K608 Critical Care (Montefiore Medical Center)
The primary purpose of this elective is to provide the senior medical student with a diverse, well-rounded, meaningful, and focused exposure to the field of Critical Care Medicine. The student will be exposed
to our Consult Service as part of our "ICU without walls" (providing critical care outside the ICU), and learn how critical care triage decisions are made. They will spend time in our Medical ICU, the
classic critical care environment, and get an exciting opportunity to rotate through our non-medical intensive care units: the Surgical ICU, where critically ill neurosurgical and general surgical/liver
transplant patients are cared for, as well as the Cardiac Surgical ICU, where patients are cared for after cardiac surgery. Over the course of the month, the co-directors will be providing weekly small
group lectures on the following topics: Advanced Cardiac Life Support, shock/multiple organ failure, respiratory failure/Acute Respiratory Distress Syndrome, acid-base issues, mechanical ventilation/ventilator
weaning, as well as sedation in the ICU, oxygen delivery equations, and hemodynamic monitoring. In addition, the students will be taught about national critical care patient safety initiatives, such
as the Institute for Healthcare Improvement ventilator associated pneumonia bundle, central line bundle, and the surviving sepsis campaign guidelines.
Students will be invited to attend our morning report, educational noon conferences for the fellows, and our Critical Care Journal Club (in addition to medicine and surgical grand rounds). Medical students
will attend daily work rounds, follow one or two patients closely each week, learn how to present critically ill patients on rounds, perform relevant literature searches, and learn fundamental cardiovascular
and pulmonary pathophysiology as it relates to the critically ill or injured patient. They will also learn the indications for and techniques of various procedures in the ICU. By the end of the elective,
medical students should have developed a broader perspective on what it means to manage a critically ill patient, improved their ability to recognize in which patients critical care is most likely to
be helpful (and, conversely, when critical care should perhaps not be provided), as well as enhanced their knowledge of end-of-life issues as they relate to the critically ill patient. They should learn
about (and temporarily become part of) the multidisciplinary critical care team, and discover the crucial role of that team in providing high-quality critical care. They will learn the challenges and
rewards of a career in Critical Care Medicine.
- Learn a thoughtful and organized approach to ICU patients
- Gain experience with interpretation of ICU patient data
- Improve understanding of common ICU problems such as invasive monitoring, mechanical ventilation, sedation, sepsis, ARDS
- Enhance knowledge of the cardiovascular and pulmonary pathophysiology pertinent to the ICU
- Learn to write initial orders for mechanical ventilator support and sedation
- Learn the rationale for commonly used ICU protocols such as ARDS ventilator management, insulin drips, weaning from ventilatory support, fast-track extubation after cardiac surgery
- Become familiar with some of the important clinical trials in critical care medicine, and the impact of evidence-based medicine on current ICU patient management.
This will be a 4-week elective, and will be located at the Moses Campus of Montefiore Medical Center. The medical student's time will be allocated as follows: one week on the Critical Care Consult service
working with the consult fellow and attending; one week in the Medical ICU at Moses; one week in the Surgical ICU at Moses; one week in the Cardiac Surgical ICU at Moses. The duration of time that a
student spends in each unit may be modified after discussion between the student and one of the course co-directors. The medical students will meet at 8 am on the first day of the elective in the Critical
Care Administration area, Gold Zone.
The ICU Book, 3rd edition, by Paul R. Marino, 2006, Lippincott Williams and Wilkins. Critical Care Secrets, 4th edition, Parsons/Wiener-Kronish, 2007, Mosby. In addition, students will be provided key critical
care references from the past decade or so in the field of critical care medicine. They will also be distributed the Society of Critical Care Medicine "Medical Student's Guide to Intensive Care Medicine"
PDF document.
Modules: All
Maximum: 4
