Course Catalog

ANES 306P. Critical Care Core Clerkship (LPCH)

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Department
Anesthesia
Courses      Clerkships


Description
During this rotation, students provide care for critically ill children at Packard Children’s Hospital. The rotation consists of a 4-week block in the NICU or the PICU. The Pediatric Intensive Care Unit (PICU) has moved into the new hospital building and is a busy 36-bed academic unit that teaches students to recognize and care for critically ill children. The patients are comprised of medical, surgical, and trauma patients both from within LPCH or are referred from other hospitals throughout Northern California. The medical admissions cover a broad range of disease processes ranging from respiratory failure, to shock, to multi-system organ dysfunction. Surgical patients represent diverse pathologies and vary from solid organ transplants to various types of neurosurgical procedures to multiple other general and sub-specialty procedures. Students will learn the pathophysiology of critical illness in children, understand the many monitoring devices used in the ICU, and become familiar with the various treatment modalities available for organ failure ranging from mechanical ventilation to ECMO. The basic differences in both pathophysiology and management of critically ill children as compared to adults should also become apparent. The Neonatal Intensive Care Unit (NICU) offers an intensive experience in the management of premature and sick term neonates admitted from the delivery room, community physicians’ offices, and an active referral service that draws from throughout Northern and mid-coastal California. The rotation emphasizes delivery room experience and newborn resuscitation skills, daily management of common newborn problems, and the special follow-up needs of NICU graduates. Exposure to advanced therapies including mechanical ventilation, extracorporeal membrane oxygenation, nitric oxide therapy, and hypothermia occurs routinely. An active maternal-fetal medicine service, pediatric surgery, and various pediatric subspecialty services support the NICU. Education in both units will occur via daily morning rounds, caring for patients, scheduled didactic sessions, and interactions with ICU attendings, fellows, and residents. Absences during the 306P clerkship: Students must contact the 306P Clerkship Director to obtain explicit advance approval for any planned absence from the clerkship. Students who anticipate missing a week (i.e., 5 weekdays) or more of the 306P Clerkship are encouraged to reschedule this clerkship during a different period. Unanticipated absences for illness or emergency must be communicated to the Clerkship Director as promptly as possible. Students with more than 2 days of unexcused absences (i.e., 3-5 days) will be required to make up one week at a later date. If the absence is longer, the time will be proportionately increased. Taking extra night or weekend call will not be considered a suitable substitute for missing weekdays during the clerkship. Arrangements to make up missed time must be made by the student with the 306P Clerkship Director. Students who miss either of the day-long ICU Medical Student Simulator courses will need to make these experiences up at a later date in order to receive a passing grade for this clerkship.

Prerequisites
Peds 300A and Surg 300A.

Periods Available
P1-12, full-time for four weeks. Maximum 3 students per period (2 PICU, 1 NICU).

Reporting Instructions:
PICU: If assigned to Team-A, report to on service Attending physician / PICU fellow in PICU, LPCH Main 420 Team room – 4th floor; If assigned to Team-B, report to on service Attending physician / PICU fellow in PICU, LPCH Main 320 Team room – 3rd floor, NICU: Report to on service Attending physician / NIC fellow in NICU, LPCH West – 2nd floor.

Units 6       Drop Code T       Call Code 2 - Students will be expected to take 6 weeknight and 2 weekend call shifts during the 4 week rotation. Student will stay until 10pm and are not expected to stay overnight.

Director:
NICU-Christine Johnson, M.D. (clcjohns@stanford.edu); PICU-Saraswati Kache, M.D. (skache@stanford.edu).

Other Faculty
LPCH PICU, NICU and CVICU faculty.

Coordinator
Bernadette F. Carvalho (berniec@stanford.edu).


 

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