Baylor College of Medicine is committed to training academic leaders in pediatric critical care medicine. The Pediatric Critical Care Medicine section currently consists of over 65 full-time pediatric critical care, cardiac intensive care, and anesthesiology physicians.
The primary clinical training of our fellows occurs at Texas Children’s Hospital, the largest pediatric hospital in the United States and an affiliated hospital of Baylor. The critical care units and offices at Texas Children's relocated on May 22, 2018, to a new state-of-the-art tower that consists of 19 new floors for critical care and cardiology which includes cardiovascular and high-acuity operating rooms.
The new tower has a total of 132 ICU beds expanding over 7 floors. Furthermore, the new tower has a dedicated 11-bed neuro-ICU with integrated epilepsy monitoring, an 11-bed surgical ICU, as well as subspecialty cohorting of medical ICU patients making us "one of a kind" worldwide.
Finally, the tower is equipped with a helipad dedicated to the transport of critically ill patients. In addition, Texas Children's has two community-based PICU's in our 18-bed West Campus facility in Katy, Texas (west of Houston), and our 10-bed PICU in The Woodlands, Texas (north of Houston).
The PICU has approximately 2,500 admissions per year, with more than half requiring assisted ventilation or other advanced support, such as oscillatory ventilation, nitric oxide administration, extracorporeal membrane oxygenation, extracorporeal liver support, and other extracorporeal therapies. It is a multidisciplinary ICU, which supports the primary through quaternary patient population of southeast Texas with patients admitted from all major medical and surgical subspecialties.
The CVICU, which will relocate in September 2018 as part of phase two of the move, is fully dedicated to critically ill children and young adults with congenital or acquired cardiac disease. Our team of heart surgeons perform over 1,000 cardiac surgeries annually, including cardiac and lung transplantation, and extracorporeal circulatory support. We have one the busiest VAD programs in the country and opened the first dedicated Heart Failure ICU in the nation in 2015.
The TICU (Transitional ICU) also has more than 2,500 admissions per year and is specifically designed for children who require long-term technological support, those with residual PICU morbidities requiring transition to home, and the management of children who require more intensive physician and nursing support. Critical care physicians, fellows, nurse practitioners, physician assistants and residents staff each of these units.
Transport and Referrals
In addition to helping the children of Houston and southeast Texas, we receive referrals from across the United States and worldwide. Our Kangaroo Crew is a dedicated pediatric critical care transport team that participates in over 1,500 pediatric transports per year. Although the majority of transports are performed by a dedicated transport team consisting of nurses and respiratory therapists, Critical Care fellows participate in the transport of the most critically ill patients.
In addition to standard medical transport, we also initiate ECMO at referring hospitals if deemed necessary for a safer transport as well as transporting patients on ECMO for those patients with refractory cardiac and/or respiratory disease. All Kangaroo Crew transports are medically managed by Critical Care physicians through Texas Children's state-of-the-art communications hub, Mission Control, that houses representatives from Room Management, Transport Services and Critical Care and includes real time tracking of ground and flight crews, weather and traffic.
Additionally, Mission Control utilizes a new electronic health record, Rescue Net, that integrates transport data and documentation into the standard medical record when the patient arrives. Mission Control manages all interfacility transports including initial intake, recommendations from our physicians, dispatch of the Kangaroo Crew, stabilization of the patient, and transport to one of our Texas Children's facilities. Fellows spend time in Mission Control while on their transport rotation assisting and learning the "art" of triage.
We pride ourselves on having a comprehensive curriculum in order to produce high-quality pediatric intensivists. Our curriculum is a mixture of invited speakers, team- and case-based didactic lectures, directed reading conferences, morbidity and mortality conferences, and journal clubs. The fellows and faculty play an active role in both scheduling and participating in these conferences, which occur three times a week. In addition to conferences, fellows participate in simulation training (low- and high-fidelity) to improve their clinical diagnostic as well as procedural skills. All fellows engage in a wide range of research (basic science, translational, clinical, qualitative and educational) according to the American Board of Pediatrics guidelines and requirements for fellowship training.