Society for Pediatric Anesthesia
We make anesthesia for children safer

Faye Evans, MD
Boston Children’s Hospital

Article by Myron Yaster MD (from the October 26, 2022 PAAD)

Many of you know Dr. Faye Evans of the Boston Children’s Hospital…and if you don’t, well, I’d urge you to introduce yourself to her at the next SPA meeting!  You won’t regret it! Dr. Evans recently completed her 4 year term on the Board of Directors at the Society for Pediatric Anesthesia and has been a leader in SPA’s Global committee which advocates for increased availability, improved quality and enhanced safety of anesthesia for children worldwide with a specific focus on low- and middle-income countries. The work of this Committee includes developing a pediatric anesthesia lecture series, supporting pediatric anesthesia fellowship training in Kenya and Thailand, sponsoring short courses in pediatric anesthesia for low-resource settings, linking members with volunteer organizations, and partnering with similar organizations to advance these causes.

While sitting at the Rovenstine lecture at the ASA’s annual meeting on Monday, I was simply blown away when they announced that Faye was the recipient of the Nicholas M. Greene award, the highest honor in our profession for global humanitarian outreach. What a wonderful honor that she so richly deserves!  I would urge all of you to congratulate her when you see her and perhaps follow my example of donating to Lifebox in her honor.  As I hope you know, Lifebox’s mission is to provide pulse oximeters and improve the safety and quality of anesthesia and surgery throughout the world. Myron Yaster MD

https://donate.lifebox.org/give/423146/#!/donation/checkout

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As I prepare to hand over the SPA Presidency to Dr. Jim Fehr, I have been reflecting on what an incredible, and in many ways unique, two years this has been as I served in this role. When I took over in October of 2020, we were really feeling the significant impact of the pandemic both at home and at work. SPA had just moved our meeting to a virtual platform, and I took the reins via Zoom. Fast forward two years, and I cannot believe how far we have come.

With COVID-19 affecting all our lives, we have had to make major adjustments. I commend our members for their resilience, dedication, and flexibility. As a Society, we exhibited these same traits. We mastered the planning and execution of our meetings virtually, and in the process, we realized that virtual options at our biannual meetings should be a component of these education opportunities going forward. Now, our members that cannot travel to meetings have the chance to be a part of them too through our hybrid programs. I was thrilled to come back together and meet in person this Spring in Tampa as we celebrated 35 years of SPA. To me, it felt like a family reunion as I reconnected with so many friends and colleagues from around the country.

When I took on my new role, I wanted to continue the work begun by my predecessors to bring more members into active roles within SPA. I saw the Society as a place where energetic and motivated individuals could showcase their strengths and build connections with other members, whether at our biannual meetings or through our committees and special interest groups. I think that the last two SPA-AAP Pediatric Anesthesiology meetings demonstrated this well. In Spring 2021, we celebrated the incredible role that women have played in pediatric anesthesiology, and over 80% of the presenters were women. In April 2022, we had an incredible number of first-time speakers on the stage, and the meeting was stronger for it. The Diversity, Equity, and Inclusion Committee and Women’s Empowerment and Leadership Initiative (WELI) have continued to grow in their outreach, and I could not be prouder of what they have accomplished. Finally, SPA continues to support young outstanding investigators through our Patient Safety, Education and Research Fund.

During the last two years, we have also prepared our Society to face the challenges of the future. Since 2020, the GME taskforce members undertook a huge endeavor to evaluate the state of our specialty and determine ways that SPA can better work for its members to prepare them for the future. They have made evidence-based recommendations regarding the workforce, education, and pediatric subspecialties that will help to guide our members going forward. We also are in the early stages of developing a more formal advocacy arm of SPA that will allow us to continue to meet our mission of advancing the safety and quality of care for our pediatric patients.

It has been a true honor to serve as President of SPA. I have had the privilege of working with an outstanding Board of Directors and Executive Committee that are innovative and forward thinking. I know I am leaving SPA in good hands for years to come. I especially want to thank Kim Battle and the Ruggles staff for their hard work and dedication to our members. And most importantly, I want to thank SPA’s members for their support and enthusiasm. It is because of EVERY member that SPA is a thriving and successful Society.

