Pediatric and Adolescent Medicine -- Critical Care - Rochester

Description:

The Pediatric Critical Care Service (PCCS) is coordinated between the departments of Pediatric and Adolescent Medicine and Anesthesiology, and is a component of the Mayo Critical Care Service. Residents on the service come from pediatrics, family medicine and anesthesiology. The PCCS functions as both a primary and consulting service for children in the Mayo Eugenio Litta Children's Hospital Pediatric Intensive Care Unit. This 14-bed multidisciplinary facility cares for children with a wide variety of medical and surgical problems beyond the neonatal period.

Specific Goals:

1. Become very familiar with the diagnostic management details of children in the PICU.
2. Become familiar with airway management and the basics of mechanical ventilation.
3. Become familiar with the basic principles and practice of circulatory support and fluid management in the PICU.
4. Become familiar with the basic principles and management of major pediatric ICU problems, including respiratory failure, circulatory failure and shock, renal failure, liver failure, central nervous system emergencies and pediatric trauma.
5. Develop minimal competency in basic invasive procedures, including peripheral IV placement and arterial puncture.

Activity Outline:

Activities consist mainly of daily rounds, core curriculum conferences, and patient care. Daily rounds, which begin at 8:30 a.m., and didactic educational activities usually take up most of the morning. The remainder of the day is devoted to patient care activities, carrying out procedures, or educational reading.

Students have the opportunity to perform basic PICU procedures and assist in carrying out more complicated procedures such as the placement of central venous catheters, arterial lines and endotracheal tubes. Because of the unpredictable presentation and clinical course of PICU patients, students are expected to take night call an average of every third night. During this clerkship, students are expected to perform as sub-interns and hence become very familiar with the management details of the children in the PICU.

In addition to the core curriculum lectures, readings are assigned by the PCCS consultants from texts available in the ICU.

Method of Evaluation:

The PCCS consultants, who spend their entire day in or near the PICU, discuss and critique students' progress throughout the elective. Ideally, an evaluation form is completed and shared with the student prior to completion of the rotation.