Transforming a PICU Into an Adult ICU During the Coronavirus Disease 2019 Pandemic: Meeting Multiple Needs

Amanda B Levin; Meghan L Bernier; Becky J Riggs; Stephanie D Zero; Emily D Johnson; Katelyn N Brant; Joe G Dwyer; Caroline J Potter; Aliaksei Pustavoitau; Thomas A Lentz Jr; Emily H Warren; Aaron M Milstone; Jamie McElrath Schwartz

doi:10.1097/CCE.0000000000000201

Transforming a PICU Into an Adult ICU During the Coronavirus Disease 2019 Pandemic: Meeting Multiple Needs

Crit Care Explor. 2020 Sep 15;2(9):e0201. doi: 10.1097/CCE.0000000000000201. eCollection 2020 Sep.

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
² Department of Nursing, Bloomberg Children's Center, Pediatric Intensive Care Unit, The Johns Hopkins Hospital, Baltimore, MD.
³ Division of Pediatric Palliative Care Medicine, Department of Nursing, Bloomberg Children's Center, The Johns Hopkins Hospital, Baltimore, MD.
⁴ Pediatric Respiratory Care Services Department, The Johns Hopkins Hospital, Baltimore, MD.
⁵ Child Life Department, Bloomberg Children's Center, The Johns Hopkins Hospital, Baltimore, MD.
⁶ Facilities Department, The Johns Hopkins Hospital, Baltimore, MD.
⁷ Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Abstract

We describe the process converting half of our 40-bed PICU into a negative-pressure biocontainment ICU dedicated to adult coronavirus disease 2019 patients within a 1,003-bed academic quaternary hospital. We outline the construction, logistics, supplies, provider education, staffing, and operations. We share lessons learned of working with a predominantly pediatric staff blended with adult expertise staff while maintaining elements of family-centered care typical of pediatric critical care medicine. Critically ill coronavirus disease 2019 adult patients may be cared for in a PICU and care may be augmented by implementing elements of holistic, family-centered PICU practice.

Keywords: adult; coronavirus disease 2019; critically ill; family-centered care; pediatric intensive care unit; staffing.

Grants and funding

K24 AI141580/AI/NIAID NIH HHS/United States