Kristen Nelson, MD, Assistant Professor, Pediatric Anesthesia

Assistant Professor
Director of Pediatric Cardiac Critical Care
knelso23@jhmi.edu

After completing her clinical fellowship, Dr. Nelson joined the PICU faculty as an attending physician in July of 2007. In 2012, she became Director of Pediatric Cardiac Critical Care. In that role she acts as a resource for any clinician who needs assistance for PICU patients with cardiac conditions. She is also Director of the Pediatric Ventricular Assist Device program. Ventricular assist devices (VADs) are mechanical heart-lung machines that can support children with severe heart failure until they receive a heart transplant. For babies and young children, the device is external, so these small patients must remain in the PICU. For adolescents, however, the device can be implanted internally, allowing patients to return home while they await a new heart. The external VADs are highly prone to causing blood clots, or thrombosis. Therefore, Dr. Nelson manages anticoagulation for patients with VADs. She is on call 24/7 anytime a PICU patient has a VAD. Dr. Nelson is also responsible for VAD-related education. Because VAD use is infrequent, she conducts what she calls “just-in-time training” to prepare approximately 250 clinicians each time a patient in the PICU will receive a VAD. She also teaches a cardiac education course for PICU nurses who are transitioning to become cardiac nurses, as well as a day-long course on cardiac ICU in the Sadie Abell PICU fellow simulation boot camp. Topics of the course include ECMO (extracorporeal membrane oxygenation), VAD, and postoperative cardiac care.

Dr. Nelson’s research focuses on coagulation abnormalities and anticoagulation in pediatric cardiac patients. These patients have a high incidence of thrombotic complications, which are often under-reported and under-recognized. However, it is unsafe to use anticoagulation therapy in all cardiac patients because it increases the risk of bleeding, particularly after surgery. Therefore, she hopes to identify risk factors that predispose children to thrombosis. Recognizing at-risk patients would enable caregivers to choose different central lines, alter treatment strategies, or begin anticoagulation therapy early.

Dr. Nelson may wear a lot of hats, but she states that her patients are the most rewarding part of her job. The many patient photos and mementos covering the walls of her office confirm the truth to this sentiment. Outside of work, Dr. Nelson loves her dogs, running, and watching football.

Education
After graduating from the University of New Orleans, Dr. Nelson attended medical school at Louisiana State University (LSU) from 1996 to 2000. She did her pediatrics residency at LSU from 2000 to 2003 and went on to complete a year as chief resident from 2003 to 2004. Finally, she undertook a clinical fellowship in pediatric critical care at Johns Hopkins from 2004 to 2007.

Selected Publications

  1. Nelson KL, Mills W, Umbel S, Crosson J, Shaffner DH, Hunt EA. Lightning, sudden cardiac death, simulation and an automated external defibrillator: the perfect storm. Resuscitation 74(3):567–71, 2007.
  2. Hunt EA, Shilkofski NA, Stavroudis T, Nelson KL. Simulation: translation to improved team performance. Anesthesiol Clin 25:301–19, 2007.
  3. Shilkofski NA, Nelson KL, Vera K, Hunt EA. Recognition and treatment of unstable supraventricular tachycardia by pediatric residents in a simulation scenario. Sim Healthcare3(1):4–9,2008.
  4. Nelson KL, Shilkofski NA, Haggerty JA, Saliski M, Hunt EA. The use of cognitive aids during simulated pediatric cardiopulmonary arrests. Sim Healthcare 3(3):138–45, 2008.
  5. Schwartz JM, Nelson KL, Saliski M, Hunt EA, Pronovost PJ. The daily goals communication sheet: a simple and novel tool for improved communication and care. Jt Comm J Qual Patient Saf 34(10): 608–13, 2008.

Laboratory Members/Key Associates/Research Collaborators

  • Elizabeth A. Hunt, MD, MPH, PhD, Assistant Professor, Pediatric Anesthesiology and Critical Care Medicine and Director of the Johns Hopkins Medicine Simulation Center
  • Nicole A. Shilkofksi, MD, Assistant Professor, Pediatric Anesthesiology and Critical Care Medicine
  • Jamie M. Schwartz, MD, Assistant Professor, Pediatric Anesthesiology and Critical Care Medicine and Director of the Pediatric Transport Team
  • Mary T. Saliski, MSN, CPNP, Nurse Practitioner, Pediatric Intensive Care Unit
  • Jamie A. Haggerty, Simulation Specialist, the Johns Hopkins Medicine Simulation Center

Honors

  • 1998 Maggie Duncan Scholarship Award of Southern Pediatric Neurology Society
  • 1999 Alpha Omega Alpha Medical Honor Society
  • 1999 Lettie Pate Whitehead Scholarship
  • 2000 American Medical Women’s Association Janet M. Glasgow Memorial Achievement Citation
  • 2000-2001 Best Intern of the Year, Aesculapian Society
  • 2002-2003 Best Resident of the Year, Aesculapian Society
  • 2002-2003 Penny Scurto Outstanding Pediatric Resident Award
  • 2002-2003 Outstanding Teaching Resident of the Year
  • 2002-2003 Best PICU Resident (chosen by staff, nurses and respiratory therapists)
  • 2002 SAFMR/SSCI Outstanding Trainee Award
  • 2003 SAFMR/SSCI Outstanding Trainee Award
  • 2006 Third Place, Best Abstract, Patient Safety, “The Use of a Cognitive Aid During Simulated Pediatric Cardiopulmonary Arrests: An Observation of 60 mock codes.” 6th Annual International Meeting on Medical Simulation
  • 2007 First Place, Best Trainee Abstract Award Winner, “Cognitive Aids Do Not Prompt Initiation of Simulated Cardiopulmonary Resuscitation.” 7th Annual International Meeting on Simulation in Healthcare Care