Critical Care Anesthesia
Bellevue is the flagship hospital for the New York City public hospital system. It is a level I Trauma Center, a brain and spinal cord injury center, and a limb re-implantation center, with a large base of critically ill patients. The Department of Anesthesiology shares responsibility with the Department of Surgery for the care of all Bellevue Hospital patients on the closed Surgical ICU team. We see a wide variety of trauma, general surgical, thoracic, neurosurgical, vascular and cardiac surgical patients. At Bellevue Hospital, this amounts to an average of 3,000 patient visits per year.
Clinical responsibilities include daily morning attending rounds, work rounds, procedure supervision, didactic teaching and topical reviews, case presentations, and discussions and research. Staffing is provided by anesthesiology residents, critical care fellows and board certified critical care attendings from the departments of anesthesiology and surgery.
The Trauma Anesthesia and Critical Care (TRACC) service at Bellevue Hospital was established in 1994. The critical care physician is integrally involved in the perioperative care of these patients when they become critically ill. In addition, the TRACC resident is a consultant to the trauma response team, as well as to the hospital cardiac arrest team. The TRACC resident is available to the ER for trauma alerts and may participate in patient evaluation and management, particularly regarding trauma anesthesia for the operating room, as well as complex airway, sedation, pain management, and resuscitation issues. In the Bellevue Surgical ICU, the TRACC service works closely with the primary services to determine and carry out the plan for patient management.
Tisch Hospital is a University Hospital with a large referral base where the resident experiences both the common ICU problems, as well as the unusual and complex ICU patient. At Tisch Hospital, all surgical, cardiovascular and medical ICU patients are managed or co-managed by a multidisciplinary critical care team. Staffing is provided by anesthesiology, medicine and surgical residents, critical care fellows from the departments of anesthesiology and medicine, and attendings of the critical care faculty group practice, which consists of board certified critical care attendings from the departments of anesthesiology, medicine, and surgery.
Anesthesiology critical care faculty include Dr. David Roccaforte, Co-Director of the Surgical ICU at Bellevue Hospital and Anesthesia-Critical Care program director, Dr. Martin Griffel, Director of the Cardiovascular Surgery ICU at Tisch Hospital and Dr. Edwin Weeks.