When a life-threatening situation arises, CHOC Specialists Critical Care physicians are available 24-hours-a-day, seven days a week and provide comprehensive services for acutely ill or seriously injured children and adolescents. These board certified or board admissible pediatric subspecialists serve as medical directors for the 24-bed Pediatric Intensive Care Unit (PICU) at CHOC, the eight-bed PICU located within CHOC at Mission, and pediatric units at select Orange County hospitals.

Additionally, CHOC Specialists Critical Care physicians are available for immediate consultation and intervention in the event patients admitted into other areas of the hospital experience unforeseen complications. They provide 24-hour coverage for the emergency departments at both CHOC and CHOC at Mission. If a life-threatening situation arises, they are immediately available.

Regionally Recognized for Expert, Tertiary-Level Critical Care

With more than 30 years of experience, CHOC Specialists Critical Care physicians are regionally recognized for their expertise and treat critically ill patients from throughout Southern California. They treat the full spectrum of pathology and disease, from the very common to the very rare. Patients with a wide range of disorders are hospitalized in the PICU, including those with:

• Conditions that require complex medical interventions including extracorporeal membrane oxygenation (ECMO)< inhaled nitric oxide, high frequency oscillatory ventilation, continuous video EEG monitoring, intracranial presure monitoring, portable CT scanning
• Severe head injuries
• Life-threatening disorders of the heart, lungs and central nervous system
• Treatment of acute respiratory failure
• Chronic conditions such as respiratory illnesses, cancer or muscular dystrophy, requiring pediatric intensive care
• Post-surgical care and management, including cardiac surgery, neurosurgery, general pediatric surgery and orthopedic surgery

Through participation in multi-center studies of children with life-threatening respiratory failure, CHOC Specialists Critical Care physicians provide the most technically advanced therapies, such as extracorporeal membrane oxygenation (ECMO), high-frequency oscillation and the use of nitric oxide. Under their leadership, CHOC has had a successful ECMO program for more than 25 years.

CHOC Specialists Critical Care physicians also are integral to the CHOC Cancer, Neuroscience, Cardiac and Orthopaedic Institutes. Their services are complemented by the multidisciplinary care provided by other pediatric subspecialty physicians, nurses, respiratory therapists, pharmacists, physical therapists, occupational therapists, speech pathologists, clinical dietitians, child psychologists and social workers at CHOC and CHOC at Mission.

According to Virtual Pediatric Systems, LLC (VPS), a national collaborative of over 200 ICUs, when compared to a cohort of 19 similar PICUs, the CHOC PICU had:

• A Pediatric Index of Mortality 3 (PIM3) standardized mortality ratio statistically significantly lower than the VPS reference group.
• A statistically significantly lower Standardized Length of Stay Ratio than the VPS reference group.
• A similar percentage of unscheduled readmissions within 24 hours when compared to the VPS reference group.

24-Hour Transport Service to CHOC and CHOC at Mission

The availability of 24-hour transport services allows CHOC Specialists Critical Care physicians to bring critical care directly to the patient — and then to bring the patient back safely to either CHOC or CHOC at Mission. The sophisticated and highly specialized CHOC Transport Service is the only one in the region equipped with a pediatric high frequency oscillator and state-of-the-art ventilator.

By ambulance or helicopter, our team is available to transport children from emergency rooms, hospital nurseries, pediatric facilities and physician offices from throughout the Southern California region. Non-emergent (ACLS) transport services are also available and may be arranged by calling the Pediatric Transport Team at either CHOC or CHOC at Mission.

Fellowship Program & Professional Education

In addition to direct patient care responsibilities, CHOC Specialists Critical Care physicians are committed to advances in pediatric medicine through research, teaching and tertiary clinical training. In addition to teaching Residents at CHOC, they also teach fellows. CHOC Specialists Critical Care has trained over 70 critical care fellows in the past 20 years. CHOC Specialists Critical Care physicians are active members in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and currently involved in multiple national clinical trials. Several of our physicians hold faculty positions in the Department of Pediatrics at Harbor-UCLA Medical Center. The Pediatric Critical Care Fellowship Program (CHOC/Harbor-UCLA Medical Center) is ACGME-approved and has graduated 25 board admissible pediatric intensivists during the last 10 years.

Additionally, CHOC Specialists Critical Care physicians provide continuing medical education, outreach programs and consulting services to the pediatric community and to the multidisciplinary subspecialty teams at CHOC and CHOC at Mission.

Family Support and Care

CHOC Specialists Critical Care physicians are committed to the health and well-being of the children of Southern California. Medical care is provided with compassion, offering each family the necessary information to understand the child’s condition and anticipated outcome.

CHOC Specialists Allergy, Asthma and Immunology physicians provide comprehensive treatment based on prevention, intervention, education and self-management. Recognized for excellence by their peers and actively involved in clinical research, they offer the latest treatment options for patients of all ages with allergic or immunologic conditions. CHOC Specialists Allergy and Immunology physicians have special expertise in caring for the medically fragile and those who have not responded to conventional therapy.

