SCC & ACS Curriculum

Rotation Schedule for 1st Year SCC Fellows

Multi-Trauma Critical Care (MTCC)

MTCC is dedicated to the treatment of the most critically ill polytrauma patients, patients with necrotizing soft tissue infections, and patients requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO). The educational experience in the MTCC includes basic and advanced ventilator management, including airway pressure release ventilation (APRV) and proportional pressure support ventilation (PPS), continuous renal replacement therapy (CRRT), and V-V ECMO.

Neurotrauma Critical Care Unit (NTCC)

As the only neurotrauma center for the state of Maryland, NTCC is dedicated to the management of patients with severe traumatic brain and spinal cord injuries. NTCC is managed by a group of faculty with diverse educational backgrounds, which include surgical critical care, neurocritical care intensivists, and neurosurgeons. The educational experience of NTCC is focused on the management of intracranial pressure, intracranial pressure monitors, seizures, stroke, blunt cerebrovascular injury, paroxysmal sympathetic hyperactivity, and high cervical spinal cord injury.

Surgical ICU (SICU)

The SICU at STC manages post-operative patients for acute care surgery, thoracic, vascular, ENT/OMFS, and transplant (liver, kidney, and pancreas) services. The educational experience in the SICU includes management of severe pancreatitis patients in multiorgan system failure, open abdomen patients, complex and open aortic repairs, and liver transplant patients.

Cardiac Surgery ICU (CSICU)

The CSICU will involve the collaborative care of post-operative patients who have undergone interventions for aortic dissections, coronary artery bypass grafting, valve replacements, and heart and lung transplantation. Additionally, during this month you will manage a wide array of mechanical support devices including V-A ECMO, left and right ventricular assist devices (LVADs, RVADs), and Impellas.

Trauma Teams

STC is the busiest trauma center in the state of Maryland, allowing fellows to evaluate and treat the sickest population of trauma patients in our state-of-the-art trauma resuscitation unit (TRU) during their two months on the trauma service. The TRU is made up of 13 dedicated trauma beds managed by trauma nurses, trauma anesthesiologists, the trauma team and our trauma radiologists. The fellow on the Trauma service is responsible for leading the team of residents (surgical and EM). During a busy and exciting month, you are responsible for admitting all trauma patients when on-call, running trauma resuscitations, managing the trauma bays, and overseeing your team in the care of all trauma patients on your service.

Acute Care Emergency Surgery Services (ACES)

The ACES service is a primary center for the management of acute necrotizing pancreatitis in the state of Maryland. First-year fellows are active members of the surgical team on the ACES service. Fellows round with the surgical team, and consult on medically and surgically complex and critically ill patients. Fellows operatively assist in complex emergency general surgery procedures such as necrotizing pancreatitis, pancreatic pseudocysts, complex upper gastrointestinal disease, mesenteric ischemia, abdominal compartment syndrome, open abdomen, and complex abdominal wall hernias. Rotating on the ACES service presents opportunities to collaborate with vascular, thoracic, cardiac, transplant surgery, orthopedics, and urology services.

Echo

Working directly with a skilled ultrasonographer, fellows will learn how to complete a full echocardiographic examination, interpret the data collected, and make recommendations on fluid status and fluid responsiveness. By the end of the rotation, fellows will have a strong foundation of TTE.

Anesthesia

During this rotation, the fellow will be partnered with a group of University of Maryland School of Medicine anesthesiologists to become more familiar with perioperative sedation, analgesia and paralytic medications as deemed appropriate for the clinical situation. Fellows will learn and apply various airway assessment scoring systems, how to maintain an open airway and provide adequate bag-mask ventilation, learn proper airway manipulation and intubation with and without a laryngoscope, and perform alternatives to conventional endotracheal ventilation, such as Bougie-assisted placement.

Fellowship Rotation Elective Options

• Critical Care Resuscitation Unit
• Neurocare ICU
• Johns Hopkins University - Bayview Burn ICU
• Medical or Pediatric ICU
• Trauma Anesthesiology
• Trauma Radiology
• Trauma Endovascular Surgery
• Trauma Infectious Disease
• Interventional Pulmonology
• Soft Tissue Surgery Service
• Emergency Medical Services
• Hyperbaric Medicine