Welcome to your Santa Cabrini Hospital ICU Rotation!
Congratulations on wanting to further your critical care experience. Whether you are planning to work in critical care, the ER, the OR or the wards, knowledge of critical care will be of immense importance to your patients, from the ability to recognize critical illness early to initiating appropriate therapy to managing ventilation, shock, weaning and procedures, the knowledge and skills will come in handy.
In our ICU you will find two critical cornerstones which are – sadly – not as widespread as they should be: (1) bedside ultrasound (head to toe, not just the cardiac stuff) as a routine, integral part of daily physical examination and assessment, and (2) integration and understanding of applied physiology to each patient (not just application of protocols).
However, to maximize your learning experience, it will be expected for you to do some reading prior to the beginning of your rotation. If you have some building blocks covered, you’ll be able to learn from us more useful, clinical and experiential information.
1. First, review your basic cardiac and pulmonary physiology. Any textbook will do, and yes, you have learned it before, but probably have not applied it much, and it may need a little dusting.
2. Review your basic inotrope and vasopressor drug pharmacology, so we can discuss the fine points of use rather than which is alpha and which is beta, etc…
3. Here are a few posts from my blog I think you should look at:
Pigtail catheter insertion – you will be expected to know this!
Sepsis: http://wp.me/p1avUV-1w
CVP: http://wp.me/p1avUV-1y
Fluid: http://wp.me/p1avUV-1G
Interesting articles: http://wp.me/p1avUV-1G
Bicarb: http://wp.me/p1avUV-4W
NS: http://wp.me/p1avUV-5x
Glycocalyx: http://wp.me/p1avUV-5S
N=1: http://wp.me/p1avUV-68
IVC ultrasound: http://wp.me/p1avUV-8E
4. For the more senior residents, here is an amazing resource by Dr. Jon-Emile Kenny (www.heart-lung.org), a review for critical care boards:
5. Get #FOAMed. As a 21st century physician, you will find that the twitter-based meducation is absolutely fantastic. If you haven’t heard of it, google it and get on board. Great resources include:
http://www.lifeinthefastlane.com
…and many more.
Yes, this is quite a bit. Don’t try and do it on the weekend before you start with us. Get a head start if you can. But this will make your rotation with us a truly unique and amazing one.
Looking forward to meeting you soon!
Philippe Rola
thinking critical care 