The information brought to you here is meant to ease your reception and adaptation process to the unit. The first days are usually accompanied with mixed feeling such as anxiety, helplessness, anger, guilt and more (everything is legitimate, of course). Your reaction might be different from that of your spouse or other family members. Please understand that and respect each other's feelings.
It is very hard to see your child hooked up to machinery and lying down without responding. Your presence in the unit next to the child helps his treatment and healing process and there is no doubt about us needing you as full partners in taking care of the child. However, it is hard for one person to do it alone, so it is highly recommended to recruit friends and family the child knows to take shifts in spending time with him –take a break from all the noise, beeping and lights and freshen up. You must remember that the child needs strong and healthy parents.
In addition to the team of doctors and nurses there is a social worker in the unit who can support, consult, and assist you in dealing with the situation. You can also consult with her with questions and feelings rising regarding the child's siblings and family members, work stress and more. We, the medical and nursing staff, are attentive to your emotions and will do everything in our power to make your stay in our unit as pleasant and short as possible and have your child get better fast.
The staff is at your service for any request and question, because we are here for YOU…
Arriving at the unit
In the Pediatric Intensive Care Unit (PICU), children are hospitalized in various conditions such as after complex surgery, pediatric diseases, infections, burns and more. The PICU is a noisy environment because of the monitoring and variety of advanced medical machinery, beeping often to alert the staff of different aspects of the children's physical condition.
When you arrive at the unit, your child's supervising nurse will receive you. At first, when a child is transferred into our unit you will be asked to wait outside and that is so we can examine him and hook him up to the medical machinery allowing the tracking of his condition. When the reception process ends, you will be able to come in and receive and explanation from a nurse and/or a doctor about your child's condition.
The child's surroundings
The children in the PICU require continuous monitoring of their heart rate, blood pressure, breathing and more. Because of that, they are strictly monitored with electronic devices. Sometimes, if necessary, they are also connected to a respirator. All these will be disconnected from the child's body when they will no longer be necessary.
When the child is ventilated he receives sedatives and hence is asleep most of the time. These drugs are necessary for him since they prevent resistance to the respiration and the suffering caused by lying down motionless and withstanding the various treatments. When the drugs are stopped the child will wake up within a short amount of time.
Because of the many machines and for other additional reasons, you can't always dress the children. We take care of their body heat by outer heating and monitor their fever continuously.
The tubes and monitors a child might be connected to
Heart monitor: stickers are put on the child's chest which tell the monitor about the heart's activity.
Saturation meter: a small finger installment attached to one of the child's fingers, monitoring the blood oxygen levels and pulse.
Peripheral IV: A thin plastic tube inserted into the vein, with which fluids and drugs are inserted into the blood stream.
Central IV: A long, thin plastic tube inserted into a central blood vessel in the neck, chest or groin. This tube allows feeding and drug administration, as well as helps with monitoring the fluid levels in the body.
Blood pressure monitor: A sleeve installment resting around the child's arm which inflates and deflates intermittently, monitoring the child's blood pressure.
Artery line: A thin plastic tube, similar to an IV, inserted into an artery to measure blood pressure continuously. The artery line allows taking blood samples without the need for repeated pricking of the child's skin.
Urine Catheter: a tube inserted into the gull bladder, in order to drain the urine into a bag for amount measurement.
Respiration tube ("Tubus"): This tube is inserted through the mouth or nose into the child's wind pipe. This tube allows the connection to the respirator.
Stomach Catheter ("Zonda"): A plastic tube inserted into the stomach, mostly through the nose, used to feed the child or to clean up stomach secretions.
According to his medical status, the child might need additional tubes, and in any case explanations can be given by the nurse.
The unit's structure
In the unit there are 8 treatment stands. One nurse is responsible for every two children, allowing each patient to receive maximal attention and intensive care.
The nursing staff is available at your service 24 hours a day, and if you have any questions you can address your child's supervising nurse.
The shift changes occur at 07:00, 15:00, 23:00.
The unit's doctors are around between 08:00-16:00 and an on-call doctor from 16:00 until 08:00 AM the next day.
At 08:00 AM, the staff does a round with the on-call doctor from the night shift and is updated on the children's status. At this point we will ask the parents to wait outside the unit to honor the privacy of all the families.