Nina Deutsch, MD
Professor, Anesthesiology and Pediatrics
Children’s National Hospital

Dear Colleagues,

It is with profound sadness that we inform you of the passing of our dear friend and a beloved member of our Pediatric Anesthesiology family, Kelly Ann Machovec, MD, MPH. She passed away on March 30th, at the age of 43. Her untimely death has left a huge hole in our lives where this amazing, impactful and dedicated pediatric cardiac anesthesiologist used to stand.

Kelly will be remembered as an exceptional academician and physician who dedicated her career to improving the lives of children undergoing cardiothoracic or vascular surgery, and for her special impact that was palpable to her colleagues and patients throughout the Duke Children’s Heart Center and larger Congenital Cardiac Anesthesiology Society.

Kelly was originally from Baltimore, Maryland. She received her Master of Public Health degree in 2005 and her Doctor of Medicine degree in 2006, both at the University of North Carolina. She went on to complete a residency in Anesthesiology at Drexel University College of Medicine in Philadelphia and a fellowship in Pediatric Anesthesiology here at Duke University School of Medicine. In 2013, we were thrilled when we convinced Kelly to stay on as faculty at Duke Children’s and she joined our Duke Anesthesiology faculty as an Assistant Professor of Anesthesiology; she was appointed an Associate Professor of Anesthesiology in 2019.

Dr Kelly Machovec was an accomplished Pediatric Anesthesiologist whose research primarily focused on the hemostasis management of children following open heart surgery performed on cardiopulmonary bypass. Earlier this year she received the Duke Pediatric and Congenital Heart Center Impact Award, recognizing her exceptional impact on the clinical practice around hemostasis, on both local and national levels. She was a fierce advocate for child-centered health care policies and always questioned the status quo. For example, she led the charge to discontinue preoperative blood testing in children to prevent them from having unnecessary painful blood draws in the preoperative clinic. Dr. Machovec’s excellence and research led to her invitation to write the book chapter on “Anesthesia for Pediatric Cardiac Surgery” in Miller’s Anesthesia textbook. In 2015, she co-founded the Hemostasis Interest Group, a committee within the Congenital Cardiac Anesthesia Society which she served on for six years as committee chair, member and mentor; she also served as an at-large member on the Board of Directors of the Congenital Cardiac Anesthesia Society. Kelly was a passionate educator, serving as chair of the Clinical Competency Committee for Duke’s Pediatric Anesthesiology Fellowship and as a question writer and committee member for the American Board of Anesthesiology’s Pediatric Maintenance of Certification. Residents and fellows loved working with her as she always brought her passion and sharp sense of humor to every encounter. Kelly was not one to leave her opinion unheard. In addition to being an outstanding clinician and a dedicated educator, she was recognized with the high honor of the Leonard Tow Humanism in Medicine Award at the Duke University School of Medicine in March of this year. Recipients of this distinguished award are recognized as exemplars of humanism in the care of their patients, their compassionate delivery of care and respectfulness given to their patients and health care colleagues, as well as for their clinical excellence.

Kelly did not let her illness define her – if anything, it brought a renewed focus and intensity. She became an advocate for basic science cancer research and raised more than $63,000 for the Dana-Farber Cancer Institute as part of her anticipated participation on their team in the 126th Boston Marathon this April. All of the money she raised will go to the Claudia Adams Barr Program in Innovative Basic Cancer Research. She said she was “running this race to raise money for the future, for the next generation of people diagnosed with cancer who need good treatments.”

Kelly was also a citizen of the world and had many passions. From 2013-2017, she advocated for pediatric health care on a global scale by taking part in medical missions in India, the Philippines and Haiti for Operation Smile and Gift of Life International.

At a recent grand rounds she gave, I introduced Kelly as having “the determination of Ruth Bader Ginsberg, the curiosity of Marie Curie and the fierceness of Wonder Woman” and these are the qualities that we all loved and admired in her. Kelly was also super funny, strong-willed and energetic, and a dedicated team member. We are going to miss her desperately.

