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PEDIATRICS UNIT

PULMONARY AND CRITICAL CARE

 

 

THE PEDIATRICS UNIT

pediaThe Pediatric Unit is a multi-disciplinary unit that was established in 2007. Its primary objective is to provide quality healthcare service to children requiring specialty pulmonary and critical care. It has a 21 bed-capacity, 15 of which are dedicated to private patients while the remaining 6 beds are dedicated to service patients. It is composed of a diverse group of experts in pediatric pulmonology, intensive care, infectious diseases, allergology-immunology, ambulatory pediatrics, cardiology, gastroenterology, hematology-oncology, nephrology, neurology/sleep medicine, rheumatology, and surgery. It offers charity out-patient services, and it caters mainly to cases of childhood tuberculosis and oncology (thoracic masses). Pay out-patient services are also available in the pediatric unit to attend to dependents of LCP employees and other private patients. 

Pediatric Unit Private Clinic Schedule

 

HUMBLE BEGINNINGS: LCP TB DOTS IN CHILDREN

In 2007, Dr. Cristan Cabanilla was tasked to spearhead a team that would provide quality pediatric care to infants and children at the Lung Center of the Philippines. His genius and foresight moved him to invite Drs. Anjanette De Leon, Arlene Dy-Co, Gilda Sapphire Erguiza, Ma. Theresa Lorenzo and Christine Sua to join the team. The immediate task then was to provide care to patients with tuberculosis and start the TB-DOTS in children. 

 

EXPANSION OF SERVICES

In 2008, with the group's expansion, came the parallel expansion of the unit's services. Priority was given to thoracic-surgical/oncologic cases. This paved the way for admission of patients at the charity service. Hospitalists/pediatric junior consultants were hired to address the growing concerns with the unit's expansion.

In 2009, the Pediatric Unit was opened to general pediatric cases. It was now recognized as an independent unit by the hospital. The organizational chart divided the unit into different teams to attend to various concerns: DOTSCh & MDRTB (to handle TB cases), General ICU and Pulmonary Critical Care, Thoracic Surgery, Bronchoscopy, and Medical Education & Training. Along with this came the addition of medical staff composed of consultants with varying expertise in Pediatrics.

In 2010, the Unit saw itself participating actively in the various activities of the hospital: grand rounds, seminars, post-graduate courses, , hospital committee meetings, and strategic planning to name a few.

At present, the Pediatric Unit had 1408 OPD consults in 2009, 694 for 2010 and 1079 in 2011, 1996 in 2012, 4574 patients seen in 2013 and 4373 in 2014.

As for admissions, we have earned 318 admitted patients in 2009, 484 in 2010, 409 patients in 2011, 402 in 2012, 361 in 2013 and 366 patients in 2014.

Currently, the Pediatric Unit is further subdivided into sub-sections as follows: DOTSCh and MDRTB, Thoracic-Cardiovascular Surgery, Oncology and Palliative Care, General ICU and Pulmonary Critical Care, Bronchoscopy, and Medical Education, Research & Training. Future plans are on the way to for Sleep Medicine, Pediatric Pulmonary Rehabilitation, Travel Medicine and Pediatric Emergency Room Expansion. To date, it now boosts of a 25-bed capacity allotted as follows: 6 for service, 15 for private patients, and 5 for ICU and Pulmonary Critical Care.

VISION

To become the premiere institution for lung and chest diseases in infants and children, providing holistic quality health-care through excellent service, training, and research.

 

 PEDIATRIC CONSULTANT STAFF:

Agrava, Ma. Amparo  ANS  Neurology 
Ang, Jonalyn Chris  Referral  Neurology 
Arnaldo, Hazel  Referral  Gastroentorology 
Astrologio, Gari  ANS  Pulmonology 
Bernal, Christine Referral Rheumatology
Bumanglag, Nathan ANS Nephrology
Bunyi, Mary Ann Referral Infectious Disease
Cabanilla, Cristan ANS Pulmonology
Canonizado, Regina ANS Pulmonology
Cruz, Meadina ANS Critical Care
Cunanan, Amelia ANS Pulmonology
De Castro, Reynaldo Referral Hematology
De Leon, Anjanette Plantilla Pulmonology/Critical Care 
De Leon, Maria Nerissa A.  ANS Pulmonology/Critical Care
Del Rosario, Maria Luz Referral Hematology/Oncology
Dela Cruz, Beverly  ANS  Pulmonology 
Delos Reyes, Carmina  Plantilla   Infectious Disease 
Dy-Co, Arlene Plantilla  Infectious Disease 
Espineda, Beda  Referral  Surgery 
Fran, Mary Anne  Referral  Allergology/Immunology 
Gepte, Beatriz  ANS  Hematology/Oncology 
Gillera, Gladys L. Plantilla Pulmonology/Critical Care
Jamero, Jean Marie E. ANS Pulmonology
Lorenzo, Maria Theresa ANS Intensive Care
Manuel, Raymund ANS Pulmonology
Mendoza, Carlo ANS Pulmonology
Neri, Renee  ANS  Ambulatory/Pediatricians 
Policarpio, Maria Theresa  Plantilla  Pulmonology/Critical Care 
Requiron-Sy, Dulce  ANS  Pulmonology/Critical Care 
Sanchez, Marion  Referral  Pulmonology 
Tubianosa, Glenda  ANS  Cardiology 
Urbi, Cristina  ANS  Neurology 
Valles, Jemaila  ANS  Pulmonology 
Venturina, Josy Naty  ANS  Pulmonology 

