The PICU and HD units in Ward 46 are well-equipped with 18 single-bedded rooms (11 PICU beds, 7 HD beds), 16 of which are negative-pressured isolation rooms and 2 are positive-pressured isolation rooms for immunocompromised patients.
All forms of mechanical ventilatory support, including non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy and high frequency oscillatory ventilation are available. Our paediatric Extracorporeal Life Support (ECMO-Extracorporeal Membrane Oxygenation) Programme was established in 2009. Renal dialysis (Continuous Veno-venous Haemodialysis or Haemofiltration) and mechanical liver support in the form of Molecular Adsorbent Recirculating System (MARS) as a bridge to liver transplant are also employed as support modalities in the PICU.
Our facilities support the National Paediatric Programmes for Liver and Renal Transplantation. We are the only centre in Singapore managing paediatric solid organ transplantation.
In addition to managing the PICU or HD unit, our consultants also run the moderate sedation, home care and transport service.
Extracorporeal Life Support (ECMO) Programme
Our paediatric ECMO programme was established in 2009. Both veno-arterial ECMO for cardiac failure such as myocarditis and veno-venous ECMO for respiratory failure such as acute respiratory distress syndrome are available. Our ECMO data is submitted to the international Extracorporeal Life Support Organisation (ELSO) registry. To date, we have performed more than 30 ECMO runs with favourable results.
Moderate Sedation Service
Our paediatric moderate sedation service is designed to alleviate the physical and emotional trauma associated with certain procedures and medical tests for children. Our goal is to conduct our sedations with safety being the primary focus. We aim to utilise the least amount of sedatives and painkillers necessary to complete the procedure. This service is provided by our paediatric critical care team and we conduct paediatric sedation training courses regularly for our staff.
Home Care Service
The Paediatric Home Care Programme @ Khoo Teck Puat - National University Children's Medical Institute was started in April 2014 with the aim of providing optimal care for children and youths with complex medical needs. Medical home visits are carried out for patients who are transitioning home after a critical illness in PICU, as well as for patients who are home-bound, requiring home ventilation and are technologically dependent. For patients who are transitioning home after a critical illness in PICU, medical home visits help to facilitate quality care within the home environment and provide the much needed caregiver training and support. For patients who are home-bound, regular medical home visits ensure that their complex medical needs are optimally managed. Outstanding medical issues can also be addressed early in the home environment, leading to early medical intervention and avoidance of hospitalisation.
As a regional centre, it is increasingly important to be able to provide access to the specialised care that we offer. This sometimes involves the moving of ill patients to our centre for treatment. This service is dedicated to the safe transport of critically ill children to or from our medical facility. We transport patients who are too medically unstable to be transferred by conventional means, thus requiring a more specialised transport service. We can function as an inter-facility transport between medical centres locally, as well as within the region or anywhere in the world accessible by plane. This is a vital service that extends the reach of our medical capabilities to almost anywhere.
Our team has in place a comprehensive simulation training programme for our paediatric residents and nurses, based at the Healthcare Simulation at NUS. Run by Dr. Nicola Ngiam and Dr. Jacqueline Ong, paediatric residents go through weekly mock codes on high-fidelity simulators and follow a curriculum that includes handling emergent situations such as cardiopulmonary arrest, upper airway obstruction and multi-trauma. Our PICU nursing staff and residents also have opportunities for inter-professional training throughout the course of the year.
Having a critically ill child in the PICU or HD unit is extremely stressful for parents and families. We encourage parents to stay close to their child during hospitalisation. Parents can either stay in the
Ronald McDonald House™ or rest on the lounge chairs in the
Ronald McDonald Family Room™. Both facilities are situated just outside the PICU or HD area.
We also have a family support team consisting of medical social workers, palliative care physician and a senior staff nurse who provide counselling, psychosocial support, as well as bereavement support for families of critically ill children.