Vital Times 2021 - 33

CA-1 Residents enjoying a lunch break and beautiful weather in
sunny Southern California.
educational need within the sponsoring institution, Los
Angeles County Harbor-UCLA Medical Center, while
providing critical care expertise in the Neurosurgical
ICU, as the primary team admitting and caring for these
patients. Our residents have been the beneficiaries of this
new learning environment. The program developed many
learning opportunities, such as:
* Hemodynamic optimization and monitoring
* Airway management and laryngoscopy
* Insertion and management of invasive monitors
* Cardioversion
* Percutaneous cricothyroidotomy/tracheostomy
* Thoracostomy tube insertion
* Management of ICP monitors
Our critical care faculty have been a welcomed addition
to resident education, since all are ABA board certified in
that subspecialty. Moreover, faculty meet the eligibility
requirement for a newly recognized ABA certification,
the neurocritical care subspecialty. Because of the vast
scope of the field, neurocritical care is a multidisciplinary
subspecialty that is devoted to the comprehensive
multisystem care of critically ill patients with neurological
diseases and conditions. As such, residents benefit from
training with faculty with expertise in neurocritical care.
New Equipment
In academic year 2020-21, our department procured
new ultrasound machines and airway equipment.
New Sonosite EDGE (23 total) and X-Porte (3 total)
Residents and fellows all together during a lunch break from
the operating room.
ultrasounds replaced outdated models. These
machines are in every OR and anesthetizing location.
Ubiquity affords ample opportunity to perform pointof-care
ultrasound (POCUS) for both diagnostic and
interventional procedures. Residents will meet recent
ACGME requirements for competency in surface
ultrasound of heart and lung and procedural guidance
for vascular access and regional procedures. Moreover,
POCUS prepares residents for the new 2022 APPLIED
exam expectations to perform ultrasound images of the
heart and lungs. Faculty with both expertise and board
certification in ultrasound use by the NBE provide the
supervision and oversight for the POCUS curriculum.
New airway equipment also replaced outdated systems.
The department procured 25 video GlideScopes with
an all-in-one system to include video bronchoscopes
for training in visualization of the airway and
tracheobronchial tree. Various sizes of bronchoscopes
provide a broad spectrum of airway management
techniques to include lung isolation with double lumen
endotracheal tube placement, endobronchial blockers,
and airway intervention. During the COVID pandemic,
intubation guidelines at many institutions recommended
these systems to be used as a first line for all patients,
given the proven benefits of improved laryngeal view,
improved first pass success rate, and lower incidence for
external laryngeal manipulation. These benefits became
increasingly relevant and valued when our trainees
dealt with COVID-19 patients, where intubation poses
a high risk of transmission when they were involved in
the airway management procedures and where time to
secure the airway is critical.
Annual Publication 2021 | 33

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