Paediatric Intensive Care — PICU at The Children's Hospital Westmead
- 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 every year.
We're open 24 hours a day 365 days a year.
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.
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.
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.
PICU provides intensive care facilities for all NSW children, and when required to interstate and overseas patients.
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.
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.
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.
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.
Who's who in PICU
The PICU has a large multidisciplinary team jointly led by Medical Director Dr Andi Christoff and Nurse Manager Wendy Stephen.
An Intensivist is a specialist doctor who is qualified in the care of critically ill children. They lead our PICU medical teams. They are also known as a Staff Specialist or Consultant.
- Fellows are doctors and trainee Intensivists who are in the final stages of their training.
- Registrars are trainee specialists undertaking formal training programs in Intensive Care, Paediatric Medicine, Surgery, Anaesthetics, Emergency Medicine and other disciplines.
Consulting Staff Specialists
Consulting staff specialists are doctors who are specialists in a specific area of the care of children - e.g. a neurosurgeon or a paediatrician. The Staff Specialist shares the responsibility of caring for your child with the Intensivist while they are in PICU, and continue to care for them after they leave the PICU.
A consulting staff specialist works with a multidisciplinary team comprising fellows, registrars, residents (junior doctors) as well as nurses, allied health staff and support staff.
- 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 hour-to-hour bedside care delivery.
- 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.
- The Allied Health team includes Physiotherapist, Occupational therapists, Dietitians, Speech Therapists, Social Worker, Clinical Pharmacist
- Data and Quality Managers, Administrative assistant, Ward Clerks
Meet the PICU team
Dr Andrea Christoff, Medical Director, MD FCICM FRACP
Main portfolios: Head of Department, Quality and Safety, PICOS and CERS
Dr Christoff trained in paediatrics in the United States and completed her fellowship training in emergency medicine and intensive care at The Children’s Hospital at Westmead.
Andrea is a fellow of the Royal Australasian College of Physicians and the College of Intensive Care Medicine of Australia and New Zealand. She has completed a fellowship in Safety and Quality with the International Society for Quality in Health Care and is the Australia New Zealand Intensive Care Society (ANZICS) paediatric representative for Safety and Quality.
She is dually trained in emergency medicine and critical care and is currently the medical co-director and lead for Quality and Safety in the PICU at The Children’s Hospital at Westmead.
Andrea is interested in facilitating the improvement in quality and safety in healthcare through networking and collaboration.
Her areas of interest include resuscitation science, simulation-based education and organ and tissue donation. She is the primary site investigator for pediRES-Q.org, an observational multicentre cohort study with an aim to characterise the quality of CPR and post-cardiac arrest care delivered to children, improving survival and neurodevelopmental outcomes through collaborative research.
Dr Elena Cavazzoni MB ChB, BMedSci, PhD, MRCPCH, FCICM
Main portfolios: Neurocritical Care, Liberation ICU, and JMO SoT/Education
Dr Elena Cavazzoni started her training in the United Kingdom in paediatrics and continued her training in paediatric intensive care in Australia. She has worked in intensive care at the Mater Children’s Hospital and at Westmead Children’s Hospital at Westmead and in 2010 became a fellow of the College of Intensive Care Medicine of Australia and New Zealand.
She has a significant interest in palliative care, organ donation, complex communication and medical education. Her research interests are in organ and tissue donation, transfusion medicine and neurocritical care. She is a lecture for the University of Sydney and has been involved in the development of the Paediatric BASIC course, Paediatric Neurocritical Care: Beyond BASIC course, Critical Conservation in PICU course and helps facilitate the Sydney Child Health Program.
Dr Jonathan Egan FCICM, FRACP
Main portfolios: Research, JMO SoT Education
Jonathan is a paediatric intensive care doctor and paediatrician.
He is a senior lecturer at Sydney University and has broad research interests.
He completed a PhD focusing on the recovery of cardiac function following heart surgery in infants and children. He is an examiner for the intensive care college and a supervisor of training for the paediatric and intensive care colleges.
Dr Marino Festa
Main portfolios: Research, Cardiac Intensive Care including Advanced Heart Failure Team, and ECMO
Marino trained in paediatrics and intensive care at Evelina Children’s Hospital, London, and completed his MD in the study of children with meningococcal septic shock at Imperial College, University of London.
Marino is a Fellow of the College of Intensive Care Medicine of Australia and New Zealand and a member of the Australia and New Zealand Intensive Care Society (ANZICS).
He is currently medical co-director of Paediatric Intensive Care at Children’s Hospital at Westmead. In addition, Marino is past chair of the Paediatric subgroup of the ANZICS Clinical Trials Group, and medical research lead for Kids Critical Care Research at Children’s Hospital at Westmead.
Marino is interested in health system improvement and the rapid translation of new knowledge to improve the quality of care and long-term outcomes of critical illness in children.