Medical Staff:

A.  Plantilla

Anjanette R. De Leon, MD  Head, Pediatric Unit   
Ma. Theresa T. Policarpio, MD  Pulmonology 
Gladys L. Gilera, MD  Pulmonology 
Carmina A. Delos Reyes, MD Infectious Disease
Arlene S. Dy-Co, MD Infectious Disease

B.  Active Non-Salaried / Visiting

Agrava, Ma. Amparo Neurology   
Ang, Jonalyn Chris Neurology/Sleep Medicine
Bumanglag, Nathan Nephrology
Bunyi, Mary Ann Infectious Diseases
Cabanilla, Cristan Pulmonology
Canonizado, Regina Pulmonology
Cruz, Meadina Critical Care
De Leon, Maria Nerissa Pulmonology
De Castro, Reynaldo Hematology
Del Rosario, Maria Luz Hematology
Espineda, Beda Surgeon
Gepte, Beatriz Oncology
Jamero, Jean Marie Critical Care
Lorenzo, Maria Theresa Intensive Care
Raymund, Manuel Pulmonology
Requiron-Sy, Dulce Pulmonology
Tubianosa, Glenda Cardiology
Bernal, Christine Rheumonology
Gari Astrologio Pulmonology
Beverly Dela Cruz Pulmonology
Amelia Cunanan Pulmonology
Jemaila Valles Pulmonology
Josy Naty Venturina Pulmonology

C.  Junior Consultants

Ador, Michelle MD
Bautista-Dataylo, Karen MD
Binua, Florence MD
Doloroso, Kristine Michelle MD 
Donato, Maria Caridad MD 
Del Rosario, Jeremie Marie MD 
Francisco, Charmie MD 
Gervacio, Dhesiree MD 
Hernando, Maria Angela MD 
Maroon, Genalyne MD 
Natividad, Racquel MD 
Pongco, Pamela MD 
Retoriano, Katherine MD 
Rey, Sherbeth Mae MD 

Pediatric hospitalists/Junior consultants are part of the team of doctors who will manage pediatric patients. They are board certified/board eligible pediatricians from duly-accredited residency training programs in the country. Their entry into the pediatric unit has likewise been approved by the accreditation committee of the hospital.

The duties and responsibilities of junior consultants include management of pediatric patients at the Emergency department, ward, out-patient and DOTS clinics, and attending to referrals from other services.

DOTSCh

The Head of DOTSCh plans and evaluates NTP activities, prepares teaching modules in coordination for dissemination to pediatricians and allied medical practitioners, and supervises health staff to ensure proper implementation of the LCP DOTSCH policies in coordination with the NTP policies at the PHDU such as:

    1. Identification, examination and classification of TB cases
    2. Implementation of case holding mechanisms, such as DOT
    3. Analysis and submission of quarterly reports
    4. Referral of TB cases to the TB diagnostic committee or other health facilities, if
          needed
    5. Ensuring adequacy of NTP drugs and supplies

The section is composed of consultants who are Pediatric consultants of any subspecialty who are on rotation duty from Mondays to Fridays. They attend to the NTP orientation on TB in children, examines patients as needed, review refferals made by the junior consultants on duty, and recommend the appropriate treatment and/or interventions of referred cases.

A Medical Officer of the day (Junior consultant) is assigned at DOTSCh. They are on rotation duty at the clinic from Mondays to Fridays. They likewise attend the NTP orientation on TB in children, identify and examine children suspected of having TB, inform and educate the mother about the child’s disease, request the necessary laboratory procedures in children suspected of TB utilizing LCP laboratories such as chest x ray, tuberculin skin testing, chest CT scan, etc, refer identified children with TB to the LCP DOTS clinic to start anti-TB drugs, perform monthly follow-up of children enrolled at the LCP DOTSCH clinic, identify and refer children with TB needing hospital admission, assist in the planning and organizing of the monthly evaluation of all TB cases enrolled at the LCP DOTSCH clinic, provide continuous health education to all TB patients under treatment. encourage family and community participation in TB control. 

SECTION OF ONCOLOGY AND PALLIATIVE CARE

The section serves to establish a pediatric pulmonary oncology program which can provide specialty care to pediatric patients with all stages of primary pulmonary and mediastinal malignancies as well as metastases to the chest in close coordination with the Department of Thoracovascular Surgery, Pathology, and Radiation Oncology. Guidelines on approach to diagnosis of thoracic masses, treatment protocols for the management of oncologic emergencies such us superior vena cava and superior mediastinal syndromes, treatment protocols for common malignant tumors in the lungs and mediastinum among children (lymphomas, germ cell tumors, neuroblastoma, Ewings sarcoma, rhabdomyosarcoma , pleuropulmonary blastoma), general guidelines in administration of chemotherapy and care of patients undergoing chemotherapy, are among the various issues which the section addresses.

