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We are a part of the Department of Anesthesiology
in the College of Medicine.
The Division of Critical Care Medicine is a multi-specialty – although
predominantly anesthesiology based – team of intensivists at Shands Hospital
at the University of Florida. As members of the College of Medicine faculty,
we are fully integrated into the clinical, academic, investigative, and
administrative functions of the University of Florida.
Our belief has been, and remains, that non-balkanized, multi-disciplinary
critical care medicine is optimal. Hence, we have worked very hard to
maintain the multi-specialty nature of the faculty and – with some
exceptions – the relatively non-specialty specific units. At present, we
manage approximately 68 intensive care beds in our institution.
The 30-bed Surgical Intensive Care Unit, the 30-bed Neuro Intensive Care
Unit, and the 8-bed Burn Intensive Care Unit, along with the operating
rooms, provides training for our students, residents, physician assistants,
and fellows, caring for what are some of the most acutely ill patients in
the Southeastern United States. Yearly, in collaboration with our surgical
colleagues, we manage approximately 3,500 critically ill patients admitted
to Shands Hospital at the University of Florida.
At present, our SICU teams admit and care for patients from nearly all
surgical specialty services, including neurosurgery, general surgery,
trauma, orthopedics, obstetrics and gynecology, vascular, and
transplantation surgery. The pone area in which our input is limited is in
the care of the post-cardiac surgery patient.
The on-call ICU teams are responsible for the care of the patients in their
units and, as well, comprise part of the Code Blue team which responds to
all adult cardiac arrests in the hospital, 24 hours per day.
The academic year is sub-divided into 13 four-week months. For each of these
four-week months, we presently provide 20 weeks of coverage, with five teams
on service: SICU A, SICU B, NeuroICU Teams A and B, and the fifth team is at
our sister hospital until 1 November. As of 1 November, our fifth team will
be back at our mother institution and will provide faculty in-house night
coverage; with this schedule change, we will have a senior physician in the
house 24 hours per day, 7 days per week.
Each of the SICU teams are staffed by an attending physician with special
qualifications in Critical Care Medicine, three to four residents, and one
to two fellows; two senior “floating” Physician Assistants provides extender
functions approximately 12 hours per day in each of the Units. In the
NeuroICU, there is 24 hour per day PA / ARNP coverage we well as limited
resident coverage; the PAs / ARNPs and attending physician provide the
majority of the patient care in the NeuroICU. One of the Critical Care
Medicine Fellows rotates in the NeuroICU.
Our units are staffed by 13 attending physicians, six of whom are
anesthesiologists – although each has training in internal medicine, and /
or general surgery as well as critical care medicine- with one pulmonologist
/ intensivist and one critical care nephrologist. Five intensivist
colleagues from the Department of Surgery also rotate with us in the units.
Residents and fellows are fully integrated into our teaching and care teams.
The experience of our trainees provides the breadth and depth that is
required if one is to be involved in the care of the critically ill. We have
daily work and teaching rounds, daily lectures, and monthly morbidity and
mortality rounds. A weekly Fellow’s conference is held each Tuesday
afternoon. Critical Care Grand Rounds are held semi-weekly. On the last
Friday of each rotation, a catered luncheon is provided and the residents
are encouraged to critique the rotation. A Critical Care Medicine journal
club is held monthly.
Research interests in the Division include, in the broadest terms,
respiratory and cardiovascular physiology, disease-state based outcomes,
traumatic brain injury, nutrition, renal physiology, and trauma. We are
involved with and have NIH funding for several of these projects. We are
proud of our history of mentoring junior faculty, fellows, and residents,
and our ability to find other mentors / collaborators either from within the
medical school or within the University proper, as needed. Thus, research
areas with which we are not involved can be developed with assistance from
colleagues within the University.
Finally, we are honored to work with some of the best nurses in the United
States, without whom we could not perform our jobs.
