Ccu, Micu, Sicu

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You are using an out of date browser. It may not display this or other websites correctly.You should upgrade or use an alternative browser. ccu, micu, sicu

• Thread starter Thread starter gassazz
• Start date Start date Jan 29, 2004

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you. G

gassazz

New Member

15+ Year Member Joined Nov 2, 2003 Messages 1 Reaction score 0 Points 0 Members do not see this ad. i'm a medical student going to begin their core rotations and have some interest in critical care. 1)I was wondering what the difference with ccu, micu, and sicu. Like what kind of patients are in each unit and when a patient ends up there. Plus I heard different doctors staffs each kind of unit. 2) So can a surgeon or anesthesiologist who is a critcal care specialist take care of a patient who is in the micu, 3) or vice versa, as in, can medicine with critical care training, see patients in the sicu? 4)and who takes care of ccu patients? 5) and the meaning of a closed or open unit?

ckent

Membership Revoked

Removed 15+ Year Member 20+ Year Member Joined Jul 31, 2000 Messages 2,138 Reaction score 3 Points 4,571 Location Smallville/Metropolis Website www.supermanhomepage.com Wow, those are a lot of questions. I will try and answer your question, and someone can correct me if I'm incorrect because my knowledge of SICU's is limited and I don't have my MICU rotation until May. 1. CCU: Coronary Care Unit: Intensive care unit for cardiac patients. These patients are frequently MI patients, but they can present with a wide variety of cardiac problems including pacemaker problems, arrhythmias, etc. MICU: Medical intensive care unit: These patients may have surgical issues that arise, but their primary problem is a medical problem SICU: Surgical intensive care unit: These patients are either post-op or have surgical issues that need to be managed 2+3. Critical care specialists are trained with a critical care fellowship are mainly trained for the MICU setting. You will find anesthesiologists who work in both the SICU and MICU setting, but for the most part, it's pulmonologists and other critical care physicians in the MICU while surgeons attend the SICUs. 4. Cardiologists and cardiothoracic surgeons attend the CCU's. 5. Open unit: Different floor teams will take care of patients in intensive care floors. Meaning that your patients may be on the general medicine floor, plus you may also be taking care of 1-2 patients in the MICU Closed Unit: A designated team takes care of all of the intensive care patients. Once your patient is transferred to the intensive care setting, you stop following the patient. This is the way that it is done at most major academic centers, with a few exceptions. B

Bobblehead

Senior Member

Verified Member Physician 20+ Year Member Joined Nov 30, 2003 Messages 849 Reaction score 330 Points 4,966

1. Attending Physician

The above post hits most of the highlights. The MICU at an academic institution is generally staffed by pulmonary/critical care specialists. While some of the other medicine subspecialities are starting to dabble in critical care (renal, ID, etc.) most critical care is via pulmonary. At an academic institution it usually goes surgery floor to SICU, medicine floor to MICU. Regarding admission criteria there are a lot of varying criteria. At our institution we have patients on general medicine floors who would be in an "ICU" in a community hospital while our ICUs are generally reserved for the sickest of our sick patients. Admissions can either be handled by a senior resident, pulmonary fellow/attending or in some instances the charge nurse (imo this is the worst set-up as they're even more likely to refuse admissions than doctors). What sends a patient to the ICU? It can be as simple as requiring respiratory distress requiring intubation, pacing, vasopressor support, unstable GI bleeding (again, our institutional bias and acuity level has us managing a lot of 'stable' GI bleeders on the floor where they'd be in an ICU at a community hospital), acute MI with hemodynamic instability, etc. Occasionally you'll end up putting someone in the ICU for a sense of impending doom (i.e. clinical judgment) although nothing may very well happen to them.

Seaglass

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15+ Year Member 20+ Year Member Joined Jul 25, 2003 Messages 1,614 Reaction score 6 Points 4,571 Age 47 Location Winston Salem, NC

1. Attending Physician

Agree with most of the above. Just some more/different info: 1. CCU - used to have the sickest/most likely to die ASAP patients but with current advances in MI care I haven't seen many MI patients die while I was in the unit, mostly myops. Usually managed by cardiologists. MICU - the sick ones who die. Leukemia/sepsis, etc. Usually managed by critical care pulmonologists. SICU - in our institution the SICU team is a consult team run by critical care pulmonologists. We do have critical care (CC) fellowship trained surgeons here but they would rather be operating. Patients are somewhere between MICU and CCU in acutiy IMHO. 2-4. As a CC trained pulmonologist or anesthesiologist you can work pretty much anywhere since the biggest issues in the unit setting are often multiple meds/pressors/ventilation, all areas both specialties are extensively trained in. IMHO CC surgeons work best in the SICU. Of course cardiologists do best in the CCU. 5. In addition to what was said above there are semi-closed units. In our MICU any medicine or med subspecialty patients go to pulm/CC, but neuro, cards, and occasionally GI can admit patients. In all cases the MICU resident team manages daily care or all patients in the unit. As I mentioned before, the SICU here is an open unit and the SICU team is a consult team. Casey Z

zambezi

Junior Member

7+ Year Member 15+ Year Member 20+ Year Member Joined Jun 14, 2003 Messages 23 Reaction score 0 Points 0 Age 47 Location Oregon In the hospital that I work in as an RN, we have a CCU and and ICU. Our ICU is medical and surgical (all systems except primarily cardiovascular) and the CCU covers any cardiovascular patient--cv surgery/post cardiac intervention/ r/o or post mi/decompensating chf...etc. In some hopsitals, you will find all kinds of ICUs--Trauma/CV/Surgical/Medical/Neuro... In our CCU, the primary docs are the cardiothoracic surgeons and cardiologists. Pulmos and renal docs consult if we have a post op cv surg we can't extubate or start CRRT... In the ICU primarily pulmos, neurosurg, trauma surgeons. Often renal docs or neuro consult. Anesthesia also has privilages in both units. Our units seem to be semi-closed (or open?) I am not sure how one goes about obtaining privilages to round in the units, but I do know that some family practice docs or other various specialties have privilages to admit and round, while others do not. You must log in or register to reply here. Share: Facebook X Bluesky LinkedIn Reddit Pinterest Tumblr WhatsApp E-mail Share Link

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