Perhaps the most important point to remember is when a patient is transferred to the PICU, it means their medical condition has deteriorated such that closer monitoring and/or support of some vital body function is needed (for example, maintaining an adequate blood pressure or assisting in lung support to maintain an adequate blood oxygen level). This means that one or several different machines may be required and a variety of new tubes and lines may be needed so that important body functions can be very closely monitored. In a situation where a transfer to the PICU is required, the patient's condition is unstable.

Patient care in the PICU, from the physician standpoint, will be shared by the staff and residents who run the PICU and by the bone marrow transplant team. The PICU team members are specialists and expert in the care of critically ill patients. The bone marrow transplant staff, of course, are expert in the recognition and treatment of problems that are unique to the bone marrow transplant patients. It is important that you are aware of the shared responsibilities and the shared decision-making that goes on in the PICU.

You will also notice the nursing care and visitation guidelines are different than on PBMT. While the nursing care in the PICU is excellent and of highest quality, it is focused, quite necessarily, on problems that are different from those that we contend with on the bone marrow transplant unit. Nurses care for 1-2 patients in the PICU. The PICU is a very busy place and thus times for visiting the patients are necessarily restricted so that the intensive medical care might be more properly administered. You should speak to your child's nurse in the PICU regarding visiting your child. They are interested in making the situation as acceptable to everyone as possible. You will need to ask your nurse if you can participate in your child's bath, mouth care, etc. The nurse may want to be with you to monitor your child and the equipment.

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