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THE UNIT: The Official Newsletter of the ACEP Critical Care Section - Winter 2017

Intubation During RV Failure, A New Model for Critical Care, NCC Certification & Fellowship


Tips and Tricks: Intubation in Right Heart Failure

Susan Wilcox 2016

01 - Figure 1, Tips and Tricks_V2Emergency intubation is a high-risk procedure in all circumstances, but intubation of patients with right ventricle (RV) heart failure can be especially perilous. Due to its weaker structure, the RV is particularly sensitive to increases in afterload, and an RV in failure may be unable to compensate any further once afterload is increased by hypoxia, hypercarbia, atelectasis after intubation or over-distention with ventilation.1,2

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The First Pathway for Emergency Physician Certification in Critical Care: Neurocritical Care

1Departments of Emergency Medicine, Neurology, Neurosurgery, and Medicine, University of Rochester, Rochester, NY, 2Departments of Emergency Medicine and Neurosurgery, University of New Mexico, Albuquerque, NM, 3Departments of Emergency Medicine, Neurology, and Neurosurgery, University of Cincinnati, Cincinnati, OH   

 Chris Zammit_2017Rob Alunday_2017_v3 Jordan.Bonomo_2017

In 2006, Neurocritical Care (NCC) became a certified subspecialty in the United States via its adoption by the United Council of Neurological Subspecialties (UCNS). This included the establishment of a certified fellowship pathway for graduates of residencies in neurology, neurosurgery, emergency medicine, anesthesiology, surgery, and internal medicine, cementing NCC as the first multi-disciplinary pathway to certification in critical care. 

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Board Certification Dates

RaghuSeethala2015For candidates seeking an upcoming board exam, click 'Read More' for the application deadlines.

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Toward a New Model of Critical Care Change: the Emergency Medicine Critical Care Employment Initiative

NickMohrStarting this year, the ACEP Critical Care Medicine Section is partnering with the Emergency Medicine Section of the Society of Critical Care Medicine (SCCM) and the Critical Care Medicine Section of the American Academy of Emergency Medicine (AAEM) to jointly sponsor the Emergency Medicine – Critical Care Employment Initiative. Announced at Scientific Assembly 2016, this initiative was designed to address the growing number of critical care fellowship graduates who are looking for diverse employment options in the critical care workforce, especially in community-based private practice. As critical care has matured in emergency medicine, so have the needs of the critical care community, and this is one initiative targeting those among us who have completed critical care fellowship training. 

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George Washington University Medical Center Critical Care Medicine Fellowship

Specialty certification pathway: Internal Medicine
Length of fellowship: 2 years
Number of fellows: 5 


Schedule: The fellow’s schedule alternates between 2 weeks on service in ICU and then 2 weeks on either elective or vacation. While on ICU service, the 2-week rotation is comprised of 1 week of days and 1 week of nights.

Which ICU’s fellows rotate through? 
Multidisciplinary mixed medical/surgical unit
Cardiothoracic intensive care unit

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