MICU

Educational Goals and Objectives

The educational objectives for the Emergency Medicine resident while on the Medical ICU rotation are as follows:

Patient Care

  • Demonstrate ability to rapidly perform history and physical exams in critically ill patients.
  • Demonstrate the ability to perform the following procedures: endotracheal and nasotracheal intubations, cricothyrotomy, needle thoracostomy, central intravenous placement, Swan-Ganz placement, transvenous cardiac pacing, arterial line placement, ABG, and foley catheterization.
  • Demonstrate the ability to manage a patient on a ventilator.
  • Demonstrate appropriate prioritization of diagnostic and therapeutic interventions in critically ill patients.

Medical Knowledge

  • Describe the dosages, indications, and contraindications of pharmacologic interventions for shock, cardiac failure, dysrhythmias, sepsis, trauma, toxins, respiratory failure, hepatic failure, renal failure, and neurologic illnesses.
  • Describe the etiologies, hemodynamic issues, and complications of septic, hypovolemic, neurogenic, cardiogenic, and immunologic shock.
  • Discuss and interpret data from ECG monitors, cardiac outputs, hemodynamic monitoring, pulse oximetry, end tidal CO2 monitors and respirators.
  • Demonstrate appropriate judgment in the management of critically ill patients.
  • Practice Based Learning and Improvement
  • Demonstrate ability to obtain and appraise medical literature applicable to the management and treatment of critically ill patients.

Interpersonal and Communication Skills

  • Demonstrate an understanding of the appropriate use of consultants in critically ill patients.

Professionalism

  • Demonstrate an understanding of the ethical and legal principles applicable to the care of the critically ill patients.

The Emergency Medicine resident will accomplish these objectives in the following manner:

  • Attend and participate in daily Medical ICU teaching rounds
  • Attend all conferences given by the Department of Medicine while on rotation.
  • Evaluate and manage patients under the supervision of Medical ICU faculty and fellows.  Progressive patient care responsibilities are at the discretion of the Medical ICU faculty based on the resident’s clinical experiences, didactic knowledge, psychomotor skills, procedural abilities and credentialing.
  • Discuss and interpret results of all ancillary testing with supervisory faculty.
  • Perform procedures under faculty supervision commensurate with their post-graduate level of training and skill.

 

Rotation Information

Where: 6th floor

When: Varies depending on the attending for the week. Between 6:00 AM to 6:00 PM. On your 1st day arrive by 7:00 AM. Meet the fellow, who will assign you patients and share his/her expectations. You can ask the chief of unit (COU) who is the attending on call and what time he/she usually rounds.

Schedule/Requests: Obtain the contact information of the scheduling chief from the COU, contact him/her for a copy of the schedule or with requests. You get one weekend day off per week, take calls every 3-4 days. 

Supervisor:  Louis Gerolemou, MD (Chief of MICU)

  • Ext: 6623
  • Email: lgerolemou@tbh.org

Attire: Scrubs with lab coat or professional attire with lab coat

Preparation: Read the ICU book – Electronic copy available.

Expectations:  Come in the morning prior to rounds, see all of your patients, documents any overnight symptoms or events, review results and imaging, obtain an ABG on all vented patients.  Update the fellow on your patients before rounds. After rounds, finish up your tasks and duties for each patient and follow up results from the AM.  Sign out your patients to the resident on call, and discuss your patients with the fellow prior to leaving for the day. Some attendings round again in the afternoon.  Make sure to update any new information about your patients and any new admissions on the official census (someone from the team will show you how).