The Division of Critical Care strives to optimize outcomes for critically ill patients through multidisciplinary education, collaborative research, cutting-edge clinical service lines, and integration of patient care across the prehospital setting, the emergency department and intensive care units.
- Improve the care of patients in the first minutes to hours of their critical illness
- Improve the care of patients boarding in the emergency department (ED) who are awaiting an inpatient ICU bed
- Leverage knowledge and connections of the emergency medicine-critical care team toward high-impact ED and system-wide critical care initiatives
- Educate emergency medicine residents, advanced practice providers, and physicians about state-of-the-art critical care as relevant to care in the ED
- Educate inpatient intensivists on the value of prehospital and emergency care
Broad Footprint & Faculty
The Department of Emergency Medicine has several dually boarded faculty who staff the ED as well as the Medical ICU, Cardiothoracic ICU, Neuro ICU, Surgical ICU, eICU, Palliative Medicine, and Critical Care Transport (Med Flight). Graduates of our emergency medicine residency program have matriculated to highly competitive critical care fellowships, and multiple current residents are on a critical care fellowship trajectory. Additionally, our high-functioning advanced practice providers have recently taken a role in our Medical ICU.
Extracorporeal Cardiopulmonary Resuscitation
Extracorporeal cardiopulmonary resuscitation (ECPR) holds promise to improve outcomes for out-of-hospital cardiac arrest (OHCA) but requires careful patient selection, timely application, and rigorous quality assurance to be effective. UW is one of the few academic emergency departments in the nation providing this life- and brain-saving technology.
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Established in 2019, the UW ECPR program has been tremendously successful—the neurologically intact survival rate for out-of-hospital cardiac arrest (OHCA) victims receiving ECPR at UW is 36.3%, compared to the national average of 8.1% for conventional CPR (CCPR).
In 2020, UW was awarded the prestigious ELSO Center of Excellence Gold Award.
Emergency Airway Management
The DEM approach to emergency and difficult airways is robust and emulated throughout the institution. This includes novel standardized “call & response” checklists, sophisticated technology, and advanced techniques including awake fiberoptic intubation and proficient surgical airway placement. Dr. Michael Steuerwald, Director of Emergency Airway, is nationally recognized for his approach to prehospital and ED airway management, and our lead for education and innovation. As a result, our trainees not only become technical experts, but also well-equipped to replicate and implement these standardized advanced approaches in their future institutions.
Additional Ongoing Initiatives
The Division of Critical Care liaises closely with operational, analytics, and research teams at both the department and institutional level. As a result, we are able to efficiently effect change for the betterment of our patients. Importantly, our residents are involved in all Division initiatives, thereby ensuring academic productivity.
eCART Implementation and Recalibration
eCART implementation and recalibration – leveraging validated predictive analytics to spot early patient deterioration and to help inform efficient and safe patient dispositions.
ED Extubation Protocol
ED extubation protocol – Aimed at identifying and facilitating potential safe extubations thereby ensuring ICU beds are available for critically ill patients in the region.
Pain, Agitation, Delirium (PAD) Protocol
Pain, Agitation, Delirium (PAD) Protocol in the ED – Prioritizes analgesia-first and monitored sedation for intubated patients thereby reducing ventilator-days, ICU LOS, and mortality.
Resuscitation Blood Gas (RBG)
Resuscitation Blood Gas (RBG) – Point-of-care speed for high-impact labs while preserving a centralized lab infrastructure.