No PICU here in small town nowhere, so no MIS-C experience either. I follow the AAP guidance for MIS-C and would transfer to the nearest PICU. Seems an awful lot like Kawasakis even in treatment (although the list of diagnostic labs are more involved than with Kawasakis) and I would suspect the similar relatively rare rates of MIS-C.
I've probably seen 100ish total kids with + Corona thus far myself, all in my outpatient clinic. Only one ended up inpatient thus far (fever and 48 hour rule out due to young age and not MIS-C). I've taken 50% of the call for our hospital since February (covers the entire area of 70,000 population) and haven't recieved a call from the ER for consult or admission other than the one above case. Ill continue to look for MIS-C and warn people to return with symptoms, but will be surprised if we end up with more than 1 (if even 1 presents). Just need more data for prevalence.