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Critical Care Medicine

Our history and milestones

Our History  |  Department Milestones


OUR HISTORY

The Paediatric Intensive Care Unit at The Hospital for Sick Children was established in 1968 as a division of the Department of Anesthesia.  Dr. Alan Conn was appointed as our first director in 1969 following 10 years as chief of anesthesia at SickKids.  

The SickKids PICU was one of the first ICU's for children in North America to have full time intensive care specialists.  In 1981 the Department of Critical Care Medicine was established - another first in Canada. Dr. Geoffrey Barker was the Chief, with a staff of four intensivists. In 2016 there are 15 full time intensivists.

A History of Excellence

The Department of Critical Care Medicine is an internationally recognized leader in clinical care, teaching, innovation and research in paediatric critical care. Our innovations include: the first clinical use of high frequency oscillatory ventilation, the first paediatric ECMO program in Canada and leading the introduction of full-time pharmacists in ICU. Our clinical fellowship program has trained over 400 physicians from five continents. Many of our trainees are intensivist-leaders in other parts of the world.

International Leadership

In 1995 Dr. Geoffrey Barker became the founding president of the World Federation of Paediatric Intensive Care Societies (WIFPICS).  In 2000 the department hosted the 3rd World Congress of Paediatric Intensive Care in Montreal. Since 1998 Dr. B. Kavanagh has led the Canada Critical Care Forum. This international meeting spans all aspects of critical care and is attended by 1,000 critical care practitioners each year. In 2007 Dr. Desmond Bohn became the president of the Pediatric Cardiac Intensive Care Society, as did Dr. Peter Laussen in 2013.

Our Evolution

From its modest beginnings as a part-time ICU housed in the recovery room of the operating theater, the Department of Critical Care Medicine now provides care to over 2,000 children and their families each year. With continued growth we have evolved.  In 2004 the department transformed in to two clinical teams: the Paediatric Intensive Care Unit (PICU) and the Cardiac Critical Care Unit (CCCU).  In 2006 the Department recognized the faculty of the two units as separate Divisions, thereby creating the first paediatric Division of Cardiac Critical Care Medicine in Canada.

In 2006 we developed a Critical Care Outreach Program. This nurse and physician Critical Care Response Team (CCRT) has been a local success, and is part of the Ontario Paediatric Critical Care Response Team Collaborative, led by Dr. Desmond Bohn.

The evolution of the critical care program at SickKids has seen exponential growth our educational programs. In 2013 we provided training, mentorship and experience to 36 healthcare professionals from Canada and around the world. These include critical care fellows, paediatric residents, nurses, pharmacists, social workers, physiotherapists, and occupational therapists.

In 2012 we established the first Canadian advanced training program in cardiac critical care, and in 2013 we established the first paediatric neurointensive care fellowship.

The Future

This strong legacy of critical care at the Hospital for Sick Children shapes our current practice and frames our future local, national and international contributions.  

 

DEPARTMENT MILESTONES

1968 
Paediatric Intensive Care Unit established at The Hospital for Sick Children.
First director Dr. Alan Conn.

1969 
First Kidney Transplant

1970 
Paediatric ICU Fellowship Program established.

1971 
Successful surgical separation conjoined twins at SickKids.  
Led by Dr. B. Shandling

1972 
270 post operative pump cases.
Arterial lines used for blood sampling lack of transducers restricted use for continuous pressure measurement,
central venous pressure and left atrial lines used.

1977 
Ontario Air Ambulance program started with SickKids participation.  SickKids helipad used.

1978 
Intermediate ICU implemented for children requiring long term ventilation  - four beds opened in University Wing

1979 
First High Frequency Oscillation ventilation used.

1981 
Critical Care Medicine Program established.
Chief Dr. Geoffrey Barker

1988 
First Computerized Nursing Duty Rotations by Dr. Gordon Tait

1988 
Continuous Renal Replacement Therapy established.

1988 
Critical Care Unit Bereavement Program started. Initially as a staff support program. First coordinator Ms. Karen Dryden-Palmer in 1994.

1989 
Computerized bedside charting system established
By Dr. Gordon Tait and Dr. John Edmonds

1989 
Extracorporeal Membrane Oxygenation Program (ECMO)

1990 
Heart Transplant

1993 
“New” Paediatric Intensive Care Unit opened in Atrium
Award from American Society of Architects

1996 New England Journal of Medicine publication – Outcome of out of hospital cardiac or respiratory arrest in children – by Schindler et al.

1996 Paediatric ABO incompatible heart transplant

1996 

    • Our first paediatric lung transplant.
    • Our first living related liver transplant.
    • Our first Advanced Practice Nurse in Critical Care.

1999 Our first, Paediatric Multi-visceral Transplantation

2000 Our first E-CPR or Rescue ECMO for Resuscitation

2001 Parents at the bedside for medical rounds

2004

    • Our first Berlin Heart.
    • Our first liver and pancreas transplant.

2006 Critical Care Response Team established. Provincial lead, Dr. Desmond Bohn.

2007

    • Specialized Intensive Care Units established – Paediatric Intensive Care Unit (PICU) and Cardiac Critical Care Unit (CCCU). Each the largest of their type in Canada. Inter-hospital ECMO retrievals begun.
    • New nursing graduates hired into ICU New Grad Program.
    • Nursing simulation education started.

2008

    • New England Journal of Medicine publication: Hypothermia therapy after traumatic brain injury in children – by Dr. Jamie Hutchison et al.
    • Paediatric non-beating heart organ donation in Canada.
    • 40th Year Anniversary of Critical Care attended by over 300 alumni, staff and friends.
    • EEG all Critical Care beds.

2009 Critical Care Medicine Nurse Practitioner

2010

    • Neonatal Lung Donor and ABO incompatible recipient for Infant Lung Transplant Program.
    • Norine Rose Chair in Cardiovascular Sciences January.

2012

    • Cardiac intensive care subspecialty fellowship.
    • Inter-professional Paediatric Acute Care Cardiology Certificate Course begun.

2013

    • Neurocritical care subspecialty fellowship.
    • Portable CT Ceretom introduced to clinical practice.
    • David and Stacey Cynamon Chair in Paediatric Critical Care.
    • Alumni association formed, first meeting held.

2014 Department retreat to define mission going forward "Aspiring to excellence in pediatric critical care....whatever it takes”

2015

    • ECLS subspecialty fellowship.
    • Highest ever staff complement with 17.3 FTE AFP faculty positions funded by MOHLTC.

2016  Hosted 8th World Congress of the World Federation of Pediatric Intensive and Critical Care Societies in Toronto; Over 1500 attendees from 82 countries

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