Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
CPT4 code
Name of the Procedure:
Subsequent Inpatient Pediatric Critical Care (SIPCC) Common names: Pediatric Critical Care, PICU Care, Intensive Care for Infants and Young Children
Summary
Subsequent inpatient pediatric critical care involves ongoing intensive medical management and monitoring of critically ill infants and young children aged 2 to 5. This care is provided in a hospital's Pediatric Intensive Care Unit (PICU) and includes constant assessment and intervention to stabilize and improve the child's condition.
Purpose
The procedure addresses severe medical conditions requiring intensive treatment, such as respiratory failure, severe infections, trauma, or post-surgical complications. The goal is to stabilize the child, support vital functions, and provide comprehensive medical care to improve their health.
Indications
- Severe infections (e.g., sepsis)
- Respiratory distress or failure requiring mechanical ventilation
- Major trauma or injury
- Complications post-surgery
- Chronic conditions requiring intensive monitoring (e.g., congenital heart defects)
- Acute exacerbations of chronic illnesses (e.g., cystic fibrosis)
Preparation
- Pre-procedure instructions include stabilizing the child’s condition before transfer to PICU.
- Necessary diagnostic tests: blood tests, imaging studies (e.g., X-rays, ultrasounds), and continuous monitoring of vital signs.
- Possible adjustments to medications or treatment plans.
Procedure Description
- Admission to PICU where continuous monitoring is established.
- Placement of intravenous lines for fluid and medication administration.
- Connection to advanced monitoring equipment (e.g., heart rate monitors, ventilators).
- Ongoing assessment by a multidisciplinary team to adjust treatment protocols.
- Interventions may include medication administration, mechanical ventilation, and other supportive therapies as needed.
Tools and equipment: Monitoring devices, mechanical ventilators, infusion pumps.
Duration
The duration of care can span several days to weeks, depending on the severity of the child’s condition and their response to treatment.
Setting
The procedure is performed in a hospital's Pediatric Intensive Care Unit (PICU).
Personnel
- Pediatric intensivists (specialized critical care doctors)
- PICU nurses
- Respiratory therapists
- Pharmacists
- Additional specialists (e.g., surgeons, neurologists) as required
Risks and Complications
- Infection at IV or catheter sites
- Adverse reactions to medications
- Complications from mechanical ventilation (e.g., pneumothorax)
- Potential for long-term organ damage
- Psychological impact on the child and family
Benefits
- Stabilization and improvement of critical health conditions
- Precise monitoring and tailored treatments
- Multidisciplinary approach enhances overall care quality
- Increased chances of recovery and survival
Recovery
- Post-procedure care includes gradual weaning from intensive support.
- Close monitoring continues until the child's condition stabilizes.
- Recovery time varies; may include short-term or long-term follow-ups, rehabilitation, and potential readmission for complications.
Alternatives
- Depending on the condition, alternatives might include step-down units for less intensive monitoring.
- Pros and cons: Less intensive settings may not provide the immediate access to advanced interventions, which can be critical for severely ill patients.
Patient Experience
- The child might experience discomfort from invasive lines and continuous monitoring.
- Pain management includes medication and comfort measures.
- Emotional support for the child and family is provided through counseling and support services within the PICU.