Additional Resources 

PICU Protocols

• You can find the Hospital-wide policies on the UH Intranet PolicyStat website.

• PICU specific protocols can be found here on the PICU Intranet webpage

  • • • • The printed out versions at the resident workroom are great references, but these are the most up-to-date versions

        • Protocols can be found along the banner at the top of the page. Click the system of interest and you will get a drop down of options.

        • Some common examples:

■       CNS- severe TBI, Chiari pain protocol, Tethered cord Release, Sedation weaning, Diabetes Insipidus in the NSGY patient

■       CV – many of these are for the CICU patients which is an APP front line provider service, can disregard

■       PULM – iNO weaning protocol, Asthma care path, High Flow Nasal Cannula, Chest tube management

■       FEN/GI/RENAL- refeeding syndrome

■       TRAUMA – blunt organ injury trauma, severe TBI

■       ENDO – DKA, Diabetes Insipidus, Fluid replacement

■       ID – Sepsis

■       ECMO – multiple order sets/protocols, talk to fellow

■       CRRT – multiple order sets/protocols, talk to fellow

• • • • • Again, ORDER SETS for EPIC are separate tabs under each organ system

PICU Resources 

• Learn PICU - Stanford University - https://www.learnpicu.com/

• OPENPediatrics - Boston Children's Hospital  --> make an account, it is free

  • • • Resident Level Curriculum - https://learn.openpediatrics.org/learn/course/internal/view/elearning/3697/7s-resident-curriculum

      • Pre-Fellow Level Curriculum - https://learn.openpediatrics.org/learn/course/3621/PCCMPre-FellowshipCurriculum 

      • PICU Fellow Rotating Curriculum -  https://learn.openpediatrics.org/learn/course/internal/view/elearning/3622/picu-rotating-fellow-curriculum 

• Deranged Physiology - Free online physiology for more in-depth review: https://derangedphysiology.com/main/home

• PedsCrit Podcast - https://www.buzzsprout.com/1809998 

• PICU Doc On Call - Podcast and Website - https://picudoconcall.org/ 

• General critical care sites - some adult, some  pedaitric references, but overall good physiology review: https://emcrit.org/ ; https://litfl.com/ 

• UpToDate, Lexicomp are great resources for quick references on disease overview or medication dosing.

• Talk to your fellow! He/She are there to help you!

• Talk to your attending! He/She are there to teach you!

• Talk to our PICU pharmacist! She is a wealth of knowledge!

• Talk to our Nutritionist! She is a weatlth of knowledge!

• Talk to our RTs! They are invaluable ! 

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Citations for this website

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2. Charts when indicated from UpToDate.https://www.uptodate.com/contents/search

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16. Weiss, Scott L. MD, MSCE, FCCM (Co-Vice Chair)1; Peters, Mark J. MD, PhD (Co-Vice Chair)2; Alhazzani, Waleed MD, MSc, FRCPC (Methodology Chair)3; Agus, Michael S. D. MD, FCCM, FAAP4; Flori, Heidi R. MD, FAAP5; Inwald, David P. MB, BChir, FRCPCH, FFICM, PhD6; Nadel, Simon MBBS, MRCP, FRCP6; Schlapbach, Luregn J. FCICM, FMH-ICU, FMH-Paeds, FMH-Neonatology7; Tasker, Robert C. MB BS, MA, AM, MD, FRCPHC, FRCP4; Argent, Andrew C. MB BCh, MMed, MD (Paediatrics)8; Brierley, Joe MD, MA9; Carcillo, Joseph MD10; Carrol, Enitan D. MB ChB, MD, FRCPCH, DTMH11; Carroll, Christopher L. MD, MS, FCCM, FAAP12; Cheifetz, Ira M. MD, FCCM13; Choong, Karen MB, BCh, FRCP(C) (methodologist)3; Cies, Jeffry J. PharmD, MPH, BCPS-AQ ID, BCPPS, FCCP, FCCM, FPPAG14; Cruz, Andrea T. MD, MPH, FAAP15; De Luca, Daniele MD, PhD16,17; Deep, Akash MB BS, MD, FRCPCH18; Faust, Saul N. MA, MB BS, FRCPCH, PhD, FHEA19; De Oliveira, Claudio Flauzino MD, PhD20; Hall, Mark W. MD, FCCM, FAAP21; Ishimine, Paul MD, FACEP, FAAP22; Javouhey, Etienne MD, PhD23; Joosten, Koen F. M. MD, PhD24; Joshi, Poonam PhD25; Karam, Oliver MD, PhD26; Kneyber, Martin C. J. MD, PhD, FCCM27; Lemson, Joris MD, PhD28; MacLaren, Graeme MD, MSc, FCCM29; Mehta, Nilesh M. MD4; Møller, Morten Hylander MD, PhD30; Newth, Christopher J. L. MD, ChB, FRCPC, FRACP31; Nguyen, Trung C. MD, FAAP15; Nishisaki, Akira MD, MSCE, FAAP1; Nunnally, Mark E. MD, FCCM (methodologist)32; Parker, Margaret M. MD, MCCM, FAAP33; Paul, Raina M. MD, FAAP34; Randolph, Adrienne G. MD, MS, FCCM, FAAP4; Ranjit, Suchitra MD, FCCM35; Romer, Lewis H. MD36; Scott, Halden F. MD, MSCS, FAAP, FACEP37; Tume, Lyvonne N. BS, MSN, PhD, RN38; Verger, Judy T. RN, PhD, CPNP-AC, FCCM, FAAN1,39; Williams, Eric A. MD, MS, MMM, FCCM, FAAP15; Wolf, Joshua MBBS, PhD, FRACP40; Wong, Hector R. MD41; Zimmerman, Jerry J. MD, PhD, FCCM42; Kissoon, Niranjan MB BS, MCCM, FRCP(C), FAAP, FACPE (Co-Chair)43; Tissieres, Pierre MD, DSc (Co-Chair)16,44. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatric Critical Care Medicine 21(2):p e52-e106, February 2020. | DOI: 10.1097/PCC.0000000000002198 

17. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287. PMID: 26903338; PMCID: PMC4968574.

18. Arora J, Mendelson AA, Fox-Robichaud A. Sepsis: network pathophysiology and implications for early diagnosis. Am J Physiol Regul Integr Comp Physiol. 2023 May 1;324(5):R613-R624. doi: 10.1152/ajpregu.00003.2023. Epub 2023 Mar 6. PMID: 36878489; PMCID: PMC10085556.

19. McMichael ABV, Ryerson LM, Ratano D, Fan E, Faraoni D, Annich GM. 2021 ELSO Adult and Pediatric Anticoagulation Guidelines. ASAIO J. 2022 Mar 1;68(3):303-310. doi: 10.1097/MAT.0000000000001652. PMID: 35080509.

20. Gajkowski EF, Herrera G, Hatton L, Velia Antonini M, Vercaemst L, Cooley E. ELSO Guidelines for Adult and Pediatric Extracorporeal Membrane Oxygenation Circuits. ASAIO J. 2022 Feb 1;68(2):133-152. doi: 10.1097/MAT.0000000000001630. Erratum in: ASAIO J. 2022 Jul 1;68(7):e131. PMID: 35089258.

21. https://www.elso.org/portals/0/files/elso_recirculation_guideline_may2015.pdf 

22. https://onepagericu.com/

23. https://www.learnpicu.com/

24. https://www.derangedphysiology.com/files/Control%20of%20Mechanical%20Ventilation.pdf 

25. https://litfl.com/