Pediatric Critical Care as a formal specialty at Children’s of Alabama and within the UAB Department of Pediatrics, began with the recruitment of Dr. Samuel Tilden as the first division director of Pediatric Critical Care in 1987. Dr. Tilden, a Louisiana native, graduated from Tulane University School of Medicine in 1977. He completed his pediatric residency at the Louisiana State University School of Medicine followed by a fellowship in pediatric pulmonology. He was recruited to the Department of Pediatrics from St. Joseph’s Hospital in Phoenix, Arizona, where he was director of the Pediatric Intensive Care Unit (PICU). The initial Pediatric Intensive Care Unit at Children’s of Alabama, developed and staffed under his direction, was an eight bed unit. It was expanded in the early 1990’s into a dedicated space consisting of 16 beds (12 ward type beds and four isolation rooms). Dr. Tilden recruited additional faculty with the hiring of Dr. Scott Curtis, who had completed training at the University of Pittsburgh in pediatric pulmonary and critical care, as well as Dr. James Royall, who had completed his pulmonary fellowship at UAB and elected to remain here.

With the beginnings of a critical mass of personnel established, Dr. Tilden began expanding the role of the division within the department. Fellowship training was established and the first fellows in pediatric critical care began their postgraduate training in 1990. In this early group of trainees was Dr. Steven Baldwin, who remains a member of the Department of Pediatric within the Division of Pediatric Emergency Medicine. The importance of fellowship training within the division has remained a point of emphasis since its early inception. The fellowship program to date has trained over 40 individuals who have gone on to establish successful private practice and academic careers at multiple institutions across the United States, Canada, Chile and Saudi Arabia. The quality of the division’s trainees is demonstrated by more than a quarter of them being recipients of the prestigious Dixon Fellowship grant, established in 1988 to support outstanding fellows for a career in academic medicine.

Additional faculty were recruited including Dr. Imad Haddad in 1993, Dr. Mark Buckmaster in 1995, who was trained in both pediatric anesthesia and critical care at the University of Minnesota, and Dr. Neil Kooy, who completed his fellowship at UAB in 1994 and returned in 1997. With these additional faculty members, Dr. Tilden continued to expand the scope of the division with coverage to include involvement with pediatric cardiac intensive care at University Hospital. This early consultative involvement provided the groundwork which later led to the establishment of a Pediatric Cardiac Intensive Care Unit at University Hospital and significant advancement of critical care services for infants and children with a wide variety of congenital heart disease.

In recognition that the provision of critical care services was important regardless of the location of the patient and the sooner such resources could be mobilized for the patient, pediatric critical care transport services were created to provide high quality, rapid medical care to critically ill pediatric patients regardless of where in the state or neighboring states the patient originated. Initially a ground and fixed wing based service, rotor craft were later added in partnership with University Hospital and later as part of a dedicated Children’s of Alabama’s fleet.

In 1999, Dr. Tilden stepped down as division director of Pediatric Critical Care and Dr. Margaret Winkler, a former fellow from 1994-1997, assumed the position. Dr. Winkler, who returned to the department after a three-year tenure at the University of Kentucky, was directly responsible for one of the fastest periods of expansion in the history of the division. With aggressive recruitment from within the fellow ranks, as well as outside the department, she expanded faculty numbers by almost threefold during her period as division director and director of the Pediatric Intensive Care Unit. She also oversaw the expansion of the Pediatric Intensive Care Unit from its long standing 16 beds to a new 24 bed unit to meet ongoing clinical demands. She became the first recipient of the Ann Dial McMillan Endowed Chair in Pediatric Critical Care.

Dr. Winkler’s faculty recruits were highly successful in implementing a major expansion of the scope of the division’s services in a wide variety of clinical arenas:

Nancy Tofil, a former fellow, led the development of the Pediatric Simulation Center for simulation training and education and became associate director of the Pediatric Residency Program. The Simulation Center has subsequently been recognized internally, as well as nationally, for the outstanding quality of its educational experience.

