BRONX-LEBANON HOSPITAL CENTER

Residents   in  the  Department  of  Pediatrics  rotate  through   the  Pediatric  Instensive  Care Unit at the Children’s Hospital  at  Montefiore  Medical  Center.  This 14-bed  unit  manages  children  with  respiratory  or   cardiovascular   disease, hematological, neurological,   or endocrinologic crises,  extensive postoperative cases, and renal transplant recipients are admitted routinely.

The PICU is a unique training resource.  Responses to illness and to treatment are more visible in the PICU, making it an important component of the pediatric Residency Training Program.

GOALS

To identify the critically ill pediatric patient.  This requires the ability to anticipate potential clinical problems prior to their development with the aid of serial physical examination and hemodynamic monitoring.

To understand the rationale behind the therapy for each disease process.

To develop a sensitivity to dealing with the family of a critically ill child, and how to provide support and information as required.

Primary Goals for this Rotation

Resuscitation and Stabilization (PICU). Recognize the critically ill patient and initiate appropriate stabilization and/or resuscitative measures.

Explain and perform steps in resuscitation and stabilization, particularly airway management, volume replacement, and resuscitative pharmacology.

Common Signs and Symptoms

Evaluate and manage, under the supervision of an intensivist, common signs and symptoms seen in critically ill infants, children and adolescents in the intensive care setting.

Common Conditions

Recognize and manage, under the supervision of an intensivist, conditions that commonly present to the intensive care unit, using consultation when appropriate.

Diagnostic Testing

Utilize common diagnostic tests and imaging studies appropriately in the intensive care unit, obtaining consultation as indicated for interpretation of results.

Demonstrate understanding of common diagnostic tests and imaging studies used in the PICU by being able to explain the indications for and limitations of each study.

Monitoring and Therapeutic Modalities

Understand how to use the physiologic monitoring, special technology and therapeutic modalities used commonly in the intensive care setting.

Demonstrate understanding of the monitoring techniques and special treatments commonly used in the PICU.

Use appropriately the following monitoring techniques in the intensive care unit under supervision of an intensivist.

Utilize appropriately or be familiar with the following treatments and techniques in the intensive care unit, including monitoring effects and anticipating potential complications specific to each therapy: