In an intensive care unit, every moment counts. Having a team of specialized physicians, nurses and other staff to care for a child with life-threatening injury or chronic disease means precious moments are used wisely and a child’s life potentially saved. Brenner Children’s Hospital, the only children’s hospital in the region, has 75 pediatricians trained in over 27 areas of medicine.

From the region’s only Pediatric Emergency Room to a Level I Pediatric Intensive Care Unit (PICU), each child receives the highest level of care available in the country. These resources help reassure a parent that their child is receiving the best medical care available.

Promising research studies conducted each year at Brenner Children’s Hospital partnered with state-of-the-art technology offer children the latest treatments available and greatest hope for recovery.

Named one of the 30 best children’s hospitals in the nation by Child magazine, Brenner Children’s Hospital offers families state-of-the-art care and a plethora of support resources and programs readily available inside and outside the hospital walls. For example, if a family must stay overnight, accommodations provided by Ronald McDonald charities make that stay a pleasant and affordable one. If a parent needs to e-mail family, check-in at work or use Internet resources, a family room provides the latest technology to accomplish those tasks while grabbing a quick snack.

The faculty and staff realize that if a hospital stay is inevitable for a family, their stay should be as comfortable as possible. At Brenner Children’s Hospital, we are making a world of difference in the world of medicine.

Care at Brenner Children’s Hospital unmatched in the Southeast

Brenner Children’s Hospital currently has seven critical care specialists on staff in the Level I PICU. In addition, a team of over 75 pediatric-trained subspecialists are on standby, ready to help each child overcome challenges during his or her hospitalization.

Many procedures offered by our physicians are found in this region only at Brenner Children’s Hospital. For example, Michael Hines, M.D., of Brenner Children’s Hospital, is the only pediatric heart surgeon in the Southeast to offer minimally-invasive surgery to repair a patent ductus arteriosus, a common heart defect in children. The outpatient procedure – which requires only three or four small incisions in the chest – replaces major surgery to make the repair. It is offered at only a handful of hospitals in the United States. Hines has performed more than 230 of the outpatient procedures at Brenner Children’s since 1995.

The defect affects about 1 in 2,000 children in the United States. Often it can be corrected with medication, but surgery is recommended when medication does not close the vessel.

For the outpatient procedure, Hines inserts a tiny camera, called a thoracoscope, and instruments through small incisions in the chest. He then uses a metal clip to close the channel. The clip lasts a lifetime and the surgery does not have to be repeated.

“The child spends a few hours in the hospital and then goes home the same day,” said Hines.

At most other hospitals, doctors use an open chest surgery, which is more painful and has a longer recovery time. Patients having the open surgery are also at increased risk of developing scoliosis later in life.

Hines and his staff performed the video-assisted surgery live via a free webcast, sponsored by Wake Forest University Baptist Medical Center in October of 2002.  TO view the webcast, visit the Wake Forest University Baptist Medical Center website, www.wfubmc.edu.

Other pediatric surgical specialists work to correct many defects common at birth including: gastrointestinal, spinal, intracranial, and urological abnormalities. Infants and children also have the option of minimally-invasive surgery at Brenner Children’s Hospital, which has the largest pediatric surgical department in the western half of the state.

Brenner Children’s Hospital also houses the region’s only Extracorporeal Membrane Oxygenation (ECMO) referral center.  ECMO can increase chances of survival for children suffering from severe, life-threatening heart or respiratory problems. Since 1996, over 150 children have been treated at Brenner Children’s Hospital, making it the busiest ECMO center in the Southeast.

 

Trauma Center

As the only designated Level-I pediatric trauma center in the state, Brenner Children’s Hospital has one-of-a-kind resources at hand to treat all trauma cases. Once a child has been transported to the children’s hospital via the transport team, specially-trained surgeons, emergency department physicians and staff work in the area’s only pediatric emergency department to stabilize the patient and begin treatment.

From cardiac and pulmonary care to surgical specialties, physicians partner with highly-trained respiratory therapists, nurses and staff to ensure that each child receives a fighting chance at life.

“The benefits of performing surgery in a children’s hospital include having all the critical pediatric specialists on hand -- anesthesiologists, nurses, and pharmacists all trained specifically to care for children,” said Robert Letton, M.D., pediatric surgeon. “This further ensures that the outcome will be both safe and successful.”

 

The region’s only Level I Pediatric Intensive Care Unit

Pediatric intensivists and anesthesiologists staff the PICU at Brenner Children’s Hospital.

