This senior year elective course, located in the Surgical Intensive Care Unit of the North Pavilion, focuses on the essentials of subsystem support with emphasis on hemodynamic and respiratory management.

The following key topics will be addressed by this rotation:

• Support of oxygenation and ventilation;
• Interpretation of pulmonary arterial catheter data;
• Hemodynamic support, including assessment of volume status and dosing of commonly used vasopressor agents;
• Indications for hemodialysis and continuous renal replacement techniques;
• Assessment of nitrogen and energy balance, and use of enteral and parenteral nutrition; and
• Assessment of fever and interpretation of microbiologic data.

The student will care for patients in association with critical care residents, fellows and attendings in a twenty-bed ICU. Although closely supervised, the student is encouraged to think independently and proactively formulate a plan of care for discussion with other members of the team. This will include a subsystem-based presentation on morning and afternoon rounds of the patient's condition resulting in the formulation by the student of an assessment and plan, the ordering of laboratory tests, pharmacologic agents, radiographic studies and nutrition. The student will also gain experience in coordinating an agreed-upon plan of management with the surgical, nephrology, cardiology and other services.