To preserve Kelly’s legacy at Duke, our department has formally established the Kelly Machovec Humanism Award. The recipient of this annual departmental award will exemplify grace and compassion in their delivery of patient-centered care, reverence for patients, their loved ones and colleagues, ethical principles, and a continuous commitment to clinical excellence. Most importantly, her legacy will live on through her family. She was a dedicated and loving wife to her husband, Scott Matthews, and proud mother to her three young daughters, Vivienne, Eva and Caroline. Her loved ones will remember her as an engaged, talented and powerful woman with unwavering passion and optimism, who loved spending time with her family and friends, running, practicing yoga, reading, and baking.

She will be deeply missed by so many; her legacy and work will continue to inspire us all.

In honor and remembrance of Dr Kelly Machovec.

Eddie Jooste and the Pediatric Anesthesia Team at Duke.

 

Written by:  Charles Dean Kurth, MD, FAAP; Robert Berg, MD; Wynne Morrison, MD; Vinay Nadkarni, MD; Andrew Costarino, MD; Todd Kilbaugh, MD

It is with sadness and a multitude of fond memories that we inform you that Dr. John J. “Jack” Downes, died peacefully at the age of 91, on Friday December 17, 2021. Jack served as Anesthesiologist-in-Chief at the Children’s Hospital of Philadelphia (1972-1996).  He was a trailblazing giant in the fields of Anesthesiology and Critical Care Medicine for more than half a century: a visionary pioneer, a master clinician, a rigorous educator, an inspirational leader, and a true gentleman. We mourn his death while we also appreciate and celebrate our good fortune to know Jack as friend, colleague and mentor over the last 60 years.

Jack came to the University of Pennsylvania for his residency training in anesthesiology in 1959 and was subsequently recruited to the Children’s Hospital of Philadelphia in 1963. He developed a multidisciplinary approach to caring for seriously ill hospitalized children, whether following surgery or with life-threatening medical illnesses. His early defining moment was in January 1967, when he inaugurated The Children’s Hospital of Philadelphia’s pediatric intensive care unit–the first of its kind in North America.  He was instrumental in fostering early training programs and research programs in his field. He and his colleagues inspired and trained multiple generations of pediatric anesthesiologists and intensivists and set a standard of care and professionalism that will endure far into the future. Jack was a tireless advocate for improving healthcare for children, and his persistent efforts led the Commonwealth of Pennsylvania to fund a pioneering home care program for the care of technology dependent children in the 1970’s. In what became his trademark as a leader, he often reminisced that ‘I held on (sometimes by my fingernails) until others fell away, even if it sometimes took several years!’ He was always a passionate advocate for the Children’s Hospital of Philadelphia, an institution that shares his dedication to advancing state-of-the-art clinical care, cutting edge discovery and rigorous interdisciplinary training to optimize outcomes for ill and injured children.

Jack will always be remembered for his utter devotion to his patients. He worked hard to make sure that every child had access to the best care possible, no matter what their background, disability, or ability to pay. He approached medicine as a moral calling. An avid student of the history of medicine, he navigated an era of rapid change in healthcare and an explosion of technology with the patient always at the center. Even following his retirement, he was a frequent visitor to Pediatrics and Anesthesiology Grand Rounds. His learned presentations on the history of Pediatric Anesthesiology and Pediatric Critical Care Medicine were a special treasure for trainees and faculty alike. He taught us the value of strategic vision, dedication and critically reflecting on our practice to continuously learn.

Those who were lucky enough to work with him, or just to meet him, will always remember his genuine curiosity, sincere humanity, keen insight and steadfast devotion to patients, colleagues, and his family. We are privileged to remember the beautiful moments we experienced with him, and how those moments will continue to influence us and make us better healthcare providers and better people.

 

A DRAFT of an update to the evidence based  American Society of Anesthesiologists’ Guideline for the Management of the Difficult Airway is available for review and comment. The Task Force that developed this update was comprised of anesthesiologists representing thirteen international organizations.  Interested members are encouraged to access the DRAFT and provide input.  The DRAFT of the update  may be accessed at the following site:

https://www.asahq.org/standards-and-guidelines