The Department of Anesthesia is committed to the development of anesthesiologists skilled in the practice of critical care. The Surgical Neuroscience Intensive Care Unit/Cardiovascular Intensive Care Unit (SNICU/CVICU) at the University of Iowa Hospitals and Clinics has been medically directed by the Department of Anesthesia since the 1970's. The 36-bed SNICU is a major referral center for support of critically ill patients in Iowa. Typical SNICU patient problems include: trauma, post-surgery, post-organ transplant (liver, and kidney), septic shock, multi-system organ failure, peri-operative complications, and acute neurological injuries (head and spine injuries, stroke). The SNICU is located in close proximity to the Main Operating Rooms and the Critical Care Laboratory, enhancing efficiency of patient care.
The CVICU is a combined medical and surgical ICU and located 1 floor below the SNICU. Anesthesia trainees on this rotation cover only the surgical patients, but are immediately available to help with the management of airways or lines on the medical patients. In addition, residents manage the airway and ventilator of adult burn unit patients requiring mechanically-assisted ventilation.
In both units, patient care is directed by board-certified intensivists who are physicians with primary certification in anesthesia, internal medicine, surgery, trauma, emergency medicine, or neurology. Patient care is provided directly by residents and fellows and supported by other health care providers including critical care nurses, pharmacists, respiratory therapists, dietitians, social workers, and physical therapists. Finally, mid-level practitioners work with residents and fellows to facilitate safe, effective and efficient patient care. The mid-level practitioners help residents with activities such as documentation of patient care (writing notes in the electronic medical record) and order-writing. We believe that close professional relations between specialties and optimal patient care result from this team approach to clinical service and teaching.
The didactic program emphasizes evidence-based practice and includes lectures, mechanical ventilation laboratories, journal clubs, morbidity and mortality conferences. Residents get significant experience in critical care procedures, including emergency airway management, mechanical ventilation, fiberoptic bronchoscopy, echocardiography, and broad aspects of hemodynamic monitoring. With graded levels of responsibility during the training process, residents develop the expertise and confidence to handle any patient care emergency in the OR or in the ICU.