Paediatric Critical Care Unit

Click here to view/download the PDF version of this information (which includes images).

Welcome to our Children’s Critical Care High Dependency Unit (HDU). We realise this is a difficult time for you and your family and have prepared this booklet to answer some of the questions you may have. Please feel free to ask any member of staff if you need more information.

Why is my child on HDU? 

Your child is being nursed in HDU so that the nurses and doctors can closely monitor them.  
They may need to stay for a few hours or several days, depending on their illness.  
Your child will then be moved to a different ward area once they are more stable.

What happens on HDU? 

• Your child will be allocated a bedside nurse to care for your child.  
• Doctors will treat your child and perform regular reviews of your child’s condition. They will also talk to you about your child.
• Machines will be used to continuously monitor your child's heart rate, blood pressure and oxygen levels to give your child the best care.
• Sometimes, your child may be given fluids and medication via a machine and the nurse will explain this to you.
• The unit can sometimes be noisy, and whilst we try to keep lighting to a minimum, this is required to provide the best care.

Visiting times

As a parent or carer, you can stay with your child 24 hours a day. Only 2 people are allowed at the bedside at any time to help keep noise levels down and avoid obstruction in emergency situations.  
Please discuss with the nurse before inviting visitors, as there may be times when only parents are allowed. You will be informed if this arises.

Can I stay with my child?

Yes, we can offer 1 bed within the HDU. Other limited accommodation may be available off the unit. Please discuss with your bedside nurse.

What if I feel I cannot leave my child? 

We understand you may be worried; however, it is important you take regular breaks to look after yourself so that you do not become exhausted. Please ask the nurses to relieve you for a break.

Will I ever be asked to leave the unit? 

Sometimes, you may be asked to leave the HDU bay for a brief period of time. This does not happen very often and is usually not for a long period of time. It is sometimes to allow us to treat another child or to allow for confidential conversations.  

Isolation and infection prevention

• Staff always wear aprons, as children are vulnerable to infection when admitted. You may also be asked to wear an apron. Staff will inform you of what protective measures you need to take when visiting your child.
• If your child is in a cubicle, this might be because they either have an infection that other children may catch or are at greater risk of infection from others.
• Alcohol gel is available for you to use after hand washing and before each contact with your child.  
• Please wash your hands before leaving the unit and after any nappy changing.
• Check and make sure you have no signs of any infection. Please let a member of the staff know if you are unsure. This is because your child could pick up a secondary infection that can be serious and hinder recovery.

Spiritual and psychological support

A multi-faith prayer room and mosque are open 24 hours a day, located on lower ground floor 2, and a quiet contemplation room is situated next to the chapel. Please ask staff for directions.
The hospital SPaRC (Spiritual, Pastoral and Religious Care) Team can visit you if you wish and can provide spiritual support and perform baptisms and blessings.

What will my child need?

Your child will need:

• A change of clothes.
• Nappies.
• Personal wash items.
• Their favourite toys, games, music, etc.

Storage space is limited, so please keep belongings tidy and limit the amount you bring into the hospital.
The hospital does not take any responsibility for the loss of personal belongings.

Medication

Drugs are dispensed from the hospital pharmacy, so there is no need to bring any medication with you. 
Parents are not allowed to give their child medicine. 
Some families whose children are on multiple drugs sometimes find it easier to bring in their medicines rather than remember all the dosages. After the medication has been noted, they need to be taken back home as soon as possible.  
Alternatively, you can write down the medication(s) and the dosage(s) and bring this with you. 

Breastfeeding 

• Please tell the nurse you are breastfeeding so that you can be supported to be able to maintain this on the ward.  
• An electric breast pump and bottles for you to store your milk can be provided if needed.
• Any excess milk will be frozen for future use.
• If your child is unable to breastfeed, expressed milk will be introduced to your child as soon as they are medically fit. This can be given via a small tube which is passed through their nose into their stomach.
• Breastfeeding mums are entitled to free meals. Please ask for a menu early in the morning so that this can be ordered.

Parent Facilities

The following is provided for your use in the parent’s room on the main ward:

• A TV.
• A microwave.
• Fridge and Freezer.
• Tea and Coffee 

Any takeaways must be eaten in the parent’s room.
Children are not allowed in the parents' room, but you may take a drink to your child’s bedside. Your child will be supplied with food whilst an inpatient on the ward. 

