatment that can’t be provided elsewhere. Some of our admissions are expected; other children are admitted in an emergency. But whatever the circumstances — we can reassure families that their children receive the best possible care from experts in the field. What’s more, the parents are part of our care team, and one of the most important parts of the care team at that.

Over the last few years the family has become a very important part of what we call the multi-disciplinary team. This is the team of caregivers looking after our patients, and includes nurses, doctors, pharmacists, social workers and families. There’s plenty of evidence now that tells us that involving the family (also called family-centered care) is not only good for the parents, but can benefit the child and certainly can benefit the staff. It’s incredibly rewarding for the families, it’s rewarding for the patients and for all of us. It makes good sense — the parents will have known their child for days, months or years — we may have only met them for a few minutes! In many ways they know their child better than all of us.

In the PICU, we try and involve families on ward rounds whenever possible. We ask them questions, answer their questions and concerns, and develop a plan of care together. We share the daily medical plan and are transparent about the care… There is little, if anything, that we can’t say in front of the family.

As difficult as it can be having a child in the ICU, I would hope that families trust that one of our team’s most important roles is to make the PICU journey a bearable one and a positive one for them, with a light at the end of what can feel like a frightening and long tunnel. As part of the team, families should always feel that they can come forward, ask questions and be listened to and involved in their child’s care as much as possible.

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