SICU Experience

[Crusher]

Hello all, I am working on my 4th year schedule and can't seem to find a spot for a SICU rotation. I hope to be able to arrange for this at a later date.

My question is, how much SICU experience are you expected to have as you enter a preliminary year in GS. What book would you recommend I read if I am unable to do a SICU rotation?

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[surg]

It depends on the program. Some places have minimal SICU exposure in year 1. Some programs hand you the book with a number of SICU patients on day 1. I'd say, if you can't get a SICU rotation scheduled, at least schedule a MICU rotation. Granted, they don't do things the same way as a SICU would, but being able to manage CHF, renal failure, and dysrhythmias will be worth the time spent there alone.

If you can't get one, I guess I would recommend Marino's ICU book. While it isn't my favorite, it is easy to read and not so big that it is unreasonable to try to read it cover to cover.

 

[Prost8]

My SICU rotation was the most educational month of my 4th year. During my sub-I the following month, I felt comfortable managing almost any floor patient and could handle nursing questions with confidence. I would definitely recommend fitting the month in somewhere - you won't regret it!

 

[UI2003]

Originally posted by surg
It depends on the program. Some places have minimal SICU exposure in year 1. Some programs hand you the book with a number of SICU patients on day 1. I'd say, if you can't get a SICU rotation scheduled, at least schedule a MICU rotation. Granted, they don't do things the same way as a SICU would, but being able to manage CHF, renal failure, and dysrhythmias will be worth the time spent there alone.

If you can't get one, I guess I would recommend Marino's ICU book. While it isn't my favorite, it is easy to read and not so big that it is unreasonable to try to read it cover to cover.

Er, are we thinking of the same pale blue Marino ICU book that weighs about as much as my 3 year old niece? I'd hate to see what kind of book qualifies as "large" in your library

 

[surg]

Big in my library is my Greenfield or Mastery of Surgery or in the critical care field: Civetta's book (which is about the same size as Greenfield and just on Critical Care). Marino is ummm... medium size (note the original words,... not so big... I'm not saying that you'll read it in one sitting, but Marino is written well enough and covers enough physiology and practical material to slowly get through over the course of a month or so.

In terms of small books:
For just practical advice, I'm personally a fan of the handbook of critical care from Duke. It's about the size of a Mont Reid and contains very practical information, but is kind of skimpy on the physiology.
For pure physiology, my favorite was a book I got in med school: Critical Care Physiology by Robert Bartlett. Easy to understand physiology. It's currently out of print, but a new edition should be due in the next year or so I would guess based on how long it's been.

 

[njbmd]

Originally posted by Crusher
Hello all, I am working on my 4th year schedule and can't seem to find a spot for a SICU rotation. I hope to be able to arrange for this at a later date.

My question is, how much SICU experience are you expected to have as you enter a preliminary year in GS. What book would you recommend I read if I am unable to do a SICU rotation?

Hi there,

I couldn't fit in SICU during my fourth year and ended up having rotations in both SICU and Trauma ICU during my internship. I read the Marino book before I started my month in SICU but learned the most from my attendings who were close at hand. I did my SICU the month before my Trauma ICU and found that I was very comfortable during that second month of ICU. I ended up doing pretty will with both rotations.

I found that it doesn't matter much whether you are covering SICU or floor patients, you need to know how to handle patients who are crashing. You do the same kinds of things to get the patient stabilized and into the SICU or in the SICU to keep them alive. The nice thing about the SICU is that you have access to more monitoring and nursing.

As an intern covering a critical care unit, you are not expected to be an intensivist but you are expected to be able to manage critical care types of problems such as CHF, respiratory failure, hypotension, shock, sepsis and other things. You have to be able to get the ball rolling. Good ICU nurses will help you out as you are getting experienced and your more senior residents are worth their weight in gold. The Marino book will get your started in the right direction. ACLS or ATLS will help you cover disaster management.

Good luck!

njbmd

 

[Minimalist M]

My 4th year schedule will definitely have at least 1 month of SICU shoved in after the SF Match. I've worked with nsurg surgical interns at SFGH and they live in the ICU. I've always wondered how they know what they know after only 2 years of clinical work in med school...I'm almost done with my MS3 year, and I'm lost in an ICU.