Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
CPT4 code
Name of the Procedure
Initial Inpatient Pediatric Critical Care, Per Day (Evaluation and Management of a Critically Ill Infant or Young Child, 29 Days through 24 Months of Age)
Summary
This procedure involves the intensive medical care and monitoring of critically ill infants or young children aged between 29 days and 24 months. It includes comprehensive evaluation and management by a team of healthcare professionals in an inpatient hospital setting.
Purpose
This procedure addresses severe, life-threatening conditions in infants and young children. The primary goal is to stabilize the patient, manage any critical illnesses, and prevent further complications to improve health outcomes.
Indications
- Severe respiratory distress
- Cardiac abnormalities
- Extremely high or low blood pressure
- Severe infections
- Post-operative care after major surgery
- Severe dehydration or electrolyte imbalances
Preparation
- Fasting may be required if surgery or certain diagnostics are anticipated.
- Blood tests, imaging studies, and a thorough physical examination are often necessary before admission to the critical care unit.
- Adjustment or discontinuation of certain medications may be directed by the healthcare provider.
Procedure Description
- Admission: The infant or young child is admitted to the Pediatric Intensive Care Unit (PICU).
- Initial Assessment: A thorough evaluation is performed, including vital signs, blood tests, and imaging if necessary.
- Monitoring: Continuous monitoring of heart rate, oxygen levels, blood pressure, and respiratory status.
- Interventions: May include mechanical ventilation, intravenous medication administration, fluid management, and nutritional support.
- Daily Review and Adjustment: Ongoing daily assessments and adjustments of the care plan based on the patient's progress and response to treatment.
Tools & Equipment: Ventilators, monitors for vital signs, intravenous lines, feeding tubes, imaging equipment. Anesthesia/Sedation: Mild sedation may be used for certain procedures or diagnostics; pain management will be tailored to the patient's needs.
Duration
The duration of critical care varies based on the patient's condition and response to treatment, ranging from several days to weeks.
Setting
The procedure is performed in a hospital's Pediatric Intensive Care Unit (PICU).
Personnel
- Pediatric critical care physicians (intensivists)
- Pediatricians
- Specialized nurses
- Respiratory therapists
- Pharmacists
- Nutritionists
Risks and Complications
- Infection from intravenous lines or catheters
- Complications related to mechanical ventilation (e.g., lung injury)
- Medication side effects
- Stress and fatigue for both the patient and family
Benefits
- Stabilization of the patient's condition
- Effective management of critical illnesses
- Prevention of further complications
- Improved chances of recovery and survival
Recovery
- Continuous monitoring and gradual weaning off intensive support as the patient stabilizes.
- Follow-up assessments and potential transfer to a general pediatric ward.
- Family education on care needs and signs of concern post-discharge.
Alternatives
- Home care with advanced support (for very specific cases)
- Transfer to specialty centers for particular conditions (e.g., congenital heart disease)
Pros:
- Intensive monitoring and immediate interventions in PICU can be life-saving.
- Specialized care and experienced staff.
Cons:
- High emotional and financial burden on the family.
Patient Experience
The patient will be closely monitored, and the family may experience stress and anxiety. Comfort measures include pain management, soothing environments, and family support services. The healthcare team will also provide regular updates and support to the family throughout the process.