First rotations: MICU

Discussion in 'Emergency Medicine' started by enfuegoEP, Jun 12, 2008.

  1. enfuegoEP

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    My first off service rotation will be in the MICU this August. Any helpful tips to prepare?

    I've found this handbook from UF, but don't know if it's worth using. Already bought Marino's ICU book.

    http://www.anest.ufl.edu/ccm/hbkcritcare.pdf
     
  2. DrQuinn

    DrQuinn My name is Neo
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    Read the "Surviving Sepsis" campaign. you can probably google it, but it came out in 2001 or so. It basically is the general approach to septic shock. There are some criticisms (especially Xigris) but it generally is helpful (mostly fluid resusc and early abx).

    If Mark Rumbak is still in the MICU just realize he'll change everything you are going to order. The Pulmonologists there are great!

    Q
     
  3. EMCC

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    I hate to disagree here, Quinn, but the new revised Sepsis guidelines are "hot off the presses." So, there are some things that have changed for 2008, such as no more routine Cortisol Stim tests, limited use for steroids, no role for Xygris, etc.

    As for what to read, Marino is a good start for the basic physio, but keep in mind he interjects his own opinion quite often, and it isn't necessarily always the "right way" to do things...

    I would get my hands on a pocket critical care/internal medicine pocket guide. I would also use www.ccmtutorials.com I would also use pacep.org for Swan gantz catheters (a really great website!!!) Don't forget to search for ventilators on Up-to-Date.

    Beyond that, the point of your rotation is to LEARN. You will learn more in your ICU month than you will on any other month (including EM months). Keep reading all the articles they suggest.

    Have an extremely low threshold for calling your senior/attending. Don't wait until the patient goes down the tubes before calling. I would prefer to be bothered early and often, rather than when the patient is coding...

    And, for the love of god, please don't try any procedures without an attending/senior resident there until you are comfortable doing them by yourself... Hope that helps!!
     
  4. Universe_Explorer

    Universe_Explorer Junior Member
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    I'm in the MICU in August as well. I appreciate all of the advice - please keep it coming! Any other recommendations for small/short high-yield books?
     
  5. enfuegoEP

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    Great advice and links! Thank you very much. Quinn, is Rumbak the guy from south africa? I've heard good things if it is...
     
  6. BklynWill

    BklynWill EM Attending
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    I'll be in the MICU in T minus 11 days... my first rotation as a resident. Good thing I did a fantastic MSIV elective at EMCC's program :D
     
  7. roja

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    This was my first rotation years ago. terrified me. Turned out fine. I used the Marino ICU book only. it's kind of the bomb in my mind. :D
     
  8. zinjanthropus

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    Yep, Rumbak is the man. I went to med school with his daughter and he is, indeed, a very good guy. He is King of the ICU at TGH.
     
  9. WallowaWanderer

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    plus one for the MICU . . . starting in seven days!
     
  10. ThedarnmikeDO

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    I'm an august MICU'er as well. Washington manual of critical care....thebomb.com. Really comprehensive and lacks the often inappropriate (yet hilarious) commentary by Marino. Small, fits in a pocket and has a lot of flow charts with arrows.
     
  11. overthebars

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    I 2nd Washington Manual, lots of algorithms and very high yield item for the long coat pocket. Not very much pathophys, but would go well with Marino.
     
  12. enfuegoEP

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    So two votes for the washington micu book and many high fives for marino. I swore I wouldn't go insane on book buying while in residency like I did as a medical student. Hopefully the medical school bookstore has a copy of the washington micu book so I could look it over.
     

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