| Rotations | Year 1 | Year 2 |
|---|---|---|
| Mercy Night Float | 2 blocks | 2 blocks |
| Elective SLU/Mercy | 3 blocks | 4 blocks |
| SLU Medical ICU | 1 block | 1 block |
| Telemedicine | 1 block | - |
| Respiratory/Nutrition | - | 1 block |
| Anesthesia | 1 block | - |
| Mercy Medical Surgical ICU | 2 blocks | 2 blocks |
| Mercy Neuro-Trauma ICU | 2 blocks | 2 blocks |
| Mercy CVICU | 1 block | 1 block |
Medical/Surgical Intensive Care Unit
Mercy's medical/surgical intensive care unit (ICU) rotation gives fellows a strong sense of medical and surgical pathophysiology.
Our ICU team includes a fellow, resident, student and critical care faculty member responsible for daily teaching rounds. This team is responsible for the care of complex medical and surgical patients, which includes performing invasive procedures.
Night coverage is provided by a night float team of fellows and physician extenders. Back-up supervision is provided by an in-house telemedicine critical care faculty member.
Neuro-Trauma Intensive Care Unit
Mercy Hospital St. Louis is a Comprehensive Stroke Center and a Level I Trauma Center. The Mercy Hospital St. Louis neuro-trauma intensive care unit provides care to patients experiencing:
- Multiple trauma
- Traumatic brain injury
- Acute stroke
- Subarachnoid hemorrhage
- Spinal cord injury
- Post-operative brain and spine surgery
- Neurologic disorders requiring respiratory support
Working closely with trauma surgeons and neurosurgeons, our neurointensivists provide bedside care for patients including placement of intra-cranial pressure monitors.
Most of the critical care attending faculty have completed the Neurocritical Care Subspecialty Certification from the United Council for Neurologic Subspecialties. Several faculty are also certified in Neurocritical Care by the American Board of Internal Medicine.
SLU Medical Intensive Care Unit
The SLU Medical Intensive Care Unit (MICU) rotation provides complete care to patients with life-threatening medical illnesses of all major organ systems.
There are two assigned MICU fellows who focus on pulmonary disease and critical care medicine. Together, they serve as team leads for each month's rotation.
In partnership with the MICU attending physician, fellows directly participate in patient care, which includes performing and/or supervising all ICU-related invasive procedures.
Telemedicine
The Mercy St. Louis Virtual Care Center supports one of the largest telemedicine programs in the country. The critical care and pulmonary critical care fellows learn ICU telemedicine skills during this rotation, covering several intensive care units alongside the critical care attending faculty and nursing staff. The fellows develop expertise navigating electronic medical records, bedside monitoring systems and the video capabilities of virtual care. The fellows learn the advantages and limitations of critical care telemedicine.
Cardiovascular Intensive Care Unit (CVICU)
During the CVICU rotation the fellows care for patients with ischemic coronary syndromes, challenging arrhythmias, vascular surgery, cardiogenic shock and post cardiac arrest hypothermia. In addition, patients requiring extracorporeal membrane oxygenation (ECMO) are managed in the CVICU in collaboration with the ECMO team. This team includes an ECMO intensivist, cardiovascular perfusionist, cardiothoracic surgeon, specialized intensive care unit nurses and respiratory practitioners.
Physician Extender Program
The Department of Critical Care Medicine is fortunate to be supported by a talented nurse practitioner (NP) and physician assistant (PA) program. The collaborative NP and PA program is mature and supports the ICU twenty-four hours a day by covering, admitting, discharging ICU patients and performing procedures when required. The NP and PA program is responsible for the Mercy Rapid Response System.
Procedures
During the fellowship, trainees perform the following procedures: central venous catheter, renal replacement catheter, arterial catheter, intracranial pressure monitor (Camino Catheter), intubation, tube thoracostomy, percutaneous dilational tracheostomy, thoracentesis, paracentesis and lumbar puncture.
