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Sat Sep 6 12:12:22 BST 2008

In tHe BTGH all patients admitted to the SICU are automaticaLly suegery patients.  All others are consultants.   Only the surGeon can wRIte orders.   Others can write a recommendation in progress notes.   

K

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-----Original Message-----
From: "Dudick, Cathy" <CDudick at meridianhealth.com>

Date: Thu, 4 Sep 2008 10:50:46 
To: <trauma-list at trauma.org>
Cc: Vernick, Jerome<JVernick at meridianhealth.com>; Kountz,  David  MD<DKountz at meridianhealth.com>; Miller,  Rick<richard.miller at Vanderbilt.Edu>; Hanna,  Niveen<NHanna at meridianhealth.com>; Garcia,  Felix<FGarcia at meridianhealth.com>; <lcbaker1 at mac.com>; Malhotra,  Atul, M.D.<AMALHOTRA1 at PARTNERS.ORG>; Maldonado,  Ivan<IMaldonado at meridianhealth.com>; Ahmed,  Nasim<nahmed at meridianhealth.com>
Subject: Surgical Intensivist Consultations

I have a question about the care of non trauma surgical intensive care
patients.

We are a level 2 trauma center with a busy SICU.  We the trauma
attendings(all double boarded in surgery/cc), provide 99% of the
critical care-lines, etc (no real resident/PA coverage at night).  We
and our surgery department support a formal policy of mandatory surgical
intensivist consultation for all SICU patients.  Our goal is to provide
24hour/7day intensivist in house coverage.  We feel this is in the best
interest of patient care. Also, it prevents us from "meeting" the
patient for the first time during a crisis, as we often are called for
septic shock, airway emergencies, etc, when no other intensivists are
readily available(mostly after hours and at night).  We would prefer to
be acquainted with the patients and perhaps treat small problems before
they escalate.  Lastly, it would help us manage our beds in the ICU.
The medical intensivists (private practitioners) do not stay in house,
but balk at the idea of a mandatory surgical Intensivist (hospital
faculty) consult policy for surgical ICU patients. 

Who cares for that patient in your unit, the surgical intensivist, the
medical intensivist, etc?

Are your intensivists in house 24/7?

Do you have a written policy that mandates a surgical intensivist
consult for all admissions to the SICU?

Your input is much appreciated.

Cathy 

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Surgical Intensivist Consultations