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At the present time, the pediatric anesthesiologists are in house 24 hours/day. Discharge/Transfer Procedures Decisions regarding transfer of patients from the PICU to the ward will be made in conjunction with the primary service and RN staff. Confirmation of the availability of a ward bed as well as an accepting physician must be made prior to transfer. The PICU attending will contact the receiving attending for medical patients, the residents should contact the receiving resident to give report. For surgical patients, the surgery service will write transfer orders. For medical patients, the PICU residents write transfer orders. On occasion, the PICU residents can help the flow of patients by writing transfer orders on surgical patients (confirm with surgical service first). On medical patients, the PICU resident should write a transfer summary prior to transfer to the floor. Any patient discharged from the PICU (including Shriners patients going back to Shriners) need a dictated summary. The Medical Record A record of patient admissions, diagnoses, date of discharge, and attending physician will be kept in the PICU. Visiting Regulations 1. Visitors other than parents may be present with parental permission. 2. Visitors may be limited to two persons at a time at the discretion of the bedside RN. 3. One immediate family member may stay with the patient 24 hours a day. 4. Visitors must check at the desk outside PICU for permission to visit the child. - 8 - Pediatric Resuscitation Course Pediatric resuscitation courses such as Pediatric Advanced Life Support (PALS) will be offered several times per year. All residents are required to complete this course. You will need to recertify for this course at the end of your second year. Schedule and other rules Call is generally q4. We don’t make your schedule. Emergency medicine interns are on call with the cross cover 2nd year pediatric resident. Subinterns take call with the PICU senior resident. Rounds start at 7:30 M-F. Prerounding, including gathering information about events of the night, vitals with I/Os, labs, and examining the patient must be accomplished prior to rounds. The time needed for this will depend on the acuity of the unit. Residents should not arrive before 6:00 am. If you are unable to pre round on all patients, do so on the most ill or acute patients so that decisions can be made on rounds. It is helpful if the post call person gives accurate, summative sign-out so that pre-rounding is not bogged down by trying to figure out what generally happened over night. The post call person should make a quick go-around the unit prior to the day people coming in so any last minute changes can be relayed. “Discovery Rounds” should be avoided. Rounds on the weekend start at 9:00 am.
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