Critical Care Consult Service
The Critical Care Consult Service (CCCS) was created in 2009 with the purpose of extending “critical care” beyond the walls of the physical ICU. By participating in the daily ventilator and overall ICU management of patients in the cardiac ICU, performing a wide variety of invasive procedures on floor patients, and aiding with the management of critically ill patients in the ED and medicine floor, the CCCS has dramatically improved the safety and shortened the length of stay of hospitalized patients and has improved the overall efficiency of day-to-day operations of the hospital. Additionally, trainees gain extensive clinical experience and proficiency in managing an assorted array of problems in the various patient populations found throughout the medical center (e.g., medicine, surgery, neurology, transplant). Despite the heterogeneity of pathology, these diverse patients have one commonality: they can get very sick.
Our Pulmonary and Critical Care Division has recently finished a complete renovation of the bronchoscopy suite at the University of Maryland Medical Center. The suite has state-of-the-art video bronchoscopic equipment and a dedicated fluoroscopic C-arm. The Division performs over 900 bronchoscopy procedures each year at UMMC. Our large volumes enable fellows to become proficient in all aspects of diagnostic bronchoscopy.
The MASTRI Center (Maryland Advanced Simulation, Training, Research and Innovation) at the University of Maryland is an innovative, research-driven, high-technology, state-of-the-art training center. Its goals are to lead in evaluation development and testing in regard to emerging simulation technologies and techniques and in the ongoing transformation of surgery and other medical procedures. Additionally, the Center is envisioned as a premier educational environment devoted to the training of healthcare practitioners across a diverse spectrum, with particular focus on how users learn and adapt to new technologies.
In the MASTRI center, our critical care fellows have the opportunity to develop their skills in diagnostic bronchoscopy, chest tube insertion, use of video laryngoscopy as an intubation technique (Glide scope) and other procedural skills. The bronchoscopy simulation software is quite realistic, and represents a major learning tool for the fellows as they develop proficiency with this procedure.
The University of Maryland has a Cadaver Lab which is a component of the University of Maryland Medical School and the Office of the Medical Examiner. Approximately twice yearly, we conduct a training session in the Cadaver Lab centering on airway management techniques, including traditional direct laryngoscopy, percutaneous cricothyroidotomy, and surgical cricothyroidotomy. The training sessions also focus on pleural space management, including standard tube thoracostomy and percutaneous pigtail catheter placement. These sessions allow the fellow to develop proficiency in these techniques with direct faculty teaching and supervision.