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Thank you for joining us. This short video is part of our Master Teacher Series and features Dr. David Wessel. In the following video, Dr. Wessel discusses the origins and development of the field of pediatric cardiac intensive care.

David, finally, are there organizational changes in how intensive care units, in particular pediatric cardiac intensive care units, are functioning that give you hope or give you pause?

Well, I think there are several things that make us hopeful. First of all, the integration of biology and science into the clinical care aspects, I think provides a lot of hope that we're going to be able to develop new solutions and new therapies for cures. So understanding the biology is really what provides the basis for innovation and new care. And we've seen much more integration of the clinical and the scientific side in cardiac intensive care units around the world.

The other practical care delivery models that have changed, and I think I've been enormously helpful, is the introduction of specialized nurse practitioners into the cardiac intensive care unit. They're so incredibly helpful in getting the work done, paying attention to families, looking at some of the detail, having a very obsessive-compulsive aspect to the work that they do that's so important to patient care, especially for complex patients.

One of the organizational changes that I found very useful in my practice has been meeting together every single morning in a media room to do a 30 minute check of all the patients with all of the right parties that are there. The cardiac surgeons are there, the cardiologists are there, the cardiac ICU people are there. There's nursing representation, and we go quickly through every patient so that we're all on the same page. And then the team that makes rounds at the bedside goes out, and of course, then spends much longer at the bedside looking after those patients.

So the teamwork aspect of this is really very important. I think it's also going to be important for us to develop the next generation of leaders that can really bring us to the next level. It's important to our organizations from succession planning that we have people there who actually take the field to a higher plane. I was reminded-- when I first got into cardiology and critical care, I still did a clinic for cardiology patients. And in my clinic was Dr. Barry Keane and Dr. Alexander Nadas, one of the pioneers of pediatric cardiology.

And I was an intensivist, Jeff, and going to clinic just wasn't really my end all and be all. And so after seeing one or two patients, I would tell Dr. Nadas that even as a junior faculty person, I needed to get back to the intensive care unit. They really needed me and I'd be on the phone and I'd have to go back.

And Dr. Nadas was a little bit famous for this quote, but he used it on me appropriately more than once. He told me to be reminded that graveyards are full of indispensable people. And I understood that to mean that there were people back there in the ICU that really knew how to do their work without me. If I didn't have that program there, then I wasn't doing my job right.

And so I think it really is important that we develop these models for the next generation to provide a level of care that will sustain the field and take it into new frontiers.

And Dave, what gives you pause about some of the organizational changes we're seeing?

• Case Study on the Field of Pediatric Cardiac Intensive Care with D. Wessel | OPENPediatrics ( Download)
• Lessons Learned in Pediatric Cardiac Intensive Care by D. Wessel | OPENPediatrics ( Download)
• Past, Present, and Future of Cardiac Intensive Care with D. Wessel | OPENPediatrics ( Download)
• Master Teacher Series: Case Study on ECPR with D. Wessel | OPENPediatrics ( Download)
• Master Teacher Series: Case Study on Inhaled Nitric Oxide with D. Wessel | OPENPediatrics ( Download)
• Pediatric In-Hospital Cardiac Arrest 2017 by R. Berg | OPENPediatrics ( Download)
• WSPF- Physiology & Management of Heart Failure in the ICU with Dr. Schwartz ( Download)
• Landmark Articles in Pediatric Cardiac Anesthesia by P. Barash, et al. | OPENPediatrics ( Download)
• Neurocritical Care after Cardiac Arrest by R. Tasker | OPENPediatrics ( Download)
• Identifying and Managing Low Cardiac Output by P. Laussen | OPENPediatrics ( Download)
• Postoperative evidence based analgesia: Fact or Fiction by R. Tibboel | OPENPediatrics ( Download)
• WSP - PICU Outcomes and Outcome Predictions by M.Pollack | OPENPediatrics ( Download)
• Pediatric & Congenital Heart Talks: Optimizing Neurological Outcomes in Congenital Heart Disease ( Download)
• WSPCHS - Interview with Dr. Wessel ( Download)
• Pediatric Cardiac Intensive Care Chapter mini-symposium ( Download)