Welcome to the KGH Intensive Care Unit. We hope that your elective with us will be both fun and educational.
The ICU at KGH is a combined medical/surgical ICU with 33 beds and an average occupancy of 90%. We admit approximately 1500 patients per year, including complicated post cardiac surgery cases, major vascular cases and all patients requiring mechanical ventilation. There is a minimum of 5 and usually 7 junior residents rotating in the ICU in 2 month rotations, drawn from Medicine, Surgery, Anaesthesia, Family Medicine, and Emergency Medicine.
Three staff physicians attend each week, during which our primary responsibilities are to the ICU patients. There will often be a Critical Care Medicine Fellow or Senior on the team who will participate in patient care supervision and teaching. There are twice daily patient rounds, a daily radiology round, and a daily teaching seminar at 0800h.
During your rotation you will function as a member of the housestaff team, with specific responsibilities. You will be welcomed and expected to participate in all the educational activities. In order to benefit as much as possible from this rotation, we encourage you to review BCLS and ACLS, and your cardiology and respiratory physiology, and to review the educational material posted on the Critical Care website.
You will be encouraged to care for one to two patients per day with the assistance of one of the residents. We hope that by the end of the elective, you will have been exposed to a variety of clinical problems. Each day you will do a history and physical examination, review the laboratory work and x-rays of your patient. You will formulate a problem list for your patient(s) and a therapeutic plan. You will present your evaluation on morning rounds and write a note on the chart. This note should include a summary of the relevant history, details of your physical exam, the summary of pertinent laboratory data and x-ray findings, and a problem formulation.
One of the Intensive Care Unit residents will also be assigned to your patients. Either the resident or the attending staff will review the patient with you. Your notes will be countersigned by either the resident or attending staff. Any orders that you write will have to be discussed and countersigned by a resident or attending staff before they can be carried out.
You will not be solely responsible for any technical procedures, but at the discretion and under the supervision of the attending staff or resident, you may perform some procedures.
You will be expected to take "buddy" call with one of the residents one night during the rotation. You are responsible for choosing a night to do this.
Caring for critically ill patients is very much a team process and this is an opportunity for you to learn how to work within that team. The nurses, physicians, and other health care workers work as a team to plan, implement, and evaluate patient care.
We are glad that you have chosen to do a rotation in the Intensive Care Unit. Attached please find a summary of the educational goals and objectives of this rotation as we see them. We will be asking you to evaluate the experience which you have while in the ICU and we will be evaluating your performance. We hope that you will find this a stimulating and enjoyable rotation. If you have any questions, please contact Laura Jaques. We look forward to having you with us!
Dr. Daniel W. Howes, Head, Department of Critical Care Medicine