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We are a part of the Department of Anesthesiology
in the College of Medicine.
The Critical Care Medicine group 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, 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 the [relatively]
non-specialty specific units. At present, we manage approximately 86
intensive care beds in our institution.
The 42-bed Surgical 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 2,000
critically ill patients admitted to Shands Hospital at the University of
Florida.
Additionally, we direct the 36-bed Intermediate Care Unit [IMC], located on
the 9th floor of the hospital. Invasive and non-invasive ventilation and
monitoring are available for all beds in the IMC. Through this unit passes
most patients who start out in the SICU.
At present, our SICU teams admit and care for patients from all surgical
specialty services, including neurosurgery, general surgery, trauma,
orthopedics, obstetrics and gynecology, vascular, and transplantation
surgery. We plan to initiate coverage in the Cardiothoracic ICU in the near
future. When this occurs, there will be no critically ill adult surgical
patient for whom we do not provide care.
The on-call SICU team responds to all adult cardiac arrests in the hospital,
24 hours per day, and is directly responsible for airway management at these
events.
We break the academic year into 13 four-week months. For each of these
four-week months, we presently provide 16 weeks of coverage, with four teams
on service: SICU A, SICU B, and the Intermediate Care Unit Teams A and B.
Initiation of services in the CICU will result in a fifth team being put
into place.
Each of the SICU teams are staffed by an attending physician with special
qualifications in Critical Care Medicine, three residents, and two fellows;
a floating Physician Assistant provides extender functions approximately 18
hours per day in the SICU. In the IMC, there is 24 hour per day PA / ARNP
coverage; the PAs / ARNPs and attending physician provide the majority of
the patient care in the IMC.
Our units are run by nine attending physicians, seven 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. Very soon, intensivist
colleagues from the Department of Surgery will begin rotating with us in the
Division of Critical Care Medicine.
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.