Treatment modalities include pharmacotherapy, immunotherapy, dietary control and environmental allergen/irritant avoidance. Inpatient and outpatient services are available for children and adults experiencing conditions related to allergies, asthma and immune deficiencies, including:

• Acute, chronic and severe asthma
• Allergic rhinitis
• Allergic conjunctivitis
• Acute and chronic sinusitis
• Complicated eczema and atopic dermatitis
• Acute and chronic urticaria
• Drug and food allergies
• Stinging insect allergies
• Cellular immune deficiencies
• Antibody immune deficiencies

Early Intervention and Outpatient Management For Acute Asthma, CHOC Specialists Allergy, Asthma and Immunology physicians are committed to providing preventive care and early intervention for asthmatic patents. Managing severe asthma exacerbations in the office has been effective in reducing the number of emergency room visits, hospitalizations and days missed from school and work.

Cost-Effective Allergy Care Emphasizing Education and Prevention The Allergy evaluation begins with a medical history, diagnostic evaluation and environmental assessment. At the conclusion of the first appointment, each patient receives a detailed treatment plan, plus educational literature on altering the home environment to minimize exposure to allergens or irritants. This approach is thorough and cost effective. By providing education for patients and their families, CHOC Specialists Allergy, Asthma and Immunology physicians promote better understanding and management of the condition through the proper use of medications, environmental controls and other preventive measures to alleviate symptoms and minimize reactions.

Active Participants in the Latest Clinical Research CHOC Specialists Allergy

Asthma & Immunology physicians serve as principal investigators for many clinical research studies, providing patients with access to the newest treatment options available. Recent studies have included new medications for asthma, allergic rhinitis, sinusitis and eczema.

Recognized within the community for excellence, CHOC Specialists Allergy, Asthma and Immunology physicians are board certified pediatric subspecialists, who have been practicing in Orange County for over 35 years. They provide medical directorship for the Allergy, Asthma and Immunology program at CHOC. As a community service, they report on daily mold and pollen counts to the Orange County Register.

CHOC Specialists Allergy, Asthma and Immunology physicians direct a summer camp for asthmatic children sponsored by the American Lung Association and participate in community education lectures and seminars.

Additionally, CHOC Children’s Allergy and Immunology Specialists are proud to be partner with the CHOC Children’s Gastroenterology Specialists to offer one of the only Eosinophilic Esophagitis Clinics in Southern California. The multidisciplinary team of allergists, gastroenterologists and dietitians, work with children from infancy to age 18 to help diagnose and treat eosinophilic esophagitis (EoE) using the very latest research-based treatments.

When a child is first diagnosed with EoE, it is an overwhelming experience. The clinic team provides the expertise and support needed to manage the patient’s health and wellbeing. The clinic meets every first and third Wednesday of the month. During the initial stages of care, patients may need to attend clinic every one to three months depending on the severity of the child’s symptoms. The EoE team also provides support services outside of the clinic through e-mail and phone calls. Once there is resolution of the EoE and the trigger is identified, we recommend yearly visits for follow-up.

The CHOC Specialists Cardiology Division strives to provide the best possible care for infants, children and adolescents with acquired or congenital heart disease as well as adults with congenital heart disease. Comprehensive inpatient and outpatient services are offered including collaborative care with the intensive care team in the dedicated Cardiovascular Intensive Care Unit (CVICU). We have a strong educational program for patients and families and we offer complete cardiovascular care.

Leading-Edge Diagnostic Capabilities & Treatment

CHOC Specialists Cardiology physicians provide the following services:

• Inpatient and outpatient consultation
• Prenatal consultation
• Echocardiography (fetal, transthoracic and transesophageal)
• Digital diagnostic and therapeutic cardiac catheterization, including atrial septal—defect or patent ductus arteriosus closure
• Electrophysiological services, including event and Holter monitoring, tilt table testing, exercise stress testing, pacemaker implementation and programming, and state-of-the-art electrophysiological testing and ablation for arrhythmias
• Comprehensive, multi-disciplinary Hyperlipidemia Clinic and new clinics in Heart Failure and Pulmonary Hypertension as well as future clinics in Arrhythmias and Adolescents with Congenital Heart Disease
• Care for adolescents and adults with congenital heart disease

Recognized For Excellence

CHOC Specialists Cardiology physicians serve as the Medical Directors for the pediatric cardiology services provided at CHOC. Our cardiologists work closely with the pediatric cardiac surgeons at CHOC. Collaboration with pediatric intensivists in the hospital’s dedicated CVICU as well as Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) provides a comprehensive, multidisicplinary approach to patient care.

Active Participants in the Latest Clinical Research

CHOC Specialists Cardiology has an active research program and has representation at the pediatric study section at the National Institute of Health (NIH). Ongoing projects include evaluating new treatments for respiratory syncytial virus (RSV) in children with cardiac disease and newer noninvasive methodologies in monitoring children after cardiac surgery. The Division has assisted in the development of new catheters to evaluate coronary problems in children. They recently participated in a national study to evaluate newer inotropic agents following heart surgery as well as management strategies for hypoplastic left heart syndrome. Future proposed projects involve an important collaboration between the CHOC Specialists Cardiology Division and the University of California, Irvine.

“The premier pediatric cardiology practice in Orange County, CA.”

The CHOC Specialists Cardiology Physicians are distinguished by their commitment to clinical excellence and research and through their training and faculty appointments at many of the nation’s most prestigious schools and hospitals including the University of California, Los Angeles (UCLA), Children’s Hospital of Los Angeles (CHLA), Boston Children’s Hospital, Philadelphia Children’s Hospital, and Texas Children’s Hospital in Houston, TX.