Nicole Teel, CA-1, on PICU rotation
The Pediatric ICU rotation provides Anesthesia residents the opportunity to understand disease processes affecting the critically ill pediatric patient while teaching approaches to the medical, surgical, and anesthetic care of this patient population. During the PICU rotation, anesthesia residents will be primarily responsible for direct patient care of critically ill and injured children. Residents will be exposed to and have the opportunity to participate in airway management including endotracheal intubation, arterial and central line placement, procedural sedation using IV anesthesia, and participation in bedside procedures including chest closure, cannulation for/decannulation from ECMO, delayed wound closures and other invasive procedures. Residents will assist with intrafacility transport of patients to off-site locations for diagnostic and therapeutic studies, and other procedures that may not be routinely performed in the PICU.
The PICU is a 12-bed unit, serving multispecialty and subspecialty medical and surgical patients. As an active pediatric heart center, we care for pediatric patients with congenital heart disease prior to and following surgery. As a leading regional level 1 pediatric trauma center, a great number of pediatric trauma patients are admitted and cared for in the PICU, in conjunction with the Pediatric Trauma Surgery team. You will also co-manage patients along with pediatric neurosurgery, orthopedics, Otolaryngology (ENT), plastic surgery, and transplant teams, in addition to providing primary management of medical PICU patients.
The goals you are attempting to achieve during this rotation are:
- Gain understanding of pediatric airway management and pediatric resuscitation, and how these differ from adults
- Learn how certain congenital syndromes and childhood illnesses affect airway management
- Review and understand normal and abnormal pediatric physiology
- Learn about the set-up, management and interpretation of complicated physiological monitoring systems, including invasive and non-invasive hemodynamic and neurologic monitoring
- Understand, evaluate, and manage special techniques (e.g. mechanical ventilation, controlled hypothermia, renal replacement therapies, ECMO, HFOV, iNO) used in the PICU
Several resources are available to enhance your learning experience. These include:
- A problem-based learning guide focusing on topics likely to be covered in anesthesia boards
- Simulation sessions for neonatal and pediatric airway management and mock-codes
- Didactic lecture series covering topics such as mechanical ventilation, shock, traumatic brain injury, fluid and electrolyte management, and other issues related to pediatric critical care medicine.
Textbooks and a reading list of the most pertinent articles affecting our practice are available in the Pediatric ICU.
Foundation Training: General OR
Primary Subspecialty Rotations:
Pediatric Anesthesia | Obstetrical Anesthesia | Regional Anesthesia & Acute Pain Management
Advanced Operative Subspecialties:
Cardiothoracic Anesthesia | TEE | Anesthesia for Vascular Surgery | Neuroanesthesia | Ambulatory | Safari |
Periopeartive Subspecialty Rotations:
Chronic Pain Management | Preoperative Assessment | Post Anesthesia Care | Critical Care (Neuro ICU and Cardiac ICU) | PICU