Welcome to Critical Care Residents in Calgary!
We invite residents from a variety of Canadian residency programs to consider doing a 4-week (or more) elective in Critical Care as a “rotating resident”.
All ICU’s in Calgary are tertiary level units in a city with a population of 1.3 million. They are all “closed units” and are staffed exclusively by Canadian Board-Certified ICU attendings. All units have a high percentage of very sick patients on multiple types of life support. All of the rotations that are available for electives will provide opportunities to care for very sick patients and when available, perform procedures as needed.
We accept Canadian residents who are in their PGY-2 year or higher. The exception to this requirement is the CVICU rotation where the requirement is PGY-4.
We have 3 different ICU’s offered for electives:
- General systems (also called medical/surgical). There are 2 ICU’s that are general systems and they are located at Peter Lougheed Center (PLC) and Foothills Medical Center (FMC).
- Neuro and trauma. This ICU has a patient population of severe multi-trauma patients (including brain trauma, but not limited to brain trauma) and also paitents with severe neurological problems that are non-traumatic (such as severe stroke). This ICU is located at FMC. This rotation is good for an elective that will focus on care of the trauma patient AND with a focus on neurological problems.
- CVICU (Cardiovascular ICU) is a post Cardiac Surgery ICU. Virtually 100% of the patients in this unit have had cardiac surgery or major thoracic vascular surgery (aorta). This is not the same as a CCU/CICU and if you are looking for a CCU rotation, please visit the Cardiology Dept website. Patients on ECMO, RVADs, and LVADs are cared for in this unit. We only accept PGY-4 residents or higher and residents must have completed at least 2 prior ICU rotations prior to this rotation.
The two General System ICU’s provide the following care and therapies:
- Standard life support for a broad range of critically ill patients with medical and surgical pathologies. As an indicator of severity of illness:
- The average APACHE scores of these patients is approximately 19-20
- Ventilated patients account for between 80 – 85 % of all admissions with approximately 70-75% of all ICU days being mechanically ventilated days
- Continuous renal replacement therapy (CRRT)
- Advanced ventilation strategies:
- Proning
- Inhaled prostaglandin administration
- Advanced hemodynamic monitoring:
- Acute hemodynamic resuscitations
- Standard intravascular pressure monitoring (arterial and central venous lines)
- Echocardiographic assessments
- Procedures including:
- Arterial access using ultrasound guidance when needed
- Central venous access using ultrasound guidance:
- Femoral, subclavian, internal jugular and axillary
- Airway access, including intubation via multiple techniques:
- Direct laryngoscopy, Glidescope, fiberoptic
- Bronchoscopy
- Percutaneous tracheostomy
- Percutaneous drainage of pleural peritoneal spaces
- Lumbar puncture
- Vascular access, dialysis (non-tunneled)
- Vascular access, special (thermoregulatory catheters)
- Vascular access, special (pacing wires)
The Neuro-Trauma ICU provides all therapies that the Medical Surgical ICUs do but with a focus on neuro-critical care and trauma:
- Exposure to patients with all forms of severe multi-trauma including serious burns
- Exposure to patient with all forms of neurological problems:
- Anoxic brain injury
- TBI (traumatic brain injury)
- Raised ICP (intracranial pressure)
- Intracranial bleeding
- Status epilepticus
- Spinal cord pathology
- Post cardiac arrest hypothermic therapy
- Multi-disciplinary neuro-critical care rounds
- Advanced neuro-critical care monitoring:
- ICP monitors including brain tissue PO2 monitoring
- Cerebral microdialysis
- Continuous and non-continuous EEG
The Cardiovascular ICU provides care to patients who have had cardiac or thoracic artoa surgery and your experience in the CVICU would focus on:
- Exposure to patients who have had:
- Coronary surgery
- Heart valve surgery
- Congenital heart defect surgery
- LVAD, RVAD, and ECMO devices
- Advanced hemodynamic monitors and therapy:
- Pulmonary artery catheter monitoring
- Echocardiography
- Intra-aortic balloon pumps
- Inhaled prostaglandin
- RV failure management
- Anti-arrhythmic therapies
- Percutaneous cardiac pacing
- Higher turnover, with usually 6-8 admissions per weekday
- Complicated mixes of multiple vasoactive agents
- Management of coagulapathy, cardiac tamponade, and massive transfusion
Teams in the ICU:
- The general system and the neuro-trauma ICU’s are comprised of the following team members who perform daily rounds:
- 1 ICU attending
- 1 ICU fellow
- 4-5 rotating residents
- 1-2 medical students
- Bedside RN
- Nurse clinician or charge nurse
- Pharmacist
- Dietician
- Night and weekend call does not exceed 1 in 4. Call for the resident is “in hospital”.
- Rotating residents can expect to be on call with a fellow between 25-50% of the time, depending on the fellow’s call schedule. Call for the fellow is “at home” call, but frequently, the fellow stays in the hospital all night.
Please note that applications must be submitted at least 3 months prior to the start of the rotation.
For more information for rotating residents about application for a Critical Care elective in Calgary, please contact:
Stephon Anderson
stephon.anderson@ahs.ca
(403) 944-2586