Jeffrey Alten, recruited after completing his critical care fellowship at Texas Children’s in Houston in 2005, led the expansion and development of pediatric cardiac intensive care at University Hospital and later within the new Benjamin Russell Hospital for Children campus, where a separate 20 bed Cardiac Critical Care unit and 10 bed monitored unit provides comprehensive care to children of all ages with simple and complex congenital heart disease. The unit is now a component of the Division of Pediatric Cardiology and oversees care to approximately 600 open heart cases per year. It is under the direction of Santiago Borasino, also recruited to the department by Dr. Winkler from Children’s Hospital of Philadelphia, after finishing a pediatric residency at UAB.

Tasked with the development of a procedural sedation service outside the operating room, the Simon Sedation service was created in 2003 under the medical direction of Mark Buckmaster. The service provides clinical services for approximately 1,200-1,600 cases per year to children requiring sedation for a wide variety of therapeutic and diagnostic services.

With the ongoing need and interest in pediatric critical care subspecialty training, Priya Prabhakaran was appointed director of the Pediatric Critical Care Fellowship Program. Under her guidance, the fellowship program has increased to six fellows. Interest in training at UAB has remained high, reflective of the quality of clinical material available and the dedication of faculty to the commitment of fellowship training remaining an educational experience that meets any goals incoming fellows may have.

The increasing supervisory insight mandated by more public and governmental regulatory agencies, led to Leslie Hayes, a former fellow who was recruited to the faculty, assuming the lead role in hospital quality improvement and patient safety initiatives as the first medical safety office for Children’s of Alabama. Dr. Hayes later became integral in the establishment of formal academic training programs in quality improvement and patient safety for UAB Health System and is currently the associate quality education officer for UAB Medicine.

Research remains an essential component of academic medicine and Michele Kong, recruited by Dr. Winkler after completion of her fellowship at UAB, has been pivotal in cementing research into the divisional foundation. Dr. Kong’s work in protease dysregulation in acute lung injury and the role of RSV induced respiratory failure in children has been recognized both internally and nationally and has led to multiple grant awards as a result. Dr. Kong, has also been responsible for establishment of KultureCity, a private foundation which provides financial, educational, and emotional support for families with children diagnosed with Autism Spectrum disorder.

William Sasser organizes the educational activities of the division as it relates to the School of Medicine and is highly involved with the organization of family centered services within the PICU.

Chrystal Rutledge has assumed the role of director of pediatric critical care transport, which in conjunction with her efforts in pediatric simulation has led to the fusion of these interests into programs providing outreach to community hospitals to improve early care for children presenting with critical illness. She along with Kristen Waddell, CRNP and Stacy Gaither, RN, has developed COACHES (Children’s of Alabama Community Healthcare Education Simulation Program) which uses simulated pediatric emergencies to train staff in emergency departments and inpatient areas in hospitals throughout the state.

This rapid expansion of the division culminated with the completion of the Benjamin Russell Hospital for Children in 2012 and the opening of a new state of the art Pediatric Critical Care Unit consisting of 24 expansive private rooms. These new rooms offer comfortable and private surroundings for the families of critically ill children. In 2017, Dr. Winkler stepped down as division director and was followed by Dr. Nancy Tofil. Dr. Tofil has continued to grow the role of the division within the department, as well as integrating the operation of critical care services more seamlessly into the overall operation of the hospital. She has continued to add to the roster of the division with ongoing recruitment of faculty, such as:

Robert Richter, a former fellow, leads the development of integrated ECMO services within the PICU. Prior to his fellowship he completed his pediatrics residency at Cincinnati Children’s Hospital in Ohio. In addition to his work with ECMO, he also engages in translational research evaluating the vascular endothelium in sepsis. In his first year, he obtained funding from the Kaul Pediatric Research Institute for his research and has subsequently received K08 funding and a NIH Loan Forgiveness Grant.

