TICU: Technology-Dependent Intensive Care Unit
Word of the Week #2
“TECHNOLOGY-DEPENDENT”: WHAT DOES IT MEAN?
We often joke about the ways in which our society is dependent upon technology and the negative impacts of that dependency. However, it is imperative that we don’t forget the ways in which technology has allowed us to thrive. It is a fact that my child would not have survived her first year (maybe even her first week) of life without the technological advances we have in healthcare today. I am forever grateful for the ways in which we have been able to care for her and improve her quality of life with the resources we have. For many people all of the world with disabilities, technology is life-changing and life-saving.
When medical providers refer to patients as “technology-dependent,” this means that the patient requires specialized technology to recover from and/or thrive with life-threatening injuries, illnesses, complications, or developmental delays. These patients often have complex diagnoses and require specialized equipment and skills from medical providers to thrive. The TICU - technology dependent intensive care unit - in hospitals is designed to provide exactly that kind of care for these patients.
WHAT WILL YOU SEE?
Patients on a hospital’s TICU could arrive there for a wide variety of reasons. They may be critically ill babies who have been transferred from the NICU due to complex medical diagnoses and continued dependence on multiple technological devices. They may be children or adults with medical complexities who were admitted for acute illnesses or surgeries who require extra attention and care before being discharged home. The TICU offers a space for these patients to receive the critical level of care they need and for the caregivers to receive the support they need that is often challenging to get on a hospital’s regular floor.
You will see a variety of types of medical equipment on a TICU floor. Some examples of medical equipment that patients in these units may need include:
“Mechanical ventilators to support or assist breathing.”
“BiPAPs/CPAPs to support or assist breathing.”
“Oxygen supplementation, including high-flow nasal cannula, to maintain adequate oxygen levels.”
“Tracheostomy tubes for a stable airway.”
“Cardio-respiratory (apnea) monitors to monitor heart rate and breathing.”
“Pulse oximetry to monitor oxygen levels in the blood.”
“Feeding pumps and supplies to maintain nutrition.”
“Hoyer lifts to assist with repositioning and wheelchair transfer.”
“Infant warmers to maintain body temperature.”
“Specialty beds when needed to prevent skin breakdown.” (CHOA, 2024)
WHO YOU WILL MEET
If you stay with a loved one in the TICU, you will likely have a large team of people dedicated to your loved one’s care. Each hospital operates differently, but some examples of people you might meet and their roles include:
Nurses and Patient Care Technicians
Nutritionists or Dietitians
Speciality Physicians
Critical Care Specialists
Cardiologists
Pulmonologists
Neurologists
Gastroenterologists
and others
Rehabilitation Specialists
Physical Therapists
Occupational Therapists
Speech Therapists
Other Therapeutic Specialists
Respiratory Therapists
Music Therapists
Educators
Patient and Discharge Educators
Equipment Educators and Specialists
Helping Professionals
Family Experience Representatives
Case Managers
Child Life Specialists
Chaplains
Social Workers
Volunteers
WHERE YOU WILL FIND THEM
Technology-Dependent Intensive Care Units are not restricted to children’s hospital settings, but for the sake of this post and the nature of what I discuss primarily on this blog site, I’ve included a small list of children’s hospital locations below. It should be noted that just because a hospital does not have a dedicated unit titled “technology-dependent intensive care unit” does not mean the hospital is incapable of treating medically complex patients. The unit may be described or named differently or may be integrated with other units and services (i.e. PICU, NICU, Critical Care, or Transitional Care Unit).
Boston Children’s Hospital (Boston, MA)*
Children’s Hospital of Philadelphia (Philadelphia, PA)*
Children’s Hospital of the King’s Daughters (Norfolk, VA)
Children’s Healthcare of Atlanta (Atlanta, GA)
St. Jude’s Research Hospital (Memphis, TN)
Cincinnati Children’s Hospital Medical Center (Cincinnati, OH)*
Dayton Children’s Hospital (Dayton, OH)
Texas Children’s Hospital (Houston, TX)*
Children’s Hospital Los Angeles (Los Angeles, CA)*
Seattle Children’s Hospital (Seattle, WA)
*Ranked in the top 10 U.S. News' 2023-24 Best Children's Hospitals Honor Roll
THE WHY BEHIND “WORD OF THE WEEK”
Parenting children with disabilities and/or medical complexities can be an overwhelming journey. The children we are blessed to parent are miraculously strong, and they are a joy to love. However, the joy and love we experience is experienced in tandem with an incredible amount of stress on a daily basis.
Each day, parents are faced with an endless number of decisions they have to make. When you are a parent of a child with disabilities and/or medical complexities, though, the weight of these decisions often sits more heavily on your shoulders. Why? Because the decisions being made directly impact the very specialized care your child needs to thrive.
My name is Hillary. I am a licensed physical therapist with a doctorate level degree and multiple years of experience working in developmental pediatrics. For years I worked with children with variety of medical complexities, disabilities, and delays in their development and gross motor skills. Shortly after leaving the world of physical therapy, I found out that I was pregnant with our second child, and several months later, I discovered our daughter had many complications.
Our daughter, Marsaili, has Lissencephaly - a rare, terminal neurological disorder characterized by a reduction or absence of folds and grooves in the brain. Even with the background and knowledge that I have from my work as a physical therapist, this road, these decisions, and the amount of information we have to handle on a daily basis is overwhelming. It’s exhausting.
While medical providers often do the best they can to educate, many parents and caregivers still struggle to fully understand the intricate details of the child’s care. This isn’t necessarily because they are incapable of understanding. It may just be because they don’t know what questions to ask or what to advocate for when they are overwhelmed with a million other things. Sometimes you simply don’t know what you don’t know.
That’s what this section of my blog is all about - breaking down parts of this world into easy-to-understand, digestible pieces. It’s about making conversations like this feel like a cup of coffee with a friend (even when the topics discussed are a little heavier). It’s about making you feel like the amazing caregiver that you are - no matter what your educational background is - because you and your child deserve to understand the pieces of the puzzle. You deserve a chance to be your child’s best advocate, because that’s exactly what you are.
*DISCLAIMER: The information provided in this blog and any other blogs by Hillary Ramos Substack - Joyful + Rising (“we”, “us,” or “our”) at https://substack.com/@joyfulandrising (the “Site”) is for general informational purposes only. All information on the Site is provided in good faith, however, we make no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any information on this Site.
This site cannot and does not contain medical/health advice. The medical/health information is provided for general informational and educational purposes only and is not a substitute for professional advice. Accordingly, before taking actions based upon such information, we encourage you to consult with the appropriate professionals. We do not provide any kind of medical/health advice.
Under no circumstance shall we have any liability to you for any loss or damage of any kind incurred as a result of the use of the Site or reliance on any information provided on the Site. Your use of the Site and reliance on any information on the Site is solely at your own risk.
REFERENCES
CHOA (Children’s Healthcare of Atlanta). (2024). Technology-dependent ICU. Children’s Healthcare of Atlanta. https://www.choa.org/medical-services/critical-care/technology-dependent-intensive-care