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

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.

Figure 1.

Timeline of events leading to the opening of an adult coronavirus disease 2019 (COVID-19) ICU in repurposed PICU space in March 2020 and April 2020. A, Maryland state and institutional responses to the developing local outbreak by day of month. B, Dates of steps taken to convert the physical space of the PICU and ready staff for opening of the negative-pressure adult COVID-19 ICU. WHO = World Health Organization.