Madhura Hallman completed her pediatric residency at UAB and her subsequent pediatric critical care fellowship at LeBonheur Children’s Hospital at the University of Tennessee in Memphis. Dr. Hallman is leading a multidisciplinary effort to develop a decision support process regarding tracheostomy and long-term ventilation in children. She is the director of Family Engagement. In 2023, she along with partners from Hospital Medicine develop the Complex Care Service (Teal Team) which is an amazing team helping better care for the patient and families of some of the most medically complex children in Alabama.

Jeremy Loberger, a former fellow, is the Medical Director of the PICU. Prior to his fellowship he completed his internal medicine/pediatrics training at Greenville, South Carolina. He has helped lead along with the NICU and CVICU Medical Directors and hospital leadership a formalized surge plan taking advantage of all ICU beds in the hospital. He leads VentLib4Kids, a multicenter collaborative focused on early liberation from mechanical ventilation for children in the PICU. This has led to a decrease of almost an entire day for our patients, allowing them to leave the ICU sooner and making their care safer.

Vidit Bhargava completed his pediatric critical care fellowship at Stanford University in Palo Alto, California. He was a pediatric resident at the University of Texas at Galveston. He is the Director of our PICU Point of Care Ultrasound Program (POCUS) and is a national expert on this subject as it pertains to research and education. He is also the PICU Medical Director of the Liver Transplant Program.

Jordan Newman completed his fellowship at Emory University in Atlanta, Georgia. Prior to that he was a pediatric resident at the University of South Carolina in Charleston where he also was a chief resident. He is the Associate Director of the Pediatric Simulation Center and certified in TeamSTEPPS. He is also the Associate Fellowship Director and the Assistant PICU ECMO Director.

James Odum completed his fellowship at Cincinnati Children’s Hospital. Prior to that he was a pediatric resident at Children’s Mercy Hospital in Kansas City, Missouri where he was also a chief resident. He is engaged in translational research evaluating the interaction of sepsis and acute kidney injury. In his first year, he obtained funding from the Kaul Pediatric Research Institute for his research and has subsequently received a NIH Loan Forgiveness Grant. He serves as a Co-Director of the Pediatric and Infant Center for Acute Nephrology (PICAN) at Children’s of Alabama.

Lece Webb completed her fellowship at UAB and prior to that completed her internal medicine/pediatrics training at Greenville, South Carolina. She is very involved with diversity efforts. She is the director of the fellowship DEI council. She studies the role of health care disparities in pediatric critical care outcomes. In her first year, she obtained funding from the Kaul Pediatric Research Institute for her research.

Nick Rockwell completed both his fellowship and pediatric residency at UAB. Nick is the Associate Director of the Pediatric Simulation Center and very interested in expanding the role of simulation throughout the hospital. He is also the Co-Director of the 4th year medical student Prep for Residency Course which is required for all graduating medical students.

Emily Dodenhoff completed her PICU fellowship at UAB before doing an additional fellowship in Hospice and Palliative Medicine. Her primary academic appointment is with the Department of Internal Medicine, Division of Geriatric, Gerontology, and Palliative Medicine with a secondary appointment with Department of Pediatrics, Division of Critical Care. She splits her time evenly. She is also the Associate Program Director of the Hospice and Palliative Medicine Fellowship Program.

Luke Burton completed his fellowship at UAB. Prior to that he completed his internal medicine/pediatrics training at Greenville, South Carolina. He is the Medical Director of Pediatric Critical Care Transport. He is also the Associate Director of the PICU POCUS Program. His scholarly works involves investigating the role of bedside ultrasound to predict airway swelling surrounding extubation.

With the planned opening of the 12th floor 50-bed PICU in the spring of 2026, the Division of Pediatric Critical Care will need to continue to evolve, and ongoing recruitment is underway to meet the increasing needs for children with critical care medical illnesses.

Division Directors

Sam Tilden- 1987-1999

Margaret Winkler- 1999-2017

Nancy Tofil- 2017 to present