Pediatric Intermediate Care Unit (PIMCU)

The PIMCU is a 24-bed unit on the 9 South ward at Boston Children’s that functions as a step-down unit and cares for patients who require more intensive nursing or observation than can be provided on the floors. Commonly encountered disorders include diabetic ketoacidosis, severe status asthmaticus, complex medical patients requiring intensive respiratory monitoring or noninvasive ventilation, and significant electrolyte abnormalities (such as diabetes insipidus) requiring close monitoring and frequent blood analyses. The service is split into 2 teams, one staffed by residents and one staffed by advanced practice providers. The resident team is comprised of a senior two interns, and an attending. This structure allows the senior resident to round independently with one of the interns on a large subset of patients, providing additional autonomy for seniors.

The nursing staff (who care for one or two patients each) and a dedicated respiratory therapist participate actively in morning and night rounds. An interdisciplinary approach is emphasized. Given the intimate structure of the team and the higher acuity on the unit, many informal teaching opportunities arise. However, residents are protected for formal teaching in the afternoons several times per week on topics such as management of DKA, airway obstruction and respiratory compromise.