Medical ICU Rotation
The critical care training is structured to provide at least six months of caring for critically-ill medical patients and three months devoted to the care of non-medical ICU patients. The objectives of the medical ICU rotation are to allow the trainee to provide ongoing care to a wide variety of critically-ill patients, develop appropriate skills for making an accurate diagnosis, learn how to prioritize areas of urgency, and apply appropriate therapies to assist these patients. The medical ICU experience provides the trainee with opportunities to develop skills in airway management, ventilator management, central line placement, thoracentesis, tube thoracostomy placement and management, Swan-Ganz pulmonary artery catheterization, calibration and management, airway management of non-intubated patients, flexible bronchoscopy, ventilator weaning, cardioversion, cardiopulmonary resuscitation, and post-resuscitation care.
Trainees spend three months providing direct ICU care to solid organ transplant patients such as liver, kidney and pancreas. The team consists of a pulmonary/critical care faculty member, a fellow, and three mid-level providers. Multidisciplinary transplant rounds are conducted daily with the transplant surgery team. The fellow may choose to spend an additional month of direct, non-medical ICU care on the Trauma Service, Bone Marrow Transplant Service, or Neuro-Critical Care Service.
Neuro-Critical Care Rotation
Each trainee spends one month during his/her first year managing critically-ill patients with neurorological disease. The goal of the rotation is to obtain the necessary cognitive and technical skills to manage patients with acute neurological conditions such as stroke, intracranial hemorrhage, status epilepticus, central nervous system infections and coma. The rotation is supervised by attending physicians with special certification in neuro-critical care disease.
Upon request, various elective are available to enhance the knowledge and skills need to manage critically-ill patients, these include anesthesia rotation at the DVAMC, trauma-ICU rotation at OUMC and echocardiography rotation at the VAMC.
Point of Care Ultrasound
A dedicated full day workshop on bedside ultrasound that includes didactics as well as hands-on training is conducted each year at the University of Oklahoma Health Sciences Center. Skills are reinforced by having a bi-weekly ultrasound round in the ICU through which direct feedback is provided to the fellows about their bedside ultrasound skills and interpretation.
Central Line Placement Workshop
A dedicated full day workshop on central line placement that includes didactics as well as hands-on training is conducted at the beginning of each year. The goals of the program are to get the fellow up to a mastery level in placing internal jugular, subclavian and axillary CVC under ultrasound guidance.
Airway Simulation Training
A dedicated out-of-operating-room airway management workshop is conducted at the beginning of the fellowship and every two years thereafter. This training is required and sponsored by the DVAMC and includes didactics and hands-on training on a high-fidelity simulator.