ICU05 Neurosurgical Intensive Care Unit
Dr. David Bowton
Rotation Director: David L. Bowton, M.D., FCCM, FCCP
Program Outline: The objective of this clerkship is to expose students to patient care in the Neurosurgery Intensive Care setting, with emphasis on patient management issues, such as differential diagnosis, rational laboratory and radiologic testing, acute and chronic management of patients with multiple medical and surgical problems. Issues such as ventilator management, acute pharmacologic therapy for hemodynamic instability, effective antimicrobial therapy, nutritional support, and multisystem dysfunction will be addressed, mainly within the context of patients who have life-threatening neurological disorders. Students will participate as an integral part of the Critical Care Team that co-manages the patients in the neurosurgical intensive care unit (NS-ICU). Students will assume supervised responsibility for evaluation, diagnostic testing, initiation and evaluation of therapy, and be exposed to patient-care issues such as End of Life decisions, organ donation, and family health care dynamics. Responsibility for supervision of students will lie with the house staff and faculty from the Critical Care section of the Department of Anesthesiology. Attendance at the daily Intensive Care lecture series, given by faculty members from the Critical Care Section of the Department of Anesthesiology is required. Students will be exposed to and have the opportunity to care for patients with a wide variety of life-threatening neurological and neurosurgical problems including ischemic stroke, intracranial / intraparenchymal hemorrhage, subarachnoid hemorrhage, subdural hematoma, acute brain injury (traumatic and non-traumatic), acute spinal cord injury, as well as patients with complications of neurological injury such as bleeding, venous thrombo-embolic disease, pneumonia, and sepsis.
Students will be exposed to and have the opportunity to observe, participate in, or perform a variety of procedures, such as arterial line placement, central line placement, hemodialysis catheter placement, PA catheter placement, intracranial pressure monitoring and drains, endotracheal intubation, thoracentesis, paracentesis, lumbar puncture, and other ICU procedures.
Students may also spend time in the Patient Simulation Laboratory (PSL), where they will have the opportunity to learn and practice management skills relating to acute cardiovascular, pulmonary, renal and neurologic intensive care. Airway management skills such as mask ventilation, endotracheal intubation, and ventilator management will be emphasized.
Each student’s experience will be unique, predicated upon the patients for whom he/she cares during the rotation. Each student may not care for a patient with each diagnosis listed above, and may not observe, participate in or perform all of the procedures listed above.
Prerequisites: Completion of Years 1-3
Length of Program: 4 weeks
Maximum Number of Students: 2 per rotation
When Offered: All rotations
Report to: Anesthesiology resident on rotation ICU-5C, 5th Floor, North Tower @ 6:00 am