The Cardiac Intensive Care Unit (CICU) is a 32-bed, high-acuity unit composed of two areas: a 20-bed main CICU and a 12-bed Intermediate Care Unit (IMU). The CICU is a nationally recognized center for advanced cardiac care, including pediatric heart failure and transplantation. We are proud to have performed the highest number of pediatric heart transplants in the country over the past three years.
Trauma Level: Peds I II III IV
BC Critical Care Certification is required
Unit Structure:
Main CICU (20 beds): Reserved for the highest acuity patients requiring intensive monitoring, complex post-operative care, and advanced support therapies such as ECMO, CRRT, and ventricular assist devices.
IMU (12 beds): Traditionally for lower acuity patients, the IMU is evolving into a higher-acuity step-down setting. Patients may be intubated (on a limited basis), or managed with tracheostomy and ventilator support, ventricular assist devices, and continuous infusions (milrinone, PGE, low dose epi, etc.). The unit is staffed by the same critical care-trained nurses and held to the same clinical care standards as the main CICU. Patient Population & Clinical Scope: Our patient population includes a wide range of congenital and acquired cardiac conditions specializing in:
Pre- and post-operative surgical care
Pediatric heart failure and transplant management
Advanced mechanical circulatory support (PediMag, CentriMag, HeartMate 3, Impella)
ECMO and renal replacement therapies (including Aquadex)
Pulmonary hypertension management
Electrophysiology: temporary and permanent pacemaker management Staffing Model: The CICU is staffed by Critical Care and Cardiology Fellows and Advanced Practice Providers (APPs), with no resident coverage. All front-line providers report directly to the attending physician.
Three Rounding Teams: A, B and C
Weekdays: 6 providers (Fellow/APPs) plus 1 APP resource; 1:6 provider-to-patient ratio. APPs write daily progress notes.
Weekends: 3 providers (Fellow/APPs) cover both units; 1:10 (main) and 1:12 (IMU) provider-to-patient ratios. Notes required for admissions, discharges, and procedures only.
Nights: 3 providers (Fellow/APPs) with similar ratios; documentation limited to admissions, procedures, and significant events. Procedural Competencies: APPs are required to independently perform essential bedside procedures including:
Removal of chest tubes, cardiac lines, pacing wires, and surgical drains Additional procedural capabilities are requested but not required:
Insertion of chest tubes, arterial and central lines, and endotracheal intubation
