Surgical Critical Care Trauma and Burn Management

Sites: BWH
Director(s): Erik Alexander, Stephanie Nitzschke
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time for one month.
Location: BWH - Brigham and Women's Hospital (23)
Open to Exclerks: Yes (may be restricted for international students)
Description: This course has a didactic and a clinical component. The didactic component consists of daily morning lectures, teaching rounds in the SICU and in the Burn and Trauma ICU and x-ray rounds. The ICU service provides daily conferences on all aspects of critical care. There is a weekly Critical Care fellow's presentation, a trauma conference and a thoracic surgery ICU conference. There is a weekly ICU/infectious disease conference. The clinical experience component focuses on all aspects of critical care including ventilation management and nutritional support as well as management of the severely traumatized and burned patients. The students form an integral part of the ICU team. The student is expected to learn the basic physiologic, metabolic and immunologic abnormalities which occur in critical illness, the basic approaches to diagnosis and management of surgical critical care patients. This subinternship provides an excellent opportunity for students to enhance their knowledge of postoperative management of complext patients following trauma or postoperative physiological derangements such as respiratory failure, sepsis, renal failure, or cardiac failure/dysfunction.
Incorporation of Basic Science Content and Evidence-Based Medicine:
During daily ICU rounds, the basic science underpinnings of critical care are reviewed. The structure of teaching rounds at the bedside lends itself naturally to an integrated review of basic science and its impact on clinical decision making. Evidence-based medicine is the central tenet of critical care and informs all treatment decisions. The best available evidence is reviewed daily on rounds guiding the management of patient care.
Grade Criteria:
Honors with Distinction: Exceptional patient care, presentation skills, self-directed learning, and initiative. Exceptional communication and interpersonal skills. Became an indispensable member of the ICU care team. Honors: Excellent performance in all dimensions including fund of knowledge, patient care, and communication skills. Became a dependable team member of the ICU. Satisfactory: Meets the minimum standards of attendance and participation on rounds, presenting patients, working effectively as part of the ICU team Unsatisfactory: Did not meet the minimum standards in attendance or participation in patient care in the ICU