Ventilator Care on a General Ward?!

To the Editor.

In the February 1998 issue of Pediatrics, Ambrosio et al¹ reported on the safety of ventilation-dependent children outside of the intensive care unit (ICU). Caution should be used when moving these children out of the ICU and to a general pediatric ward. I agree that using valuable ICU resources would improve by moving these medically stable patients to a non-ICU setting. However, the “general pediatric ward” they describe is atypical of most pediatric wards. With the specialized nursing and respiratory therapy staff; time spent in didactic teaching (80 hours); high nurse-to-patient ratios (1:2 to 1:3); and level of monitoring (continuous cardiorespiratory monitors, pulse oximetry, and end-tidal CO₂ monitors), what the authors depict as a general ward is actually a step-down or intermediate care unit. Without …