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Intensive Care Unit

The MHMH intensive care unit is a multi-disciplinary unit providing trauma, surgical, and medical (thoracic) ICU services to critically ill patients. The intensive care unit at the VA Medical Center is a combined unit that serves veterans with a variety of medical-surgical issues.

Fellow responsibilities

  • Supervise housestaff in the assessment and management of critically ill patients in an intensive care unit, either at MHMH or the White River Junction, VT, VA hospital.
  • Provide immediate consultative services to seriously ill inpatients on medical and surgical services, and in the emergency ward
  • Serve as the initial gatekeeper for intensive care services, including handling all telephone requests from outside physicians regarding transfer into the MHMH or VAMC ICU.

MHMH Multidisciplinary Intensive Care Unit

  • Initial patient assessments, including comprehensive review at the time of admission with the critical care attending.
  • Morning walk management/teaching rounds: The critical care attending and fellow on each team will review each patient on the service every day at 8:00 a.m., 5-7 days per week consistent with duty hour guidelines, along with housestaff, medical students, and bedside nurses. These rounds allow the fellow to engage in bedside teaching and to evaluate the housestaff's patient management skills.
  • Daily radiology rounds: Each weekday at 10:00 a.m., all on-service housestaff, fellows and attendings gather in the Department of Radiology with an attending radiologist to review and discuss the most recent imaging performed on their patients.
  • Directly supervised procedures: Residents have the opportunity to learn procedures under the direct supervision of the critical care attending or fellow including the safe placement of central venous catheters, dialysis catheters, arterial pressure catheters, pulmonary arterial catheters (Swan-Ganz catheters), endotracheal tubes, and thoracostomy tubes, in addition to routine procedures such as lumbar punctures, chest thoracentesis, abdominal paracentesis and others.
  • Daily ICU afternoon rounds: Each weekday at 1:30 p.m., the fellow reviews all patients with on-call residents and attendings. The residents and staff review the events of the day and the care plan for the rest of the evening for each patient.

White River Junction VA Combined Medical-Surgical Intensive Care Unit

  • Morning walk management/teaching rounds: The critical care attending and fellow review each patient with their medical service team each weekday beginning at 8:30 a.m. These rounds provide the opportunity to engage in bedside teaching and to evaluate the housestaff's patient management skills.
  • Daily radiology rounds: Each weekday at 10:30 a.m., all on-service housestaff, fellows and attendings gather in the Department of Radiology with an attending radiologist to review and discuss the most recent imaging performed on their patients. Directly supervised procedures. Residents have the opportunity to learn procedures under the direct supervision of the critical care attending or fellow including the safe placement of central venous catheters, arterial pressure catheters, pulmonary arterial catheters (Swan-Ganz catheters), endotracheal tubes, and thoracostomy tubes, in addition to routine procedures such as lumbar punctures, chest thoracentesis, abdominal paracentesis and others.
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