After HDU

• Once your child no longer needs HDU, they will be transferred to our hospital children’s ward or back to your local hospital children's ward.
• We only transfer children out of HDU when we are confident that there is minimal risk of any deterioration.
• We will ensure that medical and nursing information relating to your child’s care, including medication or special issues, is passed over to those who will continue to care for your child. They can contact us at any time.

Confidentiality

Information outside of the medical team will not be disclosed without your consent. Staff are bound by their individual governing bodies with regard to confidentiality.   
Please allocate one contact person who you regularly update to pass on the information to other family members and friends. 

Cashpoints

1. Located in the hospital LG2 near ‘Subway’.
2. External to the hospital at Tesco’s on A34.

Public transport

Taxis can be ordered from the main entrance.
Railway Station  and Bus Station located 1.5 miles from the hospital.

Amazon and deliveries

The hospital has Amazon lockers located on the lower ground (LG) floor if you need to have any deliveries made whilst you are at the hospital.

Royal Stoke Facilities in Main Atrium

• Restaurant, including vending machines.
• Costa Coffee.
• WH Smith.
• Lloyds Pharmacy.

Click here to view/download the PDF version of this information (which includes images).

The Staffordshire Children’s Hospital team would like to welcome you to our Paediatric Intensive Care Unit (PICU). We realise this is a difficult time for you and your family and have prepared this booklet to answer some of the questions you may have. 

Your Child’s Admission to PICU

• Once your child arrives on PICU, our doctors and nurses will examine, assess and transfer your child to our equipment and monitors.
• Full medical and nursing handover will be given by the referral team and a plan of action decided.
• During the first 12 hours of admission, you will be introduced to your child’s consultant. They have overall responsibility for your child’s medical care. An on-call consultant is available when your consultant is not on duty.
• Whilst you are welcome to stay and observe, you may actually find this is a good time to have a tour around the unit, have a cup of tea or coffee and a snack.

PICU Support Worker 

PICU support workers are available to help you and your family. This includes: 

• Introducing parents to the ward environment.
  Show where facilities are located.
• Show you accommodation if required / available.
• Explain our visitor rules.
• Discuss what is available within the hospital grounds and surrounding areas, including eating establishments and prayer rooms.
• Provide you with a parking permit (we will require the make, model and registration number of your vehicle)
• Help breastfeeding mums and introduce the team for further help and guidance.
• Show parents to the washers/dryers if needed.
• Ensure parents' kitchen is kept topped up with breakfast cereals, tea, coffee and sugar.
• If needed, help you access the play team for siblings.
• Parents are welcome to visit at any time of the day; however, only two people can remain at the bedside. This helps keep noise levels down and avoids obstruction in emergency situations.  

Visiting

Parents are welcome to visit at any time of the day; however, only two people at a time are allowed at the bedside. This helps keep noise levels down and avoids obstruction in emergency situations. 

Please speak to the nurse in charge before inviting siblings or other visitors to the ward. If permitted, visitors must be accompanied by a parent and with their consent.

Isolation and infection prevention

• Staff always wear aprons, as children are vulnerable to infection when admitted. You may also be asked to wear an apron. Staff will inform you of what protective measures you need to take when visiting your child.
• If your child is in a cubicle, this might be because they have an infection that other children may catch or are at greater risk of infection from others.
• Alcohol gel is available for you to use after handwashing and before each contact with your child.  
• Please wash your hands before leaving the unit and after any nappy changing.
• Before entering the unit, please remove outdoor wear and always wash your hands.
• Make sure you have no signs of any infection. Please let a member of the staff know if you are unsure. This is because your child could pick up a secondary infection that can be serious and hinder recovery.

Pain relief and sedation

Your child will be kept as comfortable as possible. Medication, including sedation, is used to help keep your child free from pain. Various techniques are used to continuously assess for signs of discomfort.

How you can help your child 

You can do as much or as little as you wish to help your child. The nurses will always be there to support and help you. Some of the ways you can help include:

• If your child is not drinking, you can gently clean their mouths every 4 to 6 hours. Alternatively, the nurses will do this.
• Nappies/pads need changing every 4 to 6 hours.
• Bed changes: the bedside nurses will tell you how you can help.
• Daily washes are given even though your child may be ill, so your help is much appreciated.
• Stories can be read to your child even if they are sleepy, as they can still hear, and stories can be comforting.
• Giving a massage to your child can be a nice way to maintain closeness if you feel this is appropriate.
• Personal care can be given to your child that may be special to them, such as a specific sleeping position. You know your child best so please tell us what your child likes so that this can be included in their care plan. This can also provide reassurance for your child.

