Pediatric Intensive Care Unit (PICU)

Gain the ability to clinically assess and stabilize critically ill children.

This rotation allows you to have the opportunity to care for sick children under the tutelage of critical care specialists. Physical findings, complications, therapeutic implications and treatment plans are discussed in depth. The pathophysiology is discussed continuously.

Our training in pediatric intensive care is designed to introduce you to the acute and chronic care requirements of the critically ill child.

Required Knowledge Base

Although you do not rotate through the ICU in you PGY-1 year, there is a body of knowledge, as well as manual skills, that provide a basis for the more advanced knowledge and skills to be acquired during your PGY-3 year. Prior to your PICU rotation, you'll learn how to:

  • provide adequate basic life support for the newborn, infant, child or adolescent (BLS training)
  • interpret respiratory and metabolic components of ABGs
  • recognize imminent deterioration in patients with common pediatric problems (e.g., asthma, croup, DKA, dehydration, etc.)
  • understand the pathophysiology and sequelae of electrolyte disturbances
  • recognize acute airway emergencies (e.g., croup, epiglottitis) and intervene appropriately
  • obtain venous and arterial access for cannulation and specimen collection
  • provide vascular access in infants, children, and adolescent under all clinical conditions


Your rotation will be a time for more advance skill acquisition and patient management. The intellectual and manual skills acquired during in earlier experiences will be further refined during your PGY-3 year.

You'll learn to:

  • provide adequate advanced life support for the newborn, infant, child, or adolescent (ACLS, PALS)
  • understand pathophysiology and initial management strategies of common pediatric critical illnesses
    • CV: shock, arrhythmias, congenital heart disease pre- and post-repair
    • respiratory: respiratory failure, hypoxia, near drowning, status asthmaticus, pneumonitis, upper airway obstruction, ARDS
    • neurologic: coma (traumatic and metabolic), status epilepticus, hypoxic-ischemic encephalopathy, brain death
    • metabolic: inborn errors of metabolism, DKA, poisonings, overdoses
    • G-J tube: Gl bleeding, hepatic failure
    • renal: acute renal failure, transplantation
    • ID: septic shock, meningoencephalitis, immunocompromised hosts
    • trauma: occult injuries, head injury, ICP management, acute hemorrhage, sequelae
  • understand indications for, and risks and benefits of, invasive and noninvasive monitoring
  • understand the basics of respiratory support (CPAP, mechanical ventilation, ECMO)
  • recognize the need for and appropriately use pharmacologic agents (e.g., inotropic agents, analgesics, sedatives, muscle relaxants, sedatives, etc.)
  • recognize need for intubation and vascular access, and perform appropriate procedures
  • recognize the need for and obtain appropriate consultations from medical, surgical and ancillary services
  • understand, monitor, and support the nutritional needs of critically ill children
  • understand alterations of immune function during critical illness
  • direct resuscitative efforts after cardiopulmonary arrest in the infant, child, or adolescent


Specialty care didactic conferences are onducted on a regular basis depending on the census of the PICU and the specific problem in the unit, and given by the fellows and attendings.


Rounding on 5 to 8 patients daily.

Year Taken

  • PGY-3

Length of Rotation

4 weeks

Clinical Site

Patient Population

  • All critically ill patients after the newborn population up to the age of 21. Patients reside in the surrounding nine counties of Western New York and northern Pennsylvania.