PICU Capability Assessment Report

Hospital Infantil Tegucigalpa - Tegucigalpa, Honduras
Assessment Date
February 12, 2026
Intelligence Age
3 hours
Verified By
Dr. Sofia Martinez, Pediatric Intensivist
Aksanio Query ID
AKS-2026-0315
⚠ LIMITED TRUE PICU CAPABILITY
This facility has nominal PICU designation but limited pediatric intensive care capability. Can manage moderate acuity cases with careful patient selection. Complex or unstable patients should be considered for transfer to regional pediatric center.

Capability Summary

Equipment

3
Pediatric Ventilators

Staffing

2
Fellowship-Trained Intensivists

Capacity

4-6
Max Ventilated Patients

Nursing

60%
Specialized Training
Overall PICU Capability Score: FAIR - Moderate Acuity Only

1. Equipment and Infrastructure

Pediatric-Specific Ventilators Available
3 units
Can Access/Maintain Implanted Vascular Ports
Yes, requires specialized personnel
Maximum Patients on Mechanical Ventilation
4-6 patients
High-Flow Nasal Cannula (HFNC) Available
Yes - 2 units
Non-Invasive Ventilation (BiPAP/CPAP)
Yes - 2 units
Bedside Portable X-ray
Yes
Bedside Ultrasound
Yes - 1 unit
Central Line Placement Capability
Yes - Routine
Arterial Line Monitoring
Yes
Continuous EEG Monitoring
No

2. Staffing and Expertise

Physicians with Formal Pediatric ICM Fellowship
2 physicians
Percentage of Nurses with Specialized PICU Training
60%
Pediatric Intensivist Coverage 24/7
By phone/telemedicine <30 min response
Respiratory Therapist 24/7
Yes - In-house
Nurse-to-Patient Ratio (Ventilated)
1:2 patients
Nurse-to-Patient Ratio (Non-Ventilated)
1:3 patients
Dedicated PICU Pharmacist
No - General pharmacy coverage
Child Life Specialist Available
No

3. Clinical Capabilities and Sustainability

Maximum TBSA Burn Manageable
15-20% TBSA
Days Can Routinely Maintain 8-Year-Old Ventilated
5-7 days
Standard Age Limits on Patient Acceptance
28 days - 14 years
Neonatal (<28 days) Capability
No - Transfer to NICU
Can Manage Diabetic Ketoacidosis (DKA)
Yes - Routine
Can Manage Status Epilepticus
Yes
Can Manage Severe Sepsis/Septic Shock
Yes - With limitations
Can Manage Acute Respiratory Failure
Yes
Can Manage Traumatic Brain Injury
Stabilization only, transfer for definitive care
Post-Operative Cardiac Surgery Capability
No

4. Advanced Therapies and Procedures

Continuous Renal Replacement Therapy (CRRT)
No
Hemodialysis
Yes - Intermittent only
ECMO (Extracorporeal Membrane Oxygenation)
No
Inhaled Nitric Oxide
No
Bronchoscopy
Yes - Flexible bronchoscopy
Therapeutic Hypothermia
Limited - Cooling blankets only
Exchange Transfusion
No
Plasmapheresis
No

5. Support Services and Transfer Capability

Pediatric Radiology (CT/MRI) 24/7
CT: Yes / MRI: Business hours
Pediatric Surgery Available
Yes - On-call 24/7
Pediatric Cardiology Available
By phone/telemedicine
Pediatric Neurology Available
By phone/telemedicine
Pediatric Anesthesiology Available
Yes - On-call 24/7
Pediatric Nephrology Available
No
Emergency Transfer to Higher Level of Care
2-6 hours (ground) / <2 hours (air)
Primary Transfer Facility
Hospital Escuela, Tegucigalpa (25 km)
International Transfer Facility
Texas Children's Hospital, Houston (air ambulance)

6. Standardized Protocols and Quality Measures

Standardized Mechanical Ventilation Weaning Protocol
Yes
Standardized Sedation and Analgesia Protocol
Yes
Standardized Fluid and Electrolyte Management
Yes
Standardized Cardiopulmonary Resuscitation Protocol
Yes - PALS certified
Standardized Post-Operative Care Protocol
Yes
Family-Centered Rounds
Yes - Daily
Open Visitation Policy
Yes - 24/7 parent access

7. Current Status and Bed Availability

Total Designated PICU Beds
8 beds
Current Census
6 of 8 beds occupied
Current Ventilated Patients
2 patients
Average Monthly PICU Admissions
35-40 patients
Bed Availability Now
2 beds available

Physician Assessment (Dr. Sofia Martinez, Pediatric Intensivist): "Our PICU can manage moderate-acuity pediatric patients including respiratory failure requiring ventilation, severe infections, and post-operative monitoring. We have limitations for very complex cases - no ECMO, no cardiac surgery support, limited dialysis capability. We maintain good outcomes for bronchiolitis, pneumonia, DKA, and post-op general surgery patients."

Equipment Status: "All three pediatric ventilators are functional. We currently have 2 patients ventilated with capacity for 2-4 more depending on acuity. Monitoring equipment is reliable. We have adequate IV pumps and central line supplies."

Staffing Reality: "Our two fellowship-trained intensivists cover Monday-Friday during business hours. Nights and weekends are covered by pediatric hospitalists with intensivist backup by phone. Our nurses are experienced with ventilated children but not all have formal PICU certification. We maintain 1:2 ratios for ventilated patients."

Transfer Threshold: "We transfer patients needing ECMO, cardiac surgery, neurosurgery, or prolonged ventilation (>7-10 days). We also transfer very unstable septic shock if not responding to initial resuscitation, and any child with multiorgan failure. We have good relationships with Hospital Escuela locally and can arrange air ambulance to Houston for complex cases."

8. Aksanio Assessment and Recommendations

⚠ APPROPRIATE FOR MODERATE ACUITY CASES ONLY

This PICU can safely manage moderate-acuity pediatric patients with appropriate monitoring and stabilization capability. However, it functions more as a "step-down ICU" or "intermediate care" rather than a full-capability PICU by tertiary center standards.

Suitable For:

  • Respiratory failure requiring mechanical ventilation (expected <5-7 days)
  • Severe pneumonia or bronchiolitis
  • Diabetic ketoacidosis
  • Post-operative monitoring (non-cardiac)
  • Sepsis (if responsive to initial resuscitation)
  • Status epilepticus

Consider Immediate Transfer For:

  • Cardiac surgery patients or complex congenital heart disease
  • Need for ECMO or advanced cardiac life support
  • Severe traumatic brain injury requiring neurosurgical intervention
  • Multi-organ failure
  • Need for continuous renal replacement therapy (CRRT)
  • Prolonged ventilation expected (>7-10 days)
  • Neonates (<28 days old)
  • Any patient not stabilizing with initial therapy

Key Strength: Experienced with common pediatric ICU conditions. Good protocols for ventilator management and sedation. Can provide safe care for appropriate cases.