The Yale NeuroICU is a 19-bed ICU. Fellows rotate on teams during day and night to provide 24/7 coverage and management to the spectrum of neurology and neurosurgical patients.
- Team 1 : This fellow rounds on the 14 dedicated NICU beds in SP6-2 with one neurointensivist, 1-2 advanced practice providers, and 1-2 neurology or neurosurgery residents.
- Team 2: This fellow is typically from vascular neurology, pulmonary critical care medicine, or surgical ICU and provides an opportunity for cross-pollination between specialties. The team 2 fellow manages the five dedicated NICU beds on SP7-1 and all outliers, including consults.
- Day Float: This fellow primarily handles triage of new patients in the emergency room or decompensating patients on the floor teams who need escalation to the NICU. This fellow works closely with the Team 2 fellow and attending and primarily manages cardiac arrest consults.
- Night Float: This fellow covers all NICU patients with the support of two advanced practice providers.
The core neurocritical care rotations provide comprehensive training in management of patients with a wide spectrum of severe brain, spine, and peripheral nervous system injuries and diseases. These include traumatic brain injury, cerebrovascular diseases, status epilepticus, neuromuscular emergencies, brain tumors, and infectious autoimmune diseases.
Vascular Neurology (2-4 weeks/year):
During this rotation, the fellow works closely with the acute stroke attending physicians and residents for acute stroke cases that need to be evaluated for acute intervention. Fellows also receive training in telestroke and telemedicine.
Neuroanesthesia and Airway Management (4 weeks/year):
Fellows rotate through the Yale New Haven Hospital Anesthesia Department under the supervision of a dedicated neuroanesthesiologist. Skills include bag-mask ventilation, endotracheal intubation, laryngeal mask airway placement and airway management.
Medical Intensive Care (2-4 weeks):
Our fellows serve as the primary Medical ICU fellows for a team of two residents and one APP. They are supervised by a Pulmonary Critical Care attending physician.
Surgical Intensive Care (2 weeks):
Fellows rotate through the Trauma Surgical ICU, supervised by the Surgical Critical Care or Anesthesia attending physician.
Point-of-Care Ultrasound Education:
Fellows rotate in the Emergency Department, scanning patients under the direct supervision of our ED faculty trained in ultrasonography.
Independent Elective/Selective Time (10-14 weeks):
- Independent research with faculty mentorship
- Additional selective experience rotations
- Critical Care EEG monitoring
- Interventional Pulmonary Medicine
- Interventional Neuroradiology
- Cardiac Intensive Care Unit (CICU)
- Cardiothoracic Intensive Care Unit (CTICU)
- Transcranial doppler ultrasonography
- Longitudinal general ultrasound training with hands-on workshops and didactics
- Arterial and venous access training, including use of advanced hemodynamic monitoring
- Simulation training for code management, brain death assessment and airway skills
- Hands-on workshops and didactics in emergency airway management
- Advanced invasive and noninvasive neuromonitoring training, including placement of quadruple lumen bolt monitoring to assess ICP, brain tissue oxygen, cerebral microdialysis and intracranial electrocorticography
- EVD management across a wide spectrum of disease states, including use of IT-tPA and IT-nicardipine
- ENLS and ATLS certification