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Goals & Objectives - ACC

Fellows will:

  • State the etiology, describe the pathophysiology, demonstrate the appropriate management and evaluate the outcomes of patients with:
    • Cardiovascular instability including arrhythmias, myocardial infarction, congestive heart failure, vascular abnormalities, and shock
    • Respiratory failure including acute respiratory distress syndrome, chronic obstructive lung disease, respiratory muscle weakness, pneumonia and pulmonary embolus
    • Renal insufficiency; acute and chronic
    • Central nervous system pathology including encephalopathy, cerebral vascular accidents and brain death
    • Metabolic, endocrine and electrolyte abnormalities
    • Infectious diseases including sepsis and septic shock. Differentiate treatment plans for patients who are immunocompetent versus immunosuppressed
    • Hematologic disorders including anemia, neutropenia, thrombocytopenia and thrombocytosis
    • Gastrointestinal diseases including acute and chronic liver failure, pancreatitis, cholecystitis, gastritis, peptic ulcer disease, and upper and lower gastrointestinal hemorrhage
    • Genitourinary pathology
    • Obstetric and gynecological disorders
    • Trauma
    • Thermal injuries
    • Pediatric emergenices, including neonatal problems
    • Nutritional disorders
    • Oncologic complications
    • Life threatening geriatric problem
    • Psychiatric disorders causing special ICU problems
    • Ethical and legal problems
  • Demonstrate effective:
    • Resuscitation skills including advanced cardiopulmonary resuscitation, advanced trauma life support, pediatric life support and crisis management.
    • Airway management using bag and mask ventilation in non-intubated, conscious and unconscious, paralyzed and non-paralyzed patients.
    • Laryngoscopy and intubation.
    • Ventilator management including the use of volume and pressure modes and the use of supplemental oxygen.
    • Implement treatment and adjust ventilator modes to manage elevated airway pressures.
    • Interpretation of pulmonary function tests.
    • Management of tension pneumothorax and summarize indications for placement of chest thoracostomy tubes.
    • Fiberoptic laryngotracheobronchoscopy for emergency therapeurtic interventions.
    • Sterile technique and insertion of arterial, central venous, hemodialysis and pulmonary artery catheters.
    • Interpretation of central venous and pulmonary artery catheter data.
    • Interpretation of electrocardiograms.
    • Insertion of emergent transvenous temporary cardiac pacemakers.
    • Pharmacologic support of circulation.
    • Management of patients on intra-aortic balloon pump.
    • Interpretation of arterial blood gas, venous blood gas and other laboratory data.
    • Monitoring and management of patients with central venous system monitors, including intracranial pressure monitoring.
    • Use of pharmacologic agents in the management of ICU patients including pharmacokinetics, dynamics, metabolism and excretion of these agents.
    • Management of patients with acute allergic reactions and/or anaphylaxis.
    • Management of patients requiring massive fluid and blood product resuscitation.
    • Application of Ethical Principles including informed consent, implementation of Do Not Resuscitate Orders, withholding or withdrawing life support, clarifying goals of Advanced Directives, setting treatment goals with patient's surrogate.
  • Interactions and communications with members of:
    • The nursing staff
    • Anesthesia staff following patient transport from the OR or Recovery Room.
    • The Primary Care team
    • Respiratory Therapy
    • Nutrition support
    • CORE (Center for Organ Recovery and Education)
    • Physical Therapy
  • Pre- and interhospital transportation of critically ill patients.
  • Administrative techniques including gatekeeping, triaging, quality assurance, and policy implementation.
  • Teaching of medical students and residents assigned to the Intensive Care Units.
  • Evaluate, critique and interpret medical literature. Discuss biostatistics and debate experimental design.
  • Participate in research projects, clinical trials occurring on patients in the ICU.
  • Provide consultation in daily patient care as emergent situations.
  • Participate in all educational activities including core lecture series, educational workshops, educational modules, Journal Club, Grand Rounds, Research Conferences, and Quality Improvement Conferences.
  • Complete mandatory procedure forms verifying satisfactory performance with endotracheal intubation, central venous, pulmonary artery and arterial line insertion and chest thoracostomy insertion.