“The diversity of our training allows us to provide the best care possible with expertise in pediatric anesthesiology and critical care medicine,” said Tom Nakagawa, M.D., medical director of the PICU at Brenner Children’s Hospital. “We see the full spectrum from saving lives to providing care for the end of life.”   

Recognizing that a child hospitalized for any reason causes tremendous stress within a family, a team of nurses, chaplains and other specialists work to help parents cope.

“We have an extensive team of people who help parents understand what is happening to their child and prepare them for each decision that has to be made,” Nakagawa said. “Our success is based upon the entire team of individuals caring for the child and the family.”

In addition to highly-qualified staff, the PICU is equipped with the latest technology.  Many children transferred to the PICU will experience breathing difficulties. Rescue therapies for acute lung injury including specialized ventilators, administration of surfactant, inhaled nitric oxide, and ECMO assist physicians in the care of critically ill children.  

The Pediatric Sedation Suite is a specialized suite in the Pediatric Intensive Care Unit where children can be safely sedated for painful procedures. Pediatric-trained critical care specialists and anesthesiologists use intravenous anesthetic agents to help children tolerate painful procedures, be less anxious and more comfortable.

“We treat over 1,000 kids each year in our Sedation Suite,” said Joseph Tobin, M.D., pediatric anesthesiologist and section head of pediatric anesthesiology and critical care medicine at the Wake Forest University School of Medicine. “These kids experience less stress and feel better about their overall stay. Patient satisfaction has increased since this program was implemented four years ago.”

Over 700 children were admitted to the PICU at Brenner Children’s Hospital last year. Many were transported by our specially-trained pediatric and neonatal transport team. Serving the western half of North Carolina, these pediatric-trained nurses and respiratory therapists stabilize the child and bring them to Brenner Children’s Hospital.

 

Transport Team provides a mobile intensive care unit

Each year more than 550 infants and children are transported to the children’s hospital via the Medical Center’s specially-equipped transport ambulances or by AirCare, North Carolina Baptist Hospital’s helicopter transport system. The transport team includes experienced registered nurses and respiratory therapists who specialize in the care of critically ill children. The team’s scope of expertise includes airway control including endotracheal intubation, placement of intravascular catheters and chest tube placement and interpretation of invasive monitoring. This skilled care is provided by the team in the referring community hospital and during transfer.

In addition, the Brenner Children’s Hospital transport team is one of only three critical care transport teams in the state that can transport a child, while receiving Inhaled Nitric Oxide (INO).

“Our goal is to provide the same level of care and expertise in the referral hospitals and the transfer units that the infant would receive in our intensive care nurseries,” said Mitzi Amerson, RN, Coordinator of the Critical Care Transport Service. “We begin using advanced skills and expertise the moment the team arrives at the referral hospital.”

The Neonatal-Pediatric Transport Service at Brenner Children’s Hospital transports neonates and pediatric patients up to the age of 5 years, from a 20-county region of western North Carolina, southern Virginia, and eastern Tennessee. Children over the age of five are transported via the medical center’s ground ambulance or helicopter.

To request the Neonatal-Pediatric Transport service, call 1-800-277-7654. Your call will be transferred to a pediatric intensivist who will be able to assist you in arranging transport of the patient to Brenner Children’s Hospital.

 

Research brings new therapies to improve care

Physicians at Brenner Children’s Hospital work to improve the lives of children in the region through various research studies. For example, doctors recently discovered that the dosage of a drug commonly administered to adults and used in children should be increased when given to children.

“Fenoldopam is used to treat blood pressure and as a diuretic in adults,” Tobin said. “But when we studied the drug we discovered that the dosage needs to be increased when we administer it to children – the opposite of what you might have expected.”

Tobin and his team hope this study is one of the first of many conducted at the children’s hospital to determine the efficacy of drugs used when treating children.

“Over 80 percent of all drugs which are FDA approved have not been studied or labeled for use in children,” Tobin said. “We’d like to study more of the commonly administered ones to determine the best dose for children.” 

Physician scientists at Brenner Children’s Hospital work to research novel analgesics to control pain and understand the developmental neurobiology of pain transmission.

 

The Ronald McDonald House. . .a home away from home

The Ronald McDonald House of Winston-Salem provides a “home away from home” for families of children who are receiving medical care at Brenner Children’s Hospital.  The house and family room programs offer physical comforts, emotional support, education, and referral services designed to promote the well-being of the whole family.

