USC ELECTIVES — COLUMBIA

Department of Surgery

SURG D621

Trauma/Critical Care

Faculty: Stephen Fann, M.D. - Course Director

Institution: Palmetto Health Richland

Location: Columbia, South Carolina

Duration:2-4 weeks

Course Offered: Throughout academic year

Number of Students: 2 per rotation

*USC SOM Third Year Elective- one student unless a 4th year student is registered

Students Report To: Palmetto Health Richland - Intensive Care Unit, 8:00 a.m.

*Can be used as Surgery AI
Upon completion of the rotation, the student should be able to:

  1. Express an understanding of mechanical ventilation, including the different modes of ventilation, the indications for initiation of mechanical ventilation, the parameters for weaning mechanical ventilation, the complications of mechanical ventilation, and interpretation of arterial blood gas data;
  2. Express an understanding of the interpretation of measurements from the pulmonary artery catheter during septic shock, hemorrhagic shock, cardiogenic shock, and neurogenic shock;
  3. Express an understanding of vasoactive medications and their use in the ICU;
  4. Express an understanding of the ABC’s of resuscitation of the acutely injured patient;
  5. Express an understanding of the management of a patient with acute brain injury, including description of the Glasgow Coma Scale, fluid management following acute brain injury, and the role of mechanical ventilation following brain injury;
  6. Express an understanding of acute renal failure, including diagnosis, differential diagnosis, metabolic and nutritional derangements, and management.
  7. Express understanding of acid/base and fluid electrolytes.

Upon completion of the rotation, the student should be able to demonstrate proficiency in the following clinical skills:

  1. Writing of ICU progress notes;
  2. Oral presentation during ICU rounds;
  3. Interpretation of CXR.

During the rotation, the student MAY gain some proficiency in the following clinical skills:

  1. Insertion of triple lumen catheter;
  2. Insertion of arterial catheter;
  3. Insertion of arterial catheter;

The student will be responsible for giving a twenty-minute presentation to the trauma/critical care service at the completion of the rotation. The student may choose any trauma/critical care topic of interest to them. The student should dicuss this with the trauma/critical care attending at the start of the rotation.

During the rotation, the student will have the opportunity to scrub for surgical cases performed by attendings on the trauma/critical care service. This responsibility should be given to the student by the chief surgical resident each night after the operating room schedule for the next day has been reviewed. M-IV students must share these responsibilities with the M-III students and do not have the right to "bump" M-III students from cases.

The student is also required to be in attendance at the following:

  1. Trauma Clinic, 1801 Sunset Blvd., 9:00 a.m., Wednesdays.
  2. Department of Surgery M&M Conference, 2 Medical Park, Dean’s Classroom, 6:30 a.m., Fridays.
  3. Surgical Grand Rounds, 2 Medical Park, Dean’s Classroom, 7:30 a.m., Fridays.
  4. Trauma Conference, PRMH auditorium, 7:00 a.m., fourth Wednesday of each month.

Suggested reading:

  1. The ICU Book, 2nd Edition, Paul L. Marino, Williams and Wilkins, Baltimore, MD, 1997
  2. Essentials of Surgical Critical Care, Edited by Jerome H. Abrams and Frank B. Cerra, Quality Medical Publishing, St. Louis, MO, 1993.