Description

The Medical Intensive Care Unit (MICU) at Yale-New Haven Hospital (YNHH) is regarded as one of the region’s elite ICUs and has developed into a major regional referral center. In March of 2010 the MICU at the York Street Campus moved into its new state of the art facilities on the 9th and 10th floors of the Smilow Cancer Hospital (North Pavilion) which contains 40 MICU beds alongside 15 step-down beds. There are 16 additional MICU beds at the Chapel Street (St. Raphael’s) campus. The MICU admits approximately 5000 patients per year including 500 patients from regional hospitals and is one of the busiest MICU nationwide. The York Street MICU has an average daily census of 36 critically ill patients with a wide range of life-threatening disorders including septic shock, acute respiratory distress syndrome, and acute hepatic failure.

York Street Campus
Four teams cover the MICU, each led by a Pulmonary Critical Care and Sleep Medicine Faculty member working with a team of fellows, residents, and midlevel practitioners. In addition to PCCSM and CCM fellows and Internal Medicine residents, the MICU is a major training site for medical students, as well as residents and fellows from several departments, including Surgery, Emergency Medicine, Obstetrics-Gynecology, Anesthesiology, Neuro-Critical Care, and Interventional Radiology. The faculty lead collaborative work rounds seven days per week and conduct morning teaching conferences on weekdays. Overnight, there are dedicated night intensivists on-site alongside overnight trainees, and patient care is further augmented by our own tele-ICU team.

Chapel Street Campus
At Chapel Street, there are two teams covering the MICU, each led by a Pulmonary Critical Care and Sleep Medicine Faculty member working with a team of fellows (PCCSM and CCM fellows), residents (primary care, EM and prelims), and midlevel practitioners. Similar to the York Street campus, faculty lead collaborative work rounds seven days per week and conduct morning teaching conferences on weekdays. Overnight, there is a night intensivist on-site alongside overnight trainees, and patient care is further augmented by our own tele-ICU team.

State of the Art Care
The MICU employs a variety of protocols to ensure adherence to best practices, including low and high PEEP ARDSnet protocols, a spontaneous awakening and breathing protocol for ventilator weaning, an insulin infusion protocol for management of hyperglycemia and a protocol for management of severe alcohol withdrawal (YAWP: Yale Alcohol Withdrawal Protocol). The MICU offers several advanced therapies, which includes a rapidly growing multidisciplinary ECMO program, operated in conjunction with our cardiothoracic surgical service for refractory ARDS and cardiogenic shock.

The MICU additionally employs point of care ultrasound technology and provides training in bedside echocardiography and ultrasound guidance for a variety of procedures (thoracentesis, paracentesis, vascular access).