Criteria for Critical Care Infants and Children: PICU Admission, Discharge, and Triage Practice Statement and Levels of Care

• Patients who are appropriately triaged according to level of illness and services provided in community/tertiary/quaternary PICU facilities will have comparable outcomes and quality of care. The specifics of each PICU level of care described above serve as a reference for minimum standards of quality care to guide appropriate PICU admissions and promote optimal patient outcomes.

• Individual hospitals and their PICU leadership team should develop admission criteria to assist in the placement of critically ill children that is aligned with their PICU level of care.

• Pediatric patients requiring specialized service interventions, such as cardiac, neurologic, or trauma-related surgery, have better/improved outcomes when cared for in a quaternary/tertiary ICU, and early interfacility transfer to the appropriate regional facility should be the standard of care.

• Congenital heart surgery should only be performed in a hospital that has a PICU with a dedicated pediatric cardiac intensive care team, including but not restricted to pediatric intensivists and nurses with expertise in cardiac intensive care, cardiovascular surgeon with pediatric expertise, pediatric perfusionists, pediatric cardiologists, and pediatric cardiac anesthesiologists.