The three main goals of the PICU rotation are:
- Achievement of proficiency in the recognition and initial management of multi-organ system problems including: sepsis, overdoses and poisonings, coagulation disorders, acute respiratory failure, acute neurologic insults, traumatic injury, acute renal failure, electrolyte/endocrine emergencies, nosocomial infections, hemodynamic instability/shock
- Development of decision making skills involved in the care of severely ill patients: Both the PL-2 and supervisory PL-3 residents are expected to integrate the patient’s history, physical exam, and laboratory data, and formulate a differential diagnosis. In addition, after discussion with the ICU attending, the PL-3 is expected to initiate and provide a supporting scientific rationale for an appropriate management plan.
- Learn the process of patient stabilization and triage: Residents are also expected to assist and participate in making decisions regarding the triage of patients from and to the PICU, including the initial resuscitation, stabilization, and transportation.
All rounds, patient care, and procedures are supervised and conducted by the ICU attendings. Cognitive skills are conveyed through patient care rounds and an on-line lecture series. Procedural skills are taught both in didactic sessions and in demonstrations at the bedside. Residents are taught the procedures of orotracheal and nasotracheal intubation as well as central venous catheterization via the femoral vein. Articles relating to patient care are distributed to assist in reinforcing the diagnosis, pathophysiology and management of patients.
The section maintains copies of the “Manual of Pediatric Critical Care” which will are available to the rotating residents for study during their rotations and which should be returned at the conclusion of the rotation.
A national self-assessment test, taken online at www.picucourse.org, will be administered to all residents at the end of their monthly rotation. The questions on this examination are based on principals discussed in the online Powerpoint lectures on the PICU resident education website.
Each resident’s performance is evaluated by all the PICU attendings during a monthly conference. Areas evaluated include overall performance, presentations, knowledge base, ability to integrate a history, physical exam, and laboratory data; ability to formulate a differential diagnosis, competency at procedural skills, and ability to initiate and formulate an appropriate treatment plan.