Surgical ICU

The frequency and volume of posts has dropped off in the past week, and the reason is that I've started my last rotation this year in the surgical intensive care unit. This operates on a 12-hour shift schedule, and last week was a bit hectic as I got to know the service and figure out how I fit in. Overall, it's not bad. We have a population of trauma victims from gunshot wounds, falls, or motor vehicle accidents. For the most part, they are otherwise healthy, and so we admit them to the ICU if they are intubated or require close neurologic checks. The other patients we have are post-operative; some come to the ICU after large surgeries like Whipple procedures while others are transferred up from the floor with illnesses like sepsis.

It's interesting and educational for me. The last time I was in a surgical trauma ICU, I was a medical student. There is much I don't know - I am less experienced at reading CTs, working with chest tubes, and assessing lacerations than my surgical colleagues. And yet, there is a lot that transfers over from my experience in anesthesia and medicine. I'm much more comfortable with managing ventilators, intubating, and extubating patients. Management of common problems like sepsis, shock, agitation, pain, and hypoxemia is the same for surgical and trauma patients as anyone else. Indeed, my experience from my pain rotation, cardiac anesthesia rotation, and medicine internship help me address issues often glossed over by the surgeons: pain management, vasopressor selection, antibiotic regimens, and even simple things like insulin management. I really think a multidisciplinary team gives patients the best care as we all have our particular expertise and deficiencies.