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Intensivist: Providing a Critical Care Pathway


Definition & Overview

Critical care medicine, also known as intensive care medicine is a study of medicine concerned with the diagnosis and treatment of life-threatening conditions. These conditions require intensive life support and monitoring. Patients that require constant attention from an Intensivist usually suffer from cardiovascular instability (hypertension/hypotension), cardiac arrhythmias, airway or respiratory compromises such as ventilator support, acute renal failure, or multiple organ failure; also known as multiple organ dysfunction syndromes. Patients are also transferred to intensive care units (monitored by Intensivists) after critical surgery when deemed too unstable to transfer to a less monitored unit.

Who is an Intensivist?

Intensivist is a medical specialist trained and deemed to be proficient in the comprehensive clinical management of critically ill patients. an Intensivist has intensive care skills that include the ability to recognize and manage severe medical disturbances like surgical, obstetric, and pediatric illness. He/she is also responsible to diagnose and treat the conditions that caused them. This usually involves invasive and non-invasive diagnostic techniques, monitoring, and treatment modalities designed to support vital organs of the patient.

What does an Intensivist Do?

Intensivists provide a full range of specialty-specific services, including crisis management, after-care of high-risk surgical patients, advanced cardiovascular monitoring, mechanical circulatory support, and tracheostomies. They treat people experiencing extreme conditions including multiorgan failure, sepsis, respiratory failure, central nervous system breakdown, and cardiac failure.

What are the Diseases treated by an Intensivist?

  • Acute kidney injury
  • Acute liver failure
  • Acute respiratory failure
  • ARDS (Acute respiratory distress syndrome)
  • Cardiogenic shock
  • Cerebral edema
  • Congenital metabolic disorder
  • Drug overdose
  • Electrolyte imbalance
  • Heart failure
  • Intracranial hemorrhage
  • Metabolic disorder
  • Multiple organ failure
  • Pneumonia
  • Pulmonary embolism
  • Bacterial Sepsis
  • Shock
  • Polytrauma
  • Stroke

What are the common Procedures Performed by an Intensivist?

  • Airway management
  • Central Venous Access
  • Intercostal drainage and management of ICD (intercostal drainage tube)
  • Continuous renal replacement therapy
  • Cardiopulmonary resuscitation (CPR)
  • Bronchoscopy
  • Extra Corporeal Membrane Oxygenator (Artificial Lung)
  • Hemodialysis catheter insertion
  • Hemodynamic monitoring
  • Intra-aortic balloon pump therapy
  • Mechanical ventilation
  • Peritoneal Tapping / Ascitic tapping/ Abdominal Paracentesis
  • Postoperative care
  • Pulmonary artery catheterisation
  • Temporary Pacemaker Implantation
  • Thoracentesis
  • Open surgical tracheostomy
  • Percutaneous dilatational tracheostomy
  • Transcranial Doppler test
  • Transesophageal echocardiography
  • Transthoracic echocardiography

What Education and Training is Required to Become a Certified Intensivist?

To become an Intensivist, a doctor must undergo five & a half years of training in M.B.B.S. from medical college. After graduation, they have to take a post-graduation course in internal medicine, respiratory medicine, or anesthesiology for three years, which is followed by either a super specialization degree in critical care medicine or a fellowship course in critical care medicine.