Many children admitted to the hospi...

Many children admitted to the hospital ne a higher horizontal of care than general inpatient pediatric critical care. Therefore, an intermediate care flat for children has been discloseed in some hospitals. "Admission and Discharge Guidelines for the Pediatric Patient Requiring Intermediate Care" is available online at http://pediatrics.aappublications. org/cgi/content/full/113/5/1430.

Admission is guided according to physiologic parameters, depending on the emblem of care needed. Children with respiratory, cardiovascular, endocrine, renal, and gastrointestinal disease who ne multidisciplinary intervention and usual monitoring may be admitted. Patients with non-life-threatening neurologic disease who ne multidisciplinary intervention, oft-repeated monitoring, and neurologic assessment each two hours or more also may be admitted, as well as children with potentially unstable hematologic or oncologic disease or non-life-threatening bleeding. Patients who have undergone surgery and require monitoring may be admitted if they do not have hemodynamic or respiratory instability.

Patients will be evaluated and considered for transfer to general or special-care units when the disease proces has revers or the physiologic point in dispute that prompted the admission has resolv The criteria forward which the decision to transfer or discharge the patient will be made include the following: the patient has stable hemodynamic parameters for at least six to 12 hours; respiratory status is stable and the patient has been extubated with evidence of acceptable gas exchange for four or more hours; the patient has minimal oxygen requirements; cardiac arrhythmias have been controll for at least 24 hours; seizures have been controll for a reasonable amount of time; and all invasive hemodynamic monitoring devices have been removed

Other criteria include the following: intravenous inotropic support, vasodilators, and antiarrhythmic unsalable articles are no longer needed; patients who be in want ofed mechanical ventilation have returned to baseline clinical status; and the patient is able to receive peritoneal dialysis or hemodialysis in succession an outpatient basis.

COPYRIGHT 2005 American Academy of Family Physicians

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