Division of Pulmonary & Critical Care
Medical ICU: Critical Care Medicine
Critical Care at Jefferson has attained pivotal importance and has been designated the sixth key "service line”. The institution has recently invested over $140 million and upgraded and added 50 additional ICU beds to bring the total to 116, of which 25 are medical. There is a recognition that our patients are sicker, more complex interventions are being performed, and state-of-the-art critical care is necessary for optimal patient care, training of housestaff, and represents a fertile environment for research. There is daily multi-disciplinary rounding on all patients 7 days per week with a housestaff team, a fellow, and an attending.
We run two independent critical care services: the Medical Intensive Care Unit (MICU) which is run by our division, and a Medical Critical Care Consult Service. The MICU is a 17-bed facility that serves the needs of non-coronary critically ill patients in the department of medicine. Fellows supervise the house staff in their initial patient evaluations and, with division faculty, guide diagnostic and therapeutic management. Two medical residents and four medical interns are assigned to the MICU and provide in-hospital coverage. Fellows take home call. All invasive procedures performed in the MICU are supervised by faculty and fellows, ensuring an opportunity for proficiency in pulmonary artery catheter insertion, arterial cannulation, central venous catheter placement and bronchoscopy. A diverse patient population offers a wide array of critical care problems, with extensive exposure to patients with shock, pulmonary edema, acute respiratory failure, acute renal failure, coma, metabolic and endocrine problems, infectious disease, hematological problems, disorders of the gastrointestinal system and others
The MICU is equipped with state-of-the-art monitoring and support capabilities, including traditional and advanced volume and pressure control modes of ventilation; Pulse contour analyses; continuous fiberoptic mixed venous oximetry; and bedside ultrasonography. A team of specially trained respiratory therapists (under the direction of the Division of Pulmonary Medicine) provides extensive physiologic monitoring and recording services. Personnel from pharmacy, nutrition, nursing and other areas are also involved in a multi-disciplinary approach to critical care.
The Critical Care Consult service is comprised of a separate fellow and medical critical care attending. The fellow and attending provide medical critical care consultation to the bone marrow transplant unit, Medical Coronary Care Unit as well as the other non-medical intensive care units in the hospital (Surgical Intensive Care, Neuro Intensive Care, and Obstetrics).