Dr Stephen Jacobe
Main portfolios: JMO SoT Education
Dr Jacobe has been a Consultant in the Paediatric Intensive Care Unit at the Children’s Hospital at Westmead since 2000. He trained at the Royal Alexandra Hospital for Children at Camperdown, Sydney Children’s Hospital, Randwick, and Great Ormond Street Hospital in London.
Dr Jacobe is a Fellow of both the College of Intensive Care Medicine (CICM) and the Royal Australasian College of Physicians, holds a Master of Health Law and a Specialist Certificate in Palliative Care Medicine, and is a Clinical Associate Professor at the University of Sydney. Dr Jacobe was the President of the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS) from 2018 to 2020.
Dr Jacobe is the Supervisor of Training and an examiner for the CICM. He is also an instructor for PaedsBASIC.
His interests include end-of-life care, ethics and law.
Dr Melanie Jansen
Main portfolios: Trauma and Retrieval, Ethics and complex decision-making, Liberation ICU
Melanie is a Paediatric Intensive Care Medicine specialist with additional training in Clinical Ethics. In addition to her medical qualifications, Melanie has a Master of Arts in Philosophy and is a Churchill Fellow, having completed her fellowship in Clinical Ethics and Medical Humanities across Europe, the UK, USA, and Canada.
Here at the hospital, Melanie’s portfolios include Trauma, Retrieval, Ethics in ICU, and PICU fellow education. She is a principal investigator on the Fibrinogen Early In Severe Trauma studY (FEISTY) Junior trial. She is also widely published in the ethics literature and contributed to many position papers and guidelines on complex decision making in the COVID-19 pandemic.
Melanie is interested in everything to do with intensive care: whole-body pathophysiology; intense teamwork; critical decision making; and the care of humans in all their raw and complex beauty. In her ‘spare’ time she reads books, cooks, tends to her wine cellar, and writes poetry.
Dr Greg Kelly
Main portfolios: Co-lead, cardiac intensive care
Greg trained in paediatrics and intensive care at the Royal Children’s Hospital Melbourne and completed his fellowship training in paediatric palliative care at The Children’s Hospital at Westmead, and paediatric cardiac intensive care at The Hospital for Sick Children in Toronto, Canada.
Greg is a fellow of the Royal Australasian College of Physicians and the College of Intensive Care Medicine of Australia and New Zealand.
He is a senior lecturer at the University of Queensland Medical School, an instructor for the College of Intensive Care Medicine, Paediatric BASIC and APLS.
Greg is interested in how we deliver medical education and the contributions medical systems and technologies can contribute to improved care and palliative interventions.
He is a regular contributor to the Pediatrica Intensiva podcast, which he co-produces with colleagues from RCH Melbourne and Boston Children’s Hospital.
Greg's professional qualifications include: BMedSc MBBS ClinDipPallMed MBA FCICM FRACP (he/him)
Dr David Schell
Main portfolios: Quality and Safety
David trained in paediatrics at the Prince of Wales Children’s Hospital and completed his intensive care training at The Children’s Medical Center and the University of Texas Southwestern Medical Center in Dallas.
He is a fellow of the Royal Australasian College of Physicians and of the College of Intensive Care Medicine of Australia and New Zealand.
David is a Clinical Advisor with NSW Health and is coordinating a study in conjunction with the University of Sydney Child Population Health Research team examining the long term outcomes of all children admitted to ICU in NSW. He was the Foundation Chair of the Australian and New Zealand Paediatric Intensive Care Registry Advisory Committee, established to monitor intensive care outcomes across Australia and NZ.
Between 2007-2011 David was a board member of The World Federation of Pediatric Intensive and Critical Care Societies and coordinated the effort to bring the 6th World Congress to Australia in 2011, where he was congress co-chair.
Dr Chong Tien Goh
Main portfolios: PICOS and CERS, Quality and Safety
Dr Tien Goh trained initially in Paediatrics in Malaysia before specialising in Paediatric Intensive Care. He became a Fellow of the College of Intensive Care Medicine of Australia and New Zealand following further PICU Fellowship training at The Children’s Hospital at Westmead.
Chong is keen on the utility of big data in healthcare and is currently working on capturing and analysing high-frequency physiological signals in critical care patients.
He can also be found sometimes clambering up various walls around Sydney as he pursues his newfound hobby of rock climbing.
Our PICU runs an active research program within the unit. Our research team forms a part of a number of national and international research studies.
We are a contributor to the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry, the Extracorporeal Life Support Organisation (ELSO) Registry and the Pediatric Resuscitation Quality Collaborative (PediResQ).
The unit maintains a robust clinical ICU database, and its reports are used to guide various quality improvement and research projects.
for more information please visit Kids Critical Care Research.
Our PICU is always keen to hear from enthusiastic health professionals who may want to join our team.
Our ICU has PICU Fellowship opportunities available for advanced trainees or recent graduates. For enquiries on this and other Junior Medical Officer opportunities please contact Dr Vishal Jatana.
For enquiries on nursing and nurse practitioner positions please contact Wendy Stephen.