ANES 306P. Neonatal and Pediatric ICU Core Clerkship
Department
Anesthesia
Courses Clerkships
Description
Medical students are offered the opportunity to enrich their pediatric training by providing care for critically ill children at Packard Children's Hospital. During this four week clerkship, students spend 2 weeks rotating through the Pediatric Intensive Care Unit and 2 weeks rotating through either the Neonatal or Cardiovascular Intensive Care Unit. The Pediatric Intensive Care Unit (PICU) is a busy academic unit comprised of 24 beds divided between a general and cardio-vascular ICU. The general PICU is comprised of medical, surgical, and trauma patients both from within LPCH or referred from hospitals throughout Northern California. The medical admissions to the ICU range from basic RSV bronchiolitis respiratory failure to septic shock in a complex liver / small bowel transplant patient. Surgical patients represent a diverse pathology, and vary from solid organ transplants to various types of neurosurgical procedures. Patients often have multi-system organ failure complicated by immune suppression. The cardio-vascular ICU manages pre and post-operative patients with complex congenital heart disease. In this rotation, students learn the basic differences in both pathophysiology and management of critically ill children as compared to adults. The age range of patients is from 2 days to 22 years, exposing the student to a breadth of disease processes. Implementation of various procedures such as intubations or central venous catheter placements will also vary significantly in the various age groups. The Neonatal Intensive Care Unit (NICU) offers an intensive experience in the management of premature as well as ill term neonates. The focus is on training future physicians to anticipate and recognize the newborn in distress, perform appropriate resuscitation and ongoing assessment and stabilization of such neonates, and deliver optimum continued care and follow up. The NICU patient population is diverse, including 23 week estimated gestational age 500 gram premature newborns; post-dates neonates with pulmonary hypertension; infants with varied cardiac, gastrointestinal, urologic and central nervous system surgical lesions; and newborns with a myriad of chromosomal and metabolic abnormalities. Exposure to therapies such as extracorporeal membrane oxygenation, nitric oxide, high frequency ventilation, surfactant and human recombinant erythropoietin occurs on a daily basis. The NICU is supported by an active Maternal-Fetal Medicine Service and pediatric surgical subspecialty services, involved pediatric radiologists and full laboratory services. It is also the site for both applied basic science and clinical research protocols carried out by members of the divisions of Neonatal and Developmental Medicine and Maternal-Fetal Medicine. Medical student participation in any of these areas is welcome. Students will be assigned to the PICU either during the first or second two week block. For the other two week block, students can choose between the Neonatal and the Pediatric Cardiovascular ICU. Preferences for a particular site will be given consideration but cannot be guaranteed. Absences during the 306P clerkship: Students must contact the 306P Clerkship Director to obtain explicit advance approval for any planned absence from the clerkship. Unanticipated absences for illness or emergency must be communicated to the Clerkship Director as promptly as possible. Students with more than 2 days of unexcused absences (i.e., 3-5 days) will be required to make up one week at a later date. If the absence is longer than this, the time would be proportionately increased. Taking extra night or weekend call will not be considered a suitable substitute for missing weekdays during the clerkship. Arrangements to make up missed time must be made by the student with the 306P Clerkship Director. Students who anticipate missing a week (i.e., 5 weekdays) or more of the 306P Clerkship are encouraged to reschedule this clerkship during a different period. Students who miss either of the day-long ICU Medical Student Simulator courses will need to make these experiences up at a later date in order to receive a passing grade for this clerkship.
Prerequisites
Pediatric: Peds 300A and Surg 300A.
Periods Available
P1-12, full-time for four weeks. 4 students per period.
Reporting Instructions:
Report to on-service fellow or attending physician in PICU, NICU or CVICU at 8:30 am on Day 1 of the clerkship.
Units 6 Drop
Code T Call
Code 4
Director:
Lou Halamek, MD (halamek@stanford.edu) and Saraswati Kache, M.D. (skache@stanford.edu).
Other Faculty
C. Alvira, M.D., J. Andrus, M.D., R.L Ariagno, M.D., W.E. Benitz, M.D., D. Cornfield, M.D., L. Frankel, M.D., D. Franzon, M.D., A. Gupta, M.D., G. Hammer, M.D., S. Hintz, M.D., H. Lee, M.D., A. Madan, M.D.,W.D. Rhine, M.D., S. Roth, M.D., D.K. Stevenson, M.D., P. Sunshine, M.D., K. Van Meurs, M.D., G. Wright, M.D., E. Wessler, M.D., F. Su, M.D., J. Williamson, D.O.
Coordinator
Theresa Kramer - Department of Anesthesia 650-498-5624, H-3580.
