Thread by @DrOrtmannCICU

I’m a CICU doctor. I’m the CICU director.

But somehow I’ve found myself finishing a week of PICU service. The PICU is wild!

So here’s what I’ve learned and why the PICU is tougher than the CICU.

a thread #PedsICU #pedscicu

1. High turnover

CICU: median length of stay about 3 days. Weekend and night admissions uncommon.

PICU: length of stay felt like about 18 hours. 5 new patients show up overnight.

This was exhausting.

2. Unplanned admissions

CICU: I start hearing about the patient 2 months before they’re born.

PICU: Rolling in off the street like Amazon packages.

3. Unknown diagnosis

CICU: 99.9% of the time I have at least an anatomic diagnosis.

PICU: ”This child is weird and smells funny. Figure it out.”

4. Lines

CICU: Here’s your patient with 2 art lines, 4 RA lumens and a PICC.

PICU: They had a 24G IV but they ate it.

5. Consultants

CICU: 3 surgeons and a cardiologist to deal with daily (that’s not nothing). Other consults come around but seem uncomfortable and leave quickly.

PICU: Neurosurg, ENT, ortho, gen surg, ID, neuro, nephro, behav health, palliative. That’s just Wednesday.

6. The patients

CICU: lots and lots of babies

PICU: “That’s not her blood, it’s the cop’s”

CICU: wtf PICU

As I finish my last shift (ever?) in the PICU I’d like to tell my PICU docs, APPs, RNs, RTs, CNAs and everyone else there that I think you’re awesome and have one of the hardest jobs in the hospital. You will always have my respect.