Dr. John Pope is a pediatric intensivist, director of medical education and attending physician in the Pediatric Critical Care unit at Akron Children’s Hospital. A graduate of Case Western Reserve University School of Medicine, he is certified by the American Board of Pediatrics and Pediatric Critical Care Medicine. In addition to roles at Akron Children’s, Pope is a member of several medical associations and an assistant professor of pediatrics at Northeast Ohio Medical University. In 2014, he was awarded the Akron Children’s Distinguished Service Award, which is the hospital’s highest employee honor.
HealthScene Ohio: Most people are familiar with pediatricians, either from going to one as a child or taking their children to see one. How does your subspecialty of pediatric intensivist differ from a more general pediatrician?
Dr. John Pope: One way to answer this is to look at how we’re trained. Everybody who goes into pediatrics does three years and when you’re done with the three years you’re qualified to be a general pediatrician. If you want to do a subspecialty, it’s usually another three years. So, to be a pediatric critical care physician you go on and train in critical care for another three years. We practice pretty much exclusively in hospitals, usually in children’s hospitals and more commonly in a pediatric intensive care unit. The patients we take care of are children who have sometimes life-threatening illnesses, critical medical illnesses such as pneumonia or meningitis, traumatic injuries from car or bike accidents, and children who have had surgery such as heart or neurosurgery to remove a brain tumor. It’s a wide practice and the common theme is children who are relatively ill or at least have the potential to become sicker.
HSO: What are some of the most common critical conditions that you treat in children? Are there certain groups or ages of children that you’re more likely to work with due to these conditions?
JP: The most common condition we see is respiratory illnesses and respiratory failure, especially starting (in winter) with viruses. That’s our biggest group of patients. The challenging and interesting thing about pediatric critical care is that we take care of children essentially from birth until they’re adults. Statistically, more of the children we take care of are younger, so our biggest age group is going to be under 2.
HSO: How has pediatric cardiac care changed over the years since you’ve been practicing?
JP: The growth in pediatric cardiac and congenital cardiac care has really just been incredible in my career and I’ve been doing this for 26 years now. For example, many babies used to not be able to survive, but now there are options to fix their heart to some degree and allow them to have a relatively normal life. The care continually keeps changing and the technology keeps getting better and better.
HSO: Working with children rather than adults in any profession poses unique challenges. What difficulties arise specifically in pediatric critical care?
JP: The biggest difficulty is that little children can’t understand what they’re going through. You can have an adult on a mechanical ventilator and that adult can actually be awake and interactive. A 2-year-old is not going to be able to do that, so it’s a challenge to help them get through that experience. It requires that we sedate the children, which has its own risks. That’s the biggest challenge, trying to help the children deal with a situation that they have no idea what’s going on and that they certainly don’t want to be in.
HSO: What treatment techniques and methods of care do you use for children that readers receiving adult medical care might not realize?
JP: We tend to have to sedate the children a little bit more than you would an adult. We do have some wonderful people called child life workers who really help work with children. They help them get through procedures like blood drawing and putting in IVs and help parents work with their child to soothe them. We’re doing some new things where we’re trying to do nonpharmacologic therapies to help children on ventilators. In the old days, we used to really heavily sedate the children, keep them in bed and not allow them to move. Now we’re going the complete opposite direction where we’re taking children that have a breathing tube in and sitting them up, and in some places actually walking them around. Keeping people moving when they’re sick is a way to get them better faster.
HSO: Along with kids, you also interact with children’s parents and caregivers. How do you navigate difficult family relations when a child is in critical condition?
JP: The biggest thing is to gain the parent’s trust, that they believe we’re all really trying to do the best thing for their child. I think listening to the parents and being empathetic to their situation is also very important, especially with parents who have children with chronic diseases. They know their children better than anybody and it’s really important that the health care team listen to them and work with them.
HSO: Critical emergencies are rarely anticipated events. However, what are your tips for parents to avoid critical situations with their children?
JP: Pediatrics is all about prevention. Immunize your children. There are diseases I used to see 30 years ago that don’t exist anymore in the ICU thanks to immunization. Put bicycle helmets on your children and put children in car seats and seatbelts. If you have guns at home, please lock them up. Eight children die or are injured every day from guns in the house. It’s really those preventative things that are important.
HSO: Professional resources in pediatric critical care are extensive, but what are some resources for readers to stay informed about pediatric health?
JP: The website at Akron Children’s Hospital, www.akronchildrens.org, has a parents section (found under Health Information and Kidshealth Topics). There’s a lot of information contained on there. The other website I’d recommend is the American Academy of Pediatrics, www.aap.org.
Maggie Ash is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