Starting from 09:00, the children are each examined by the unit's doctor. The doctor's round with the attending doctor will start at 11:00 AM.
Detailed information about the child's condition will be given to the parents only by the attending physician after the doctor's rounds are over. Generally, you can speak to a doctor every day and become updated on the child's condition. If there are critical changes in the child's condition you can speak to the doctor very quickly. During evening and night time hours you can receive information from the on-call doctor.
We believe that having one of the parents stay with the child contributes to their healing process, and so we request one parent or a person close to them will stay with the child during his entire hospitalization period. We have a parents' room in which you can spend the night.
It is important to remember that a large amount of visitors interrupts the sick child and in some cases can even jeopardize his health. In addition, multiple visitors makes the medical and nursing team difficult. Visitation will be allowed for grandparents only.
A number of rules for preventing infections in the unit which put the children in danger:
One must wash their hands before entering the unit
Only two people can stand next to the child's bed simultaneously, including parents.
No personal belongings are allowed in the unit.
No small children are allowed in the unit (siblings of a sick child can enter if coordinated with the staff).
It is forbidden to walk around among the other children's beds, each child's parents and visitors will stay only around their child's own bed.
Cellphone use is strictly forbidden inside the unit.
Please clarify to your family these rules mentioned above and the visiting hours.
Frequently Asked Questions by parents
Can the child hear?
Definitely. Even though often the child is sedated with drugs, he can hear but cannot react or speak. Thus, it is important to keep pleasant and calming verbal communication with the child by a known adult or his favorite music.
Can we speak with the sick child?
Mostly, it is possible and even recommended to speak with the child, read him stories and have him listen to music. Your child needs encouraging words and your love and calmness. However, in certain cases the staff will instruct you to leave the child to rest.
Can we touch the child?
Definitely yes. Your child needs you now more than ever, a loving touch and embrace and the feeling you are there with him to help him. Touch can greatly assist in calming the child and giving him a safe feeling. However, in certain cases the staff will instruct you to leave the child to rest.
Can you bring the child stuff from home?
As a rule, you need to consult the staff about bringing stuff from home. Usually, you can bring the child a known blanket from home, a bottle they're used to or one of their favorite toys.
What does "We do our best" mean?
It means that the staff is doing everything in its power to treat the child in a way which make him better in the shortest amount of time. That is done by using medication, machinery and the most advanced means at our disposal.
Where can we rest?
The parents' room is located next to the entrance to the unit, and it houses recliners which open into a bed. Sheets can be received from the nurse in the unit. There are 9 of these chairs, one for each family. If another parent stays the night, they have to find a different sleeping arrangement outside the parent room, unless there is an available recliner.
In the parents rom there is a samovar, a refrigerator, a bathroom, a shower and lockers with lock and key for storing personal equipment.
Locker keys will be given by the nurse for a 20 shekel deposit which will be returned when you will be released from the unit. Please keep the key safe in order for other parents to be able to use the locker after you.
The parents' room is for all the parents to rest and so we ask you to avoid many visitors in this room and to keep it quiet and clean.
There is a pay phone at your service in the entrance to the parent room, and it's number is +972-2-6410909.
Discharge from the unit
Once your child gets better and stable, not needing continuous strict monitoring, he will transfer for continuing treatment condition tracking in the Pediatric department. In the department, the environment is different – it is less noisy and the child is usually not connected to many machines or contraptions like the parents have gotten used to seeing in the PICU. Another difference concerning the transfer to the Pediatrics department is the fact that in the department, the parents are the main caretakers of the child and thus one parent must be in the department at all times. Towards release from the PICU, you will receive instructions from the nursing staff regarding continuing treatment in the department and about how the parents can be active partners in their child's treatment.
We wish to remind you: It is an intensive care unit, in which critically conditioned children are hospitalized for needing intensive treatment. It is possible that you will be asked to leave the unit at times in order for us to treat your child. Please listen to the staff's instructions and cooperate. During your stay you might hear details about other patients. Please respect their privacy as it is important to you for others to respect your own privacy.
In the entrance to the department we have a suggestion box. We will gladly receive comments and ideas, suggestions and compliments from you.
We at the Pediatric Intensive Care Unit wish you a quick recovery!
Unit telephone number: +972-2-6776023
Unit Fax number: +972-2-6777579