A Closer Look: Division of Pediatric Critical Care Medicine

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Pediatric Clinical Update | June 2019

Ten pediatric intensivists at UH Rainbow Babies & Children’s Hospital provide the full range of advanced, family-centered pediatric medical and surgical intensive care services around the clock each year to more than 1,600 critically ill or injured children from birth to 18+ years.  The patient outcomes in our 20-bed Pediatric Intensive Care Unit (PICU) consistently rank in the top 15% among the 60+ PICUs across the country that have ECMO capability (data from Virtual Pediatrics Systems, LLC).  Members of the division have special training and expertise in the management of the critically ill child and are experienced in all modern ICU technologies, including extracorporeal membrane oxygenation (ECMO), high-frequency oscillatory ventilation (HFOV), negative pressure ventilation, continuous renal replacement therapy (CRRT), high resolution ultrasound and video laryngoscopy.  In addition to directing PICU services, pediatric critical care faculty also provide pediatric sedation, pain management and pediatric critical care transport services.

The UH Rainbow Babies & Children’s PICU staff cares for children with diagnoses ranging from complex congenital heart disease, sepsis, and severe traumatic brain injury to asthma, bronchiolitis, and diabetic ketoacidosis. With a multidisciplinary care approach, patients in the 20-bed unit benefit from dedicated PICU-specific nurses, respiratory therapists, pharmacists, nutritionists and social workers. Other services – including all medical and surgical sub-specialties, occupational therapy, physical therapy, speech therapy, and more – are also available to support patients.

To optimize the quality of care, PICU faculty participate in the Virtual Pediatrics System Virtual PICU registry and benchmark outcomes against PICUs providing similar high levels of care for the most complex conditions.  In 2016 and 2017 (most recent data available), UH Rainbow standardized mortality rates based on Pediatric Index of Mortality score were in the top 15% of all ECMO-capable centers in the registry.

The Pediatric Sedation Unit (PSU) located on the 4th floor of Rainbow, houses eight private patient rooms used for induction, procedures and recovery. Treatment rooms are available for dental, V-beam laser treatment and specialized ophthalmology imaging and endoscopy.  In addition, the unit has patient rooms for induction and recovery for radiation therapy. 

The PSU team includes critical care nurses, critical care faculty and fellows, child life and ancillary support to provide sedation services for children requiring invasive procedures and tests requiring controlled immobility.  More than 2,000 patients safely receive procedural sedation for both diagnostic and therapeutic studies on an outpatient and inpatient basis. These include MRI, nuclear medicine, dental procedures, intraspinal chemotherapy administration, proton and photon radiation treatment and GI endoscopy. The Pediatric Sedation Unit is led by Drs. Nicole Johnson and Anne Stormorken, current President-elect of the Society for Pediatric Sedation. To make a referral or schedule an appointment, please call 216-844-7733.

Division contact:
Main number 216-844-3310
Fax number 216-844-5122

Pediatric Critical Care Medicine Faculty Roster

Steven L. Shein, MD
Chief, Division of Pediatric Critical Care Medicine
Associate Program Director, PICU Fellowship Program
Director, UH Rainbow PICU Clinical & Translational Research Program
Chair, Society of Critical Care Medicine Clinical Research and Epidemiology Committee
Steven.Shein@UHhospitals.org
Research interests: critical bronchiolitis, long-term neuro-cognitive morbidity after critical illness

Ingrid Anderson, MD
Director, Pediatric Simulation
Co-Medical Director, Pediatric Transport
Ingrid.Anderson@UHhospitals.org
Special interests: simulation-based education, feedback and educational curriculum development

Jason Clayton, MD, PhD
Co-Medical Director, Pediatric Transport Quality
Jason.Clayton@UHhospitals.org
Research interests: epidemiology and health outcomes of community-associated C. difficile in pediatric patients, influence of the microbiome in critically ill children

Nicole Johnson, MD
Co-Medical Director, Pediatric Sedation Unit
Nicole.Johnson@UHhospitals.org
Special interests: safe practice of procedural sedation, lowering the cost of medical care for all Americans, and solving the national physician shortage, physician and patient advocacy

Kathryn Miller, MD, MA
Associate Director, Rainbow Center for Pediatric Ethics
Kathryn.Miller@UHhospitals.org
Special interests: bioethics, critical care oncology, family centered care, pediatric shared decision making, medical student education

Katherine Slain, DO
Director, Pediatric Critical Care Medicine Fellowship Program
Katherine.Slain@UHhospitals.org
Research interest: impact of socioeconomic status on pediatric critical illness 

David Speicher, MD
Medical Director, Cardiothoracic ICU
Medical Director, UH Rainbow Quality Assurance
David.Speicher@UHhospitals.org
Special interests: ECMO, resuscitation, quality assurance

Richard Speicher, MD
Medical Director, UH Rainbow PICU
Co-Director, Pediatric Trauma
Richard.Speicher@UHhospitals.org
Special interests: pediatric critical care medicine, pediatric trauma

Anne Stormorken, MD
Medical Director, Pediatric Pain Management 
Co-Medical Director, Pediatric Sedation
Anne.Stormorken@UHhospitals.org
Special interests: analgesia, sedation, ICU delirium, early mobilization to improve long-term outcomes for critically ill children  

Philip Toltzis, MD
Pediatric Critical Care Medicine
Philip.Toltzis@UHhospitals.org
Special interests: nosocomial infections, antimicrobial resistance, epidemiology of hospital acquired infections

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