hey guys, i was wondering if anyone can tell me which hospitals have anesthesiologist docs running the ccu. i know ucsf is one, any other places ? thanks!
The SICU at the University of Florida is run by Anesthesia. It has around 40 patients not including the IMC (Intermediate Care Unit) which is likewise run by Anesthesia. The CT and CICU (Cardiothoracic and Cardiac) ICU will by taken over by Anesthesia soon. It is definitely one of the biggest in the country and a great educational experience for the Anesthesia residents.
NYU and MetroHealth both have SICUs staffed by Anesthesia. Attendings may be anesthesiologists or trauma surgeons depending on the schedule, but anesthesia residents rotate through and run the show.
UTHSC San Antonio's ICU rotations are in the VA SICU which is staffed by anesthesia faculty and residents. They take care of all of the patients with the exception of general surgery.
At Johns Hopkins, the CICU (Cardiac Intensive Care Unit--MI's and such) is run by cardiologists. The Medical ICU and Neonatal ICU are run by internists and pediatricians, respectively. As for units that anesthesiology residents regularly rotate through: The CSICU (Cardiac Surgical Intensive Care Unit--CABG's and valves and such), and both Surgical ICU's (one in each building) are run by Anesthesiology and Surgery. I'd say the attending is an anesthesiologist 60-70% of the time. The PICU (pediatric ICU) is run by both anesthesiologists and pediatricians about 50/50; many are boarded in both. The NCCU (Neurocritical care unit) is run by neurologists and anesthesiologists about 50/50, with many boarded in both. Each unit is directed or co-directed by a member of our department.
Indiana University has residents rotate through and the attending will be either an anesthesiologist or trauma surgeon
Cornell=> Anesthesia runs the Cardio-Thoracic ICU, and shares 50% of responsibility in the neuro ICU and Sloan-Kettering ICU (mixed medical/surgical unit). Anesthesia also runs the pseudo-ICU at HSS (they don't really have one, but the step-down is close) and will be running their ICU when it opens in the near future.
The HSS pseudo-ICU is actually the recovery room. During the day, it functions as a regular PACU--completely run by anesthesiologists. Sick/old patients stay in the PACU overnight. Patients who decompensate on the floor get transferred back to the PACU for r/o MI, mechanical ventilation, and the like. Really sick patients get transferred to the NY-Presbyterian medical ICU across the street. Overnight and on the weekends, the HSS PACU and the pain service are both run by one anesthesiology resident with one attending who may not be in the building.
While Vandy's NeuroCare Unit is run by Anesthesia, an important distinction to make is that anesthesia is not the primary team on any patient (I did my Critical Care rotation on the unit there). So it's considered an open unit. Therefore, the neurosurgeons and neurologists make many of the decisions and there can be primary team/critical care team issues at times. Many of the units in academic centers that anesthesia is running are actually open units, so that surgeons of all types are acting as the primary docs, with anesthesia doing the procedures, call, emergent issues, etc. Just thought that might help to answer the OP
Thanks for clarifying, Beck. Yeah, I haven't run into too many truly closed units on the trail...lots of "semi-closed" ones which I guess means "open" more or less. So, did you rotate at Vandy? I liked it there a lot.
MGH SICU is a closed anesthesia run unit. While the surgeons will round on those patients and their advice is always welcome from a surgical point of view, but all facets of management are dictated by the anesth. team
Umass ICU is runned by mostly Anesthesiologists (ithink 4 out of six of the MDs). They are pretty strong in ICU, and it is one of the few fellowships they offer. If I'm not mistaken, I believe Baystate also is runned by anesthesia (not sure about this one though).
Baystate had at least one anesthesiologist on staff when I rotated there, but not a unit run by any one service if I remember right. Multidisciplinary, but they do have a fellowship. UMass has Dr. Stephen Heard, the president of the Society of Critical Care Anesthesiologists. A major contributing author of the Irwin & Rippe critical care text, and a great speaker as I just heard a grand rounds by him last month. And at UMich anesthesia runs the CT-ICU.
I did a month of ICU at Baystate. It's a combined 24 bed medical/surgical closed ICU. They have internal medicine intensivists, trauma surgeons s/p surgical critical care fellowship, and anesthesiologist-intensivists. There's two teams, medical and surgical, but the anesthesiologists can be found rounding with medicine and the medicine intensivists rounding with surgery, which is kinda unique, I think. As an anesthesia resident you'd be on the surgical team with surgical residents or interns, and sometimes EM dudes. I loved it -- I think the residents dug it too. The ICU fellowship is through anesthesiology department -- it involves 9 months of ICU and 3 months of cardiac anesthesiology.