Things to bring with you

• All your child’s toiletries.
• Nappies and pads if required.
• Adaptors, if your child has a gastrostomy tube.
• Any favourite blankets or teddies.
• Your child’s favourite dummy, as this may be needed once they come off their ventilators.
• The ward only has a small stock.
• Clothes for you whilst you are in hospital.
• A ‘comforter’ if your child has one.
• A small supply of special feeds if your child needs a specific type of milk, as the ward only keeps a limited stock.

Spiritual and psychological support 

A multi-faith prayer room and mosque is open 24 hours a day, located on lower ground floor 2, and a quiet contemplation room is situated next to the chapel. Please ask staff for directions.
The hospital SPaRC (Spiritual, Pastoral and Religious Care) team can visit you if you wish and can provide spiritual support and perform baptisms and blessings.

PICU Facilities

There are 8 patient beds in the CICU and 7 en-suite bedrooms for parents to stay in; however, priority is given to those families from out of the area. No accommodation can be offered to other relatives.

If you are allocated a room, please remember to leave the key with a member of staff when you leave the unit. This is so we can gain access to clean your room.

Mobile phones and devices: It is important when using a mobile device in hospital that you are careful not to:

• Take anyone’s photo without permission (including staff or people in the background).
• Make video calls in a way that means the other person(s) can see other patients, visitors or staff.
• Make phone calls on the ward due to the risk of interference with medical life support equipment. 

Please make phone calls in the reception area, in your room or outside.

Daily ward routine

Medication

As drugs will be dispensed from the hospital pharmacy and parents are not allowed to give their child medicine, there is no need to bring medication with you.  
Some families whose children are on multiple drugs may decide to bring in their medicines rather than remember all the dosages. These need to be taken back home as soon as possible.  
Alternatively, you can write down the medication (s) and the dosage (s) and bring this with you.

Breastfeeding

Please tell the bedside nurse if you are breastfeeding. This is so that we can support you to maintain this whilst your child is on intensive care:

• We can provide you with an electric breast pump and bottles for you to store your milk.
• Any excess milk will be frozen for future use.
  Expressed milk will be introduced to your child as soon as they are medically fit.  
• Breast milk is given via a small tube which is passed through their nose into their stomach.
• Breastfeeding mums are entitled to free meals.
  Please ask for a menu early in the morning so that this can be ordered.

If you have any problems, please speak to us. 

Child’s Diary

We have designed a simple diary which allows you and the staff to write in daily events.  
If you have not been offered a diary, please ask the staff for one. 

• The diary belongs to you and your child, and you can decide how much or how little you put into it. 
• Photographs can be taken with your permission and put into the diary. 
• The diary is useful as children receiving intensive care are often sedated and are therefore unaware of what has happened to them.
• Parents and children find it useful to refer to later on if there is something to help them recall what happened.
• Parents have said that in the months after discharge they have found comfort in reading the daily events, as this helps them remember. 

After PICU

• Once your child no longer needs intensive care, you will be transferred back to your local hospital’s children’s ward.
• Sometimes your baby may be observed on our children’s ward before being transferred.
• We only transfer children out of PICU when we are confident there is minimal risk of any deterioration.
• We will ensure that the medical and nursing information relating to your child’s care including medication or special issues, is passed over to those who will continue to care for your child. They can contact us at any time.

Confidentiality

Information outside of the medical team will not be disclosed without your consent. Staff are bound by their individual governing bodies with regards to confidentiality.

Significant details about your child cannot be given to friends or relatives who phone. We are only able to share the child’s current clinical status. 
Please allocate one contact person who you regularly update to pass on the information to other family members and friends.

Cashpoints

1. Located in the hospital LG2 near ‘Subway’.
2. External to the hospital at Tesco’s on A34.

Public transport

Taxis can be ordered from the main entrance.
Railway Station  and Bus Station located 1.5 miles from the hospital.

Hotels

Amazon and deliveries

The hospital has Amazon lockers located on the lower ground (LG) floor if you need to have any deliveries made whilst you are at the hospital.

Royal Stoke Facilities in Main Atrium

• Restaurant, including vending machines.
• Costa Coffee.
• WH Smith.
• Lloyds Pharmacy.