Intermediate Care Program Research and Innovation

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The Intermediate Care Program (ICP) at Boston Children’s Hospital is home to a large number of complex patients that require a high level of monitoring.   We take the following steps to ensure optimal supervision takes place at all times:

  • ICP is designed so that monitors are visible in each room. Since there is a fixed ratio of 1 nurse to every 2 patients, if an alarm goes off in one room it will also go off in the second room the nurse is attending. This way, the nurse is able to see what the patient is doing and respond as quickly as possible.
  • ICP has a continuous presence of nurses, respiratory therapists and doctors. Since our doctors take care of both the ICP and the Medicine Intensive Care Unit (MICU), they never leave the floor. The attending doctor in charge of the floor is present at all times.  
  • Our clinicians carry phones that alert them when an alarm goes off. This enables the doctors to and nurses to respond to the situation even before it’s announced overhead. 

Treatment

ICP patients usually are admitted through the Emergency Room, however some are transferred from different Boston Children’s Hospital intensive care units as they continue to recover from illness, and some transfer from the floor as they may need more intensive care.  

Many patients in the ICP have respiratory illness or chronic respiratory problems, and often they need additional respiratory supports.  One means of supporting a patient’s breathing is through noninvasive ventilation (also called BiPAP or CPAP).  If a patient needs noninvasive ventilation for a chronic condition, it is frequently started in the ICP so the family can receive teaching on equipment that they will then use at home. 

What is noninvasive ventilation?

Noninvasive ventilation is a ventilator that gives pressure through a mask on a child’s face. 

Common noninvasive ventilation techniques include:

  • Bilevel Positive Airway Pressure machines (BiPAP): use different levels of air pressure to help a person inhale and exhale. This is commonly used to treat respiratory problems from muscle weakness or pauses in breathing.
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