Anesthesia and Perioperative Care
140.03B: ADVANCED INTENSIVE CARE UNIT
- John Turnbull, M.D.
The student will participate in the care of critically ill adults with a variety of medical and surgical conditions. This advanced clinical clerkship integrates the understanding of respiratory, cardiovascular, cerebral and renal pathophysiology with the diagnostic and therapeutic techniques required to care for patients with multisystem failure. This course is usually full all year with UCSF students.
Core Learning Objectives
After this clerkship, the student should be able to:
Clinical skill/procedural objectives
• On rounds, give an oral presentation of an ICU patient in a succinct, focused manner, including H&P, assessment and plan.
• Write an ICU admission note/progress note which clearly summarizes the pertinent ICU problems and delineates the student’s thought process about appropriate diagnostic and therapeutic plans
• Describe or demonstrate techniques to place arterial lines, central lines, and central line guidewire exchange
• Perform a literature search on an ICU patient’s diagnosis, treatment, or prognosis and describe how to use the information to care for the patient.
• Write initial mechanical ventilation orders for patients with the following conditions: ARDS, COPD, asthma, postoperative. Explain the rationale for the settings.
• Write initial noninvasive ventilation orders for a patient with COPD. Explain the rationale for the settings.
• Describe the clinical management of a patient presenting to the ICU with respiratory failure (related questions below).
• Describe reasons that a patient may require tracheal intubation or mechanical ventilation
• Explain what happens with the following mechanical ventilator modes: AC (volume controlled and pressure controlled), SIMV, PSV
• Explain the process of weaning from mechanical ventilation
• Describe the clinical management of the patient with ARDS (both ventilator and non-ventilator therapy).
• Describe the clinical management of a patient presenting to the ICU with hypotension (related questions below).
• Explain how to choose a vasopressor/inotrope for a patient with septic shock
• Describe the clinical management of a patient in the ICU with postoperative pain. List appropriate pharmacologic and non-pharmacologic therapies.
• Describe the reasons why ICU patients require treatment with sedative-hypnotic drugs. Explain the different drug classes used for treatment, and the potential impact on the patient’s care.
• Describe the clinical use, indications, contraindications, and complications of these invasive hemodynamic monitors: arterial line, central line, PA line
• Explain the ethical principles behind the withdrawal of life support in an ICU patient receiving vasopressors and mechanical ventilation.
Patients with ARDS, multisystem organ dysfunction, post transplant (pancreas, liver, heart, and lung), neurology/ neurosurgery, and cardiology/cardiothoracic.
Recommended Text or Reading:
A list of recommended articles and the articles themselves will be available during the rotation. Any general ICU text would also be valuable.
ICU attending and fellow, residents from internal medicine, emergency medicine, anesthesia, and surgery.
Patient Contact Hour Number (hours):
Classroom Time (hours):
Outside Study (hours):
Students are expected to stay late one night per week of their choice. Only one student should stay per night, so students should make their own schedule. Students will attend rounds on one weekend day of the rotation.
Medicine 110 and Surgery 110.
Quarters Taught: Su, Fa, Wi, Sp
Location: UCSF Parnassus
Minimum Weeks Offered: 4
Maximum Students per Block: 2
Contact Name: CourtneyCarter
Contact Phone: (415) 353-1211
Location to report to: 8am, M919
Comments: UCSF STUDENTS ONLY.
How to Add & Drop a course:
To add or drop this course, please submit a request through the online elective request system.