Paediatric Intensive Care — PICU at The Children's Hospital Westmead

Contact details

  • Phone: (02) 9845 1171
  • Fax: (02) 9845 1993
  • Location: Intensive Care Unit, Ward Street, Level 3

Our vision is to provide the best care to children and their families.

The Paediatric Intensive Care Unit (PICU) is a 25-bed unit providing supportive care to 1400 infants, children and adolescents each year. Patients come to us with the entire spectrum of critical care problems. We manage all critical illnesses, including mechanical ventilation, mechanical support of the circulation, and support of organ systems.

Patients may be admitted following surgery including cardiac surgery, neurosurgery, liver or renal transplant or with a range of other conditions such as respiratory illness, trauma, burns or other severe medical conditions.  We provide an Outreach Service for review of ward-based patients following discharge from PICU, and any patient experiencing clinical deterioration where PICU assistance is requested or any patient that may require PICU admission.

The PICU is one of the few units in Australia that provide care for children undergoing extremely complex surgeries such as Liver Transplantations and Hypoplastic Left Heart surgeries. We are also the state referral unit for Paediatric Burns.

PICU provides intensive care facilities for all NSW children, and when required to interstate and overseas patients. PICU is open 24 hours a day 365 days a year.

Quality and safety

Our mission is to serve critically ill children with the highest level of expertise, dedication and compassion. For many years PICU has monitored quality and safety and incident management procedures have been in place since the mid-1980s. In 2014 PICU redesigned its Quality and Safety Committee to align with The National Safety and Quality Health Service Standards. The philosophy of the quality and safety committee is to promote a just culture, enhance incident reporting and encourage staff participation in quality initiatives. To enhance staff and consumer engagement, PICU provides:

  • A visible electronic safety and quality board in the ward
  • Quarterly Quality, Safety and Research newsletter (QuaSaR)
  • Regular auditing
  • Family advisory council within PICU

PICU meets monthly to review any incidents and quality improvement projects, with changes implemented by a team of senior staff. All staff involved in direct patient care are included in running clinical projects and are supported to implement changes to enhance Quality care in PICU. 

For parents

Being in the PICU is different than being in a regular hospital ward. The intensive care environment and the experiences of parenting a critically ill child can be challenging. Your child may look very different with all the monitoring and care equipment surrounding them. There may be swelling, skin tone differences and your child will likely not be wearing pyjamas. Your child may also act differently, depending on his or her age and how awake he or she is while in PICU. Your child may be very sleepy or unusually restless.

Your bedside nurse and the other members of the team are there to explain these changes and help you to anticipate what will happen next. We recognise that you are the expert about your child and need you to help determine your child’s needs with us. Together we can make sure your child is comfortable, rests well and is supported toward recovery.

It’s important to ask questions about things that you notice about your child and the PICU care.

Because your child requires specialised care, there will be a number of different health-care providers will be involved with your child’s care. The PICU team will coordinate and communicate with your child’s other doctors and team members during your time in PICU.

Your child’s care

Every day a pod will be assigned to your child’s and they will work with your child’s nurse to answer all your questions. Let the bedside nurse know you have questions or issues to discuss and they will arrange for the right person to meet with you.

Each day one of our intensive care consultants will see your child to check on their progress. These visits are called rounds and occur at your child’s bedside, and are attended by the bedside registered nurse, PICU doctors (consultant, fellow and registrar), nurse team leader / access nurse and a nurse practitioner.

Morning rounds commence at 8am with afternoon round starting from 3pm. During rounds, your child’s condition will be discussed with plans made for the day. You are welcome to be present and are encouraged to ask questions at the end of the round.

Procedures

Sometimes medical procedures take place in PICU. Some of these procedures are planned and some are emergencies. If a procedure is happening to another child in your child’s room we will ask all family members of the other children to wait outside the room.

If your child is having a procedure while in PICU, you can discuss with your nurse how we can help you to support your child during the procedure. Each situation is different and a plan for the procedure can be made ahead of time.

Keeping in touch

You can call day or night: When you are at home or outside PICU, phone the main desk on 02 9845 1171, alternatively you can contact your child’s bedside on 9845 15_ _ (bedside number i.e. bed 1, dial 01, bed 10 dial 10) and speak directly with your child’s nurse for progress reports.

Information is given to parents or legal guardians. If we cannot come to the phone, someone will explain why. We will call you back as soon as possible.

Visiting PICU

As a parent, you are encouraged to be with your child as often as you wish. Supervised visits by brothers and sisters a welcome, however, if your child is critically ill it might be better for siblings to wait until improvement has been made. There’s a supervised sibling care play area on Level 1 of the hospital and you may prefer to let siblings play there while you spend time with your child in PICU.

Relatives and friends are welcome to visit but a parent must be present when they visit and none can have access to your child without your permission and presence. A maximum of two visitors are able to be with you and your child at any one time.

Visiting hours for relatives and friends is 10-noon and 3-8pm. PICU rest time is from noon-3pm. Visiting hours are limited for children in PICU as they require time to rest and recover.

Access to PICU

The PICU doors are locked 24-hours a day and access is only available by using the intercom on the wall outside the department and speaking with a staff member who will be able to see you on camera and unlock the doors to let you in.

Please don’t let others follow you into the ward.

To exit PICU you must press the green button on the left-hand side of the wall near the exit door to unlock the doors.

Our Team in PICU

The PICU has a large multidisciplinary team jointly led by Dr Nicholas Pigott and Jenny Malloy as co-heads of the unit.
The staff is comprised of:

Intensivist

  • An Intensivist is a doctor with expertise in caring for critically ill children.  

Fellows

  • Fellows are doctors who have completed their core education and are now focusing on children with critical illness.

Registrars

  • Registrars are doctors who are undertaking further education in Paediatric Medicine, Surgery, Anaesthetics, Emergency Medicine and other disciplines.

Consulting Staff Specialists 

  • Consulting staff specialists are doctors who are experts in a specific area of the care of children. The Staff Specialist will assist in the management of your child.
  • You may have a team who cares for your child outside of PICU. The PICU team will work with that team. A consulting staff specialist will also have a team of fellows and residents.

PICU Nurses

  • The PICU team is made up of a Nurse Manager, three Nurse Unit Managers( NUM), a Nurse Educator (NE), five Clinical Nurse Educators(CNE), 20 Clinical Nurse Specialists (CNS) and approximately 185 Registered Nurses (RN). We are supported by a team of five Nurse Practitioners (NP).
  • The nursing team is a dynamic, energetic and dedicated group, providing critical care to a complex and diverse patient population. Frontline clinicians are supported by a number of expert practitioners and hands-on clinical leadership team who provide in hour-to-hour bedside care delivery.

Nurse Practitioners

  • PICU has a team of Nurse Practitioners are experienced and knowledgeable paediatric intensive care nurses. They are expert responders to a deteriorating child and provide clinical support to both nursing and medical staff.
  • PICU Nurse Practitioners hold a range of clinical skills including advanced assessment, diagnostic ordering and reasoning, decision-making, prescribing, intravenous access, airway management, and team-leading acute situations.

Allied Health

  • The Allied Health team includes Physiotherapist, Occupational therapists, Dietitians, Speech Therapists, Social Worker, Clinical Pharmacist

Support Staff

  • Data and Quality Managers, Administrative assistant, Ward Clerks