Course Catalog

ANES 306P. Critical Care Core Clerkship (LPCH)

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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. A rotation through the CVICU may be possible but is dependent on the unit’s ability to accommodate a student in any given month. Please contact the clerkship coordinator in advance to determine if CVICU is available. The Pediatric Intensive Care Unit (PICU) is a busy 20-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. 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. The Cardiovascular ICU (CVICU) manages pre- and post-operative patients with complex congenital heart disease. 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. The basic differences in both pathophysiology and management of critically ill children as compared to adults should also become apparent. Education in all 3 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.

Pediatric: Peds 300A and Surg 300A.

Periods Available
P1-12, full-time for four weeks. Exceptions as noted below. Maximum 3 students per period (2 PICU, 1 NICU). Note: NICU will be closed to enrollment during period 6 and limited to 1 student during period 7.

Reporting Instructions:
Report to on-service fellow or attending physician in PICU, NICU or CVICU following orientation on Day 1 of the clerkship.

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

NICU-Christine Johnson, M.D. (; PICU-Saraswati Kache, M.D. (

Other Faculty
LPCH PICU, NICU and CVICU faculty.

Theresa Kramer - Department of Anesthesia 650-498-5624 (


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