Menu Search Donate
Guideline identity image

Cardiac handover to PICU

This document is only valid for the day on which it is accessed. Please read our disclaimer.

Transfer of complex patients between different services has been identified as a risk area for patient care.

This document aims to formalise the handover process, delegate responsibilities, and act as a template to ensure all vital patient information is handed over.

The 3 parts of the handover are:

  1. Technology Transfer
  2. Information Handover
  3. Discussion and Plan

These are performed sequentially and each must be completed before going onto the next.

Technology Transfer

The team sets up the equipment

1. Ventilation is configured, confirmed and turned on Anaesthetist
2. Monitoring Tram is connected to PICU monitor Technician
3. Visually check transducer level  Patient Nurse
4. Drains are connected to suction Nurse 1
5. Heat table (as required) is plugged in and turned on Nurse 2

This is ALL that is done upon patient arrival in PICU unless immediate patient intervention is required

Safety Check

The Anaesthetist makes the following checks once the equipment setup is complete prior to verbal handover:

  1. Equipment is appropriately configured and plugged in
  2. The patient is appropriately ventilated
  3. The patient is appropriately monitored
  4. The patient's condition is stable
  5. The receiving nurse and doctor have been identified and have confirmed their readiness to proceed

The handover of information or case-related discussions should not start until the safety check is satisfactorily completed.

Information Handover

  • The Anaesthetist speaks alone and uninterrupted, providing the relevant information according to the PICU Handover Checklist
    The anaesthetist will confirm the transfer of information is complete
  • The Surgeon speaks alone and uninterrupted, providing any further relevant surgical information
    The surgeon will confirm the transfer of information is complete

Safety check

The receiving nurse and doctor should use the PICU Handover Checklist to check that all necessary information has been obtained.

Discussion and Plan

The Surgeon, Anaesthetist and PICU Team should discuss the case as a group.

  1. Anticipated problems should be identified
  2. Anticipated recovery should be discussed from the following options:
    1. Wake and wean
    2. Review in 2-6 hours
    3. Leave ventilated over night aiming for "stability"
    4. ECMO high risk (pump circuit should be primed)

The PICU Team now have responsibility for patient care

The PICU Team reassess patient status:

  1. Check that monitoring and support are appropriate
  2. The patient plan is re-confirmed
  3. Chest x-ray ordered and reviewed
  4. Additional tests are done as appropriate
  5. Complete handover tasks, e.g. zero pressure transducers, zero and detangle pumps, label chest drains

The PICU Consultant / Registrar (± Surgeon) or PICU Nurse update family

The patient care strategy should be reviewed at the evening ward round. Anticipated problems and pathway of recovery strategy should be set up for the night team.

PICU Handover Checklist

Download a printable copy of the PICU handover checklist here.

Did you find this information helpful?

Document Control

  • Date last published: 05 October 2011
  • Document type: Other
  • Services responsible: Paediatric Intensive Care Unit
  • Editor: John Beca
  • Review frequency: 2 years