“At the Ronald McDonald House, families from outside the community whose children are receiving medical treatment at local medical facilities are provided temporary lodging,” said Anita Ogburn, executive director of the Winston-Salem Ronald McDonald House. “Cheerful bedrooms, recreation areas indoors and out, and a kitchen stocked with food for all provide for the physical needs of the guests. A caring staff and the Family Assistance Program offer emotional support, education resources, and referral services to help the family adjust to the child’s illness.”

In the Ronald McDonald House family room, located near the intensive care units at Brenner Children’s Hospital, the services offered at the house are extended by providing a place for parents to take a break from the bedside of their hospitalized child. The Ronald McDonald family room is one of a handful of rooms across the country, offering these services to families.

Visitors to the family room can enjoy a snack in the kitchen, relax in one of the seating areas, or use the computers to keep in touch with family and friends. At the house and the family room, staff, volunteers, and fellow guests provide families with much-needed support.   

 

Training tomorrow’s experts

As an academic medical center, residents training in emergency medicine, anesthesiology and pediatrics rotate through the PICU at Brenner Children’s Hospital. Currently, the children’s hospital has 37 pediatric residents in training to become board-certified pediatricians.

 

Community physicians: part of the treatment team

Referring physicians are considered an integral part of the treatment team. In addition to providing regular updates on your patients, Brenner Children’s Hospital offers round-the-clock telephone access to specialists through the Physician’s Access Line (PAL®) at 1-800-277-7654.

 “We have a diversified and talented group of physicians who are ready to communicate back to the community physician on the status of their patient,” Nakagawa said. “We want to serve as a resource for the community physicians, while helping get their patient back on his or her feet quickly,” Nakagawa said.

 

For more information about the PICU at Brenner Children’s Hospital or other services and programs, call the PAL line at 1-800-277-7654 or visit our website at www.brennerchildrens.org.    

 

PICU at a glance

Seven critical care physicians staff the pediatric intensive care unit at Brenner Children’s Hospital. These experts care for over 700 children at Brenner Children’s Hospital each year.

The PICU has 12 intensive care beds and 7 intermediate care beds with 1:1 and 1:2 nursing patient ratios..

The unit serves 20 counties in western North Carolina, Virginia, Tennessee and South Carolina.

Michael Hines, M.D., a pediatric heart surgeon at Brenner Children’s Hospital, is the only pediatric heart surgeon in the Southeast to offer a minimally-invasive surgical procedure to repair a common heart defect in children.

Brenner Children’s Hospital is staffed by over 75 physicians specializing in over 25 areas of pediatric medicine.

Brenner Children’s Hospital was named one of the nation’s 30 best children’s hospitals by Child Magazine.

Brenner Children’s Hospital opened a state-of-the-art inpatient and outpatient facility in May of 2002, bringing the latest treatments to children in a friendly environment. The facility is geared to meet the needs of the entire family and make their stay as comfortable as possible.

Brenner Children’s Hospital is part of Wake Forest University Baptist Medical Center, which is consistently ranked as one of America’s best hospitals by U.S. News and World Report (top 50).

The Sedation Suite at Brenner Children’s Hospital provides a state-of-the-art, family-centered setting for children who are undergoing procedures.

Staff nurses at Brenner Children’s Hospital have specialty training in pediatrics and pediatric critical care for newborns through adolescents.

Brenner Children’s Hospital treats over 4,500 children from western North Carolina, as well as parts of Virginia, South Carolina, and Tennessee each year.

A part of Wake Forest University Baptist Medical Center, Brenner Children’s Hospital treats patients from birth to age 18. Children admitted to the hospital suffer from a variety of serious conditions such as leukemia and congenital heart defects.

Brenner Children’s Hospital is staffed by over 75 full-time pediatric faculty, representing more than 27 pediatric and surgical subspecialties including: adolescent medicine, allergy and immunology, anesthesiology, behavioral medicine and development, cardiology and cardiothoracic surgery, critical care, dermatology, endocrinology, otolaryngology, gastroenterology, general pediatrics, genetics, hematology and oncology, infectious diseases, neonatal perinatal medicine, nephrology, neurology, neurosurgery, orthopaedics, plastic and reconstructive surgery, psychiatry, psychology, pulmonology, radiology, and urology. In addition, Brenner Children’s Hospital is staffed by physicians representing all pediatric surgical specialties.

Currently, the hospital has 37 pediatric residents in training to become board-certified pediatricians.

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