CRITICAL CARE MEDICINE

Critical Care Medicine, also known as intensive care unit medicine, is a subspecialty that involves caring for patients with complex, often life-threatening illnesses.  These patients may have varying degrees of organ failure related to any number of diseases, such as severe infections, drug overdoses, gastrointestinal bleeding events, heart attacks, strokes, seizures, or other non-surgical illness.  Critical care physicians also play a supportive role in post-operative patients who require mechanical ventilation or prolonged stays in the intensive care unit.

Our physicians are all board certified in critical care medicine and provide a range of critical care services, including, but not limited to the following:

INTUBATION

This procedure, peformed after sedation is administered, is used to establish mechanical ventilation.  A tube is inserted into the main airway, the trachea to allow positive pressure ventilation.

MANAGEMENT OF MECHANICAL VENTILATION

Mechanical ventilation is indicated for a variety of reasons, including life-threatening decreases in oxygen level, for airway protection in patients with decreased mental status, and in patients who have impaired gas exchange in the lungs.

CENTRAL VENOUS CATHETER PLACEMENT

A central venous catheter is an IV that is placed in a large vein in the neck, upper chest, or groin.  These catheters, placed using sterile techniques under ultrasound guidance, are used to administer fluids and medications and to measure pressures in the blood vessels.

CHEST TUBE PLACEMENT

A chest tube is a small plastic tube inserted into the pleural spaceafter the patient is given adequate anesthesia.  The chest tube is used to drain air or fluid from the pleural space, a potential space between the chest wall and lungs.  Large fluid or air collections in the pleural space can lead to serious medical problems; tube placement allows proper drainage.

FIBEROPTIC BRONCHOSCOPY

Bronchoscopy is a procedure performed after the patient is sedated with IV medications.  Subsequently, a camera at the end of a thin scope is introduced into the lungs, typically via the nose or if the patient is mechanically ventilated, through the breathing tube.  Because the patient is sedated, it is not typically an uncomfortable procedure.  Bronchoscopy can be used to inspect the air pipes for abnormalities.  Bronchoscopy can also be used to sample lung tissue in the evaluation of various diseases.

THORACENTESIS

Thoracentesis is a common procedure to drain fluid out of the pleural space.  This procedure is performed with local anesthesia, also known as a numbing shot.  The pleural space is a potential space between the chest wall and the lungs; fluid can accumulate in this space in a variety of diseases, including heart failure, after a trauma, or with infection.  This procedure is often performed under ultrasound guidance, allowing the pulmonologist to visualize the pocket of fluid before sampling it and enhancing safety.

CRITICAL CONNECTIONS

Tri-State Pulmonary Associates, partnered with The Christ Hospital, offers Critical Connections, an electronic intensive care unit, providing 24 hour critical care coverage to patients in the Intensive Care Units at The Christ Hospital.

This team monitors every aspect of the patient’s condition 24 hours a day, seven days a week.  Vital signs, medications, test results, imaging results and other real-time information is monitored continuously.  Critical Connections physicians and critical care nurses interpret this information and work with the bedside nurses and physicians to enhance care.  Also, computers process the various pieces of patient-generated data, generating alerts to care providers when changes in clinical status are detected.

The Critical Connections nurses and physicians can electronically interact with the patient and staff via 2 way camera connections.

Excellent staff at the patient’s bedside, powerful technology, and board certified critical care physicians with critical care registered nurses in Critical Connections allow us to provide the very best care possible.

CRITICAL CARE TEACHING

While in the intensive care unit, TriState Pulmonary doctors supervise and teach resident physicians.