University of Alberta
Division of Critical Care Medicine
Adult Critical Care Medicine Resident Training Program
CARDIOVASCULAR ICU ELECTIVE ROTATION
The rotation occurs in the Cardiovascular ICU at the University Hospital. The 19 bed unit uses a semi-closed medical model and is staffed by Intensivists and Advanced Nurse
Practitioners. Cardiac surgery residents provide night time and weekend coverage. The unit provides care for more than 1400 cardiac surgery cases per year.
EDUCATIONAL OBJECTIVES
Medical Expert / Clinical Decision Maker
Knowledge Base:
Coronary Artery Bypass Surgery

Understand indications for cardiac surgery and interpretation of cardiovascular data

Differences between on and off pump surgery

Understand the differences between arterial and venous revascularization
Diseases of the Aortic, Mitral, Tricuspid and Pulmonary Valves

Understand pathophysiology, surgical options and management of valvular heart disease
Diseases of the Aorta
 Management of aortic dissection, aortic arch and descending thoracic aortic surgery
Cardiac Anesthesia
 Understand preoperative assessment of the cardiac surgical patient
 Understand etiology and treatment of perioperative cardiac arrhythmias
 Hemodynamic monitoring and its’ indications
 Principles of transesophageal echocardiography
 Effects of inhalation anesthetics on systemic hemodynamics & coronary circulation
 Understand use of opioids in cardiac anesthesia
 Cardiopulmonary bypass and its’ implications
 Management of coagulation and bleeding disorders
 Extracorporeal devices, intraaortic balloons, and related technologies
 Myocardial protection during cardiopulmonary bypass
Postoperative Management of the Cardiac Surgical Patient
 Initial assessment and management and the stabilization phase (first 4 hours)
 Weaning phase and postextubation phase, and difficult to wean patient
 Management strategies for hypotension and hypertension
 Electrocardiograph monitoring and interpretation
 Management strategies for dysrhythmias
 Common infections
 Management of oliguria and acute renal failure in cardiac surgical patients
 Neurocognitive deficits, their etiology and management options
 Hyperglycemia and management in cardiac surgical patient
 Fast-track recovery following cardiac surgery
 Guidelines, indications, and treatment options for transfusion following cardiac surgery

University of Alberta
Division of Critical Care Medicine
Adult Critical Care Medicine Resident Training Program
Transplantation
 Understand transplant immunology and the use of immunosuppressive agents in solid organ transplantation
 Specific critical care problems in heart, heart-lung, and lung transplant recipients
 Diagnosis and treatment of rejection and infection in transplant recipients
Psychiatric Issues in the Cardiac Surgical Patient
 Diagnosis and treatment of anxiety, depression agitation and delirium
Skills

Hemodynamic monitoring and management of postoperative cardiac surgery patient

Postoperative management of the heart, lung, heart-lung transplant patient

Intra - aortic balloon pump management

Cardioversion

Temporary pacemakers

Chest tube insertion

Extra corporeal devices

Fiberoptic bronchoscopy
Communicator/Collaborator a.
Communicate effectively with:

Patients and families

Health care personnel in the cardiovascular ICU and wards

Medical staff (Cardiac Surgeons) and consulting services b.
Prepare accurate and legible documentation c.
Function effectively in a team environment in the Cardiovascular ICU
Manager a.
Use health care resources (cost) effectively b.
Sets realistic priorities c.
Use time effectively
Health Advocate a.
Intervene on behalf of patients with respect to their care b.
Recognize and respond appropriately in situations with regard to patient safety
Scholar a.
Assess & critically appraise health & medical information b.
Use information effectively in clinical decision-making

University of Alberta
Division of Critical Care Medicine
Adult Critical Care Medicine Resident Training Program
July 2008
Professional a.
Demonstrate integrity, honesty, compassion and respect for diversity b.
Fulfill medical, legal & professional obligations of the specialist c.
Demonstrate reliability and conscientiousness d.
Understand the principles of bioethics and apply these in clinical situations e.
Have awareness of personal limitations and seek advice when necessary f.
Assess own performance and have insight into attaining professional standards

University of Alberta
Division of Critical Care Medicine
Adult Critical Care Medicine Resident Training Program
IN-TRAINING EVALUATION REPORT
Name of Resident:
Hospital:
EXPECTATIONS: (for rotation/level of training)
Program Director: Dr. Darren Hudson
Rotation: Cardiovascular ICU
Period: to __________
A. MEDICAL EXPERT a) basic science knowledge b) clinical knowledge c) selects appropriate monitoring d) recognition and management of emergency situations
B. COMMUNICATOR a) communicates effectively with patients, families & health care workers b) prepares documentation that is accurate and legible
C. COLLABORATOR a) consults and delegates effectively b) functions effectively in a team environment
D. MANAGER a) makes cost effective use of health care resources based on sound judgement b) sets realistic priorities and uses time effectively to optimize performance
E. HEALTH ADVOCATE a) intervenes on behalf of patients with respect to their care b) recognizes & responds appropriately in situations with regard to patient safety
F. SCHOLAR a) develops & implements an ongoing and effective personal learning strategy b) assesses & critically appraises health & medical information c) uses information effectively in clinical decision-making d) teaches effectively in clinical environment
G. PROFESSIONAL a) demonstrates integrity, honesty, compassion and respect for diversity b) fulfills medical, legal & professional obligations of the specialist c) demonstrates reliability and conscientiousness d) understands principles of bioethics and applies these in clinical situations e) is aware of personal limitations and seeks advice when necessary f) assesses own performance and has insight into attaining professional standards
H. PROCEDURAL AND TECHNICAL SKILLS Cardiovascular ICU a) Intra aortic balloon pump management b) Temporary pacing c) Hemodynamic monitoring and management d) Cardioversion e) Chest tube insertion f) Fiberoptic bronchoscopy g)
Comments: (your comments especially relating to ratings 0, 1 and 4 are specifically requested).
0 1 2 3 4

University of Alberta
Division of Critical Care Medicine
Adult Critical Care Medicine Resident Training Program
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