Medical Intensive Care Unit (MICU)

You will take comprehensive medical histories and physical examinations for patients with these conditions, and learn to counsel patients and their families effectively regarding pathophysiology, treatment options and prognosis.

Many intensive care patients are at particular risk for iatrogenic complications such as decubitus ulcers and hospital-acquired infections, and you will gain skills to assess these risks and act proactively to reduce them.

You will be expected to acquire skills in the following subjects as outlined below:

• perform hemodynamic assessment 
• distinguishes between shock states 
• list a differential diagnosis and treatment for each shock state 
• recall and apply the guidelines from the surviving sepsis guidelines
• use ICU monitoring tools to accurately assess intravascular volume status and resuscitative endpoints
• describe the diagnosis and treatment of ACS and unstable angina 
• identify and describe the treatment for the major classes of dysrhythmias 
• define the role for hypothermia and coma outcome prediction in the management of post cardiac arrest patient 
• identify and manage patients with left-and right-sided heart failure

• describe the two types of respiratory failure and the basis of their treatment
• memorize the basic modes of invasive mechanical ventilation
• memorize the basic modes of non-invasive mechanical ventilation
• apply the understanding of mechanical ventilation to disease specific states
• understand the diagnosis and management of ARDS
• distinguish respiratory, metabolic and mixed acid-base disorders
• recognize the importance of prevention of VAP and implement the VAP bundle
• recall and implement use of airway pressures in the management of ventilated patients (Cstat, Raw, PAP and PP)
• express understanding and implement use of a standardized approach to the liberation from mechanical ventilation

• develop a differential diagnosis for acute oliguria and AKI in the ICU
• describe the treatment of acute renal failure in the ICU
• distinguish respiratory, metabolic and mixed acid-base disorder

• describe key elements in Glucose Control and implement the management of blood glucose control in critically ill patients.
• identify and diagnose patients at risk for adrenal insufficiency in the ICU

• define and Implement the guidelines related to prevention, diagnosis and management of catheter related blood stream infections
• define and Implement the guidelines in the prevention, diagnosis and management of ventilator associated pneumonia
• recognize the importance of early, appropriate antibiotic coverage in sepsis
• use appropriate antibiotics for the treatment of community-acquired pneumonia and health care facility-acquired pneumonia
• list the pharmacodynamics and pharmacokinetics of anti-microbial agents

• implement the sedation-analgesia guidelines and protocols for mechanically ventilated patients
• manage seizure, status epilepticus and medical of intracranial hemorrhage syndromes according to the best available evidence
• recall microbiology involved in Meningitis and choose the appropriate diagnostic and therapeutic plan to the case at hand

• diagnose and manage common overdoses and poisonings

• recall the indications, site considerations, complications and place an arterial catheter and central venous catheter under ultrasound guidance
• list the indications, use and complications related to the use of pulmonary-artery catheter

• PGY-1: one module (4 weeks)
• PGY-3: one module (4 weeks)