The CCMD provides the following clinical services:
Intensive Care Unit (ICU)
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| Morning rounds provide opportunities for teaching and interdisciplinary care. At NIH, referring teams are encouraged to join rounds so that information about underlying diseases and prior history is fully integrated into the care plan. |
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The Intensive Care Unit (ICU) at the NIH is located on the third floor of the Mark O. Hatfield NIH Clinical Center. This is a 12-bed Medical/Surgical ICU with an adjoining 6-bed intermediate care unit. The unit can provide hemodynamic monitoring, diagnostic ultrasound, ventilatory, renal replacement, and cardiovascular support. In addition, all medical patients and some surgical patients with predominantly medical problems are cared for by Critical Care Medicine Department (CCMD) senior physicians and medical fellows.
The ICU team physicians, nurses, respiratory therapists, and a pharmacist, nutritionist, and social worker dedicated to the management of CCMD patients. The department also provides a diagnostic pulmonary service for patients with bronchoscopy and elective pulmonary artery catheterization. The CCMD accepts patients from any service within the Clinical Center. Admission of patients for CCMD care can be requested by contacting the CCMD physician on-call via the page operator or by calling (301) 451-0567.
Code Team
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| Afternoon rounds are essential for effective patient handoffs to the evening team. These rounds are also important to assure that the entire ICU staff has input into the management plan. |
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"Code Blue" procedures a have been established to obtain emergency medical assistance for patients, visitors, and employees. The code team serves as a mobile emergency response team, rendering lifesaving first aid, and making appropriate referrals to any needed services including outside facilities. The Critical Care Medicine Department (CCMD) fellow serves as the team leader.Other members of the code team include the surgery oncology fellow, two intensive care nurses, two respiratory therapists, and the CCMD attending physician. The team responds typically to respiratory and cardiac arrests, anaphylaxis, respiratory distress, severe seizures, and hypotensive/ syncopal episodes.
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| A cadre of strong nurse practitioners supports the physician team. |
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A Rapid Response Team (RRT) had been established to obtain early access to critical care consultation for any inpatient or outpatient if their condition appears to be deteriorating. This service is provided to improve recognition and response to a change in patient condition and to enhance a culture of safety for the patient. The RRT team consists of the CCMD fellow and the ICU charge nurse. The patient's physician, nurse, or respiratory therapist may call for this assistance whenever needed. Patients and families may also use the service when requested through their health care provider.
Procedures, Vascular Access, and Conscious Sedation (PVCS) Services
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| Faculty work closely with fellows to manage patients who often have complex underlying pathology. |
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The Procedures, Vascular Access, and Conscious Sedation (PVCS) Services are staffed by critical care fellows and the Nursing Service and provides temporary vascular catheters to those patients requiring continuous vascular access for long periods of time.
The service places multilumen jugular, subclavian, and femoral vascular catheters as well as peripherally inserted central catheters. All catheters are placed using ultrasound guidance. This service also provides conscious sedation when necessary for procedures such as vascular access, bronchoscopy, and bone marrow biopsies.
Patient care providers may call (301) 451-0336 to make an appointment for their patients to have catheters placed.
Critical Care Therapy and Respiratory Care Section (CCTRCS)
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| Respiratory therapists are involved in cutting edge technologies and therapies, including investigations of the efficacy of nitric oxide. |
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The Critical Care Therapy and Respiratory Care Section (CCTRCS) was established, with specially cross-trained respiratory therapists, to provide respiratory critical care and essential support to accomplish specific therapeutic goals.
In 1999, the CCTRCS expanded its staff and clinical services to support all areas of the Clinical Center.
In addition to our patient care responsibilities, the CCTRCS provides monthly Basic Cardiac Life Support recertification classes to all allied healthcare personnel and has developed a weekly lecture series to foster continued professional growth and development of our staff.
Critical Care Nurse Practitioners
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| Staff review images each morning as a team to enhance patient care and training. |
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The critical care nurse practitioners provide care to critically ill patients and their families. The nurse practitioners provide this highly skilled care in close collaboration with the critical care physicians, critical care respiratory therapists, and other members of the multidisciplinary health care team.
The scope of practice for critical care nurse practitioners encompasses patients of all ages, from infancy through adulthood, with a variety of potentially life-threatening problems. These nurse practitioners provide care for patients on protocols from any of the institutes of the NIH through complex and vigilant assessment and interventions.
Although the patient population is widely variable, the nurse practitioners are particularly skilled in caring for immunosuppressed patients with life-threatening infections and/or respiratory failure and for patients requiring continuous renal replacement therapy for acute renal failure.