The Head of the section of Oncology (MS II) will lead in the establishment of the pediatric pulmonary oncology program, create guidelines for pre-operative risk assessment of candidate oncologic surgery patients, oversee surgical biopsies among pediatric patients with pulmonary and mediastinal masses in close cooperation with the Pediatric Pulmonary Medicine and Cardiology and initiate researches and participate in clinical studies on pulmonary and mediastinal malignancies in children. 

The Head of the Section of Palliative Care (MS II) will spearhead in the management of the hospice and palliative care of the department whose main role is to co-certify the terminal prognosis of the pediatric patient; lead the team in the development of the plan of care, provides consultation with other physicians regarding hospice care, and lead in the training of the department on hospice and palliative care. 

The Head of the Section of Palliative Care (MS II) will spearhead in the management of the hospice and palliative care of the department whose main role is to co-certify the terminal prognosis of the pediatric patient; lead the team in the development of the plan of care, provides consultation with other physicians regarding hospice care, and lead in the training of the department on hospice and palliative care.

BRONCHOSCOPY

The Head of the Bronchoscopy Unit (MS II) performs administrative functions as follows: procures and checks maintenance of Bronchoscopy equipments, formulates guidelines and SOPs in the Pediatric Bronchoscopy Unit, oversees implementation of Pediatric Bronchoscopy policies and procedures, and recommends to the Department Head special activities related to the unit. Specific objectives of the unit include the following: answers bronchoscopy referrals for evaluation, oversees the holistic management of patients undergoin the procedure, performs and teaches bronchoscopy rotators in the performance of diagnostic and therapeutic procedures, teaches bronchoscopy rotators in the correct interpretation of the dynamic and static findings utilizing video and picture results of actual cases, schedules and conducts follow-up check-up of post-bronchoscopy patients at the OPD clinic; conducts family conferences/counseling with bronchoscopy rotators and patients’ family, coordinates with other subspecialty services needed as indicated, guides pediatric Bronchoscopy research activities.

The Members of the Bronchoscopy Team answers bronchoscopy referrals for evaluation and indications of the procedure, performs and teaches bronchocopy rotators in the performance of diagnostic and therapeutic procedure, teaches bronchoscopy rotators in the correct interpretation of the dynamic and static findings utilizing video and picture results of actual cases, schedules and conducts follow-up check-up of post bronchoscopy patients at the OPD clinic, makes regular rounds on all admitted patients for Pre and Post bronchoscopy procedure at the Ward and Pediatric Intensive Care Unit, conducts family conferences/counseling with bronchoscopy rotators and patients’ family, coordinates with other subspecialty services needed as indicated for patient, and guides pediatric Bronchoscopy research activities.

PEDIATRIC INTENSIVE CARE UNIT AND PULMONARY CRITICAL CARE

The Pediatric ICU and Pulmonary Critical Care aims to provide multi-disciplinary definitive care for a wide range of complex, progressive, and rapidly changing medical, surgical, and traumatic disorders occurring in pediatric patients of all ages, excluding premature newborns. The PICU will provide optimal care for the unique needs of the seriously ill pediatric patient. It aims to project a multi-disciplinary team approach in the management and care of patients, provide a functional & user- friendly environment that will cater to the need of the patients & PICU staffs.

To set up a Level I PICU that will provide a continuous observation, monitoring, short/long term ventilation and that can provide all aspects of intensive care including invasive hemodynamic monitoring & dialysis.

The Head of The Pediatric ICU (MS II) and Pulmonary Critical Care (MS II) will have full responsibility in the ICU and coordinate its needs with the head of the Department. The head is responsible for coordinating and providing policies needed by the section.

SECTION OF TCVS

The Head of TCVS (MS II) and its members will evaluate service patients for thoracic surgery. The Pediatric OPD facilitates in the admission and management of service patients for surgery. Cases are presented in a regular medical staff conference together with the thoracic surgeons to optimize pre-operative planning and management of the case.

EDUCATION AND TRAINING

The Section of Education and Training of the Department of Pediatrics is responsible for coordinating and implementing activities related to education, training and research policies of the department. It is also responsible for coordinating its activities with the Professional Education and Training Section of the Institution.

The Head (MS II) is the academic leader with programmatic, managerial and fiscal responsibilities for the Section of Education and Training of the department. As such, the Head provides local oversight (i.e., broad managerial oversight) of education and training policies and processes. This oversight can be delegated to any member of the Section. But, the final review and implementation is the responsibility of the Head. The Head reports to the Unit/Department Manager.

The members of the section of Education and Training of the Department of Pediatrics may be delegated the responsibility of providing local oversight to the implementation of the education, training and research policies of the department. The members of this Section should be representative of the different Sections (Sections on Bronchoscopy, General ICU and Pulmonary Critical Care, DOTSCh, MDRTB, TCVS) of the department. It is preferred that the representative from the different Sections is the Section Chair.