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Critical Care Medicine

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Welcome to the Division of Critical Care Medicine. Formed in 2023, our vision is to advance care of critically ill patients within the Department of Emergency Medicine through innovative research, world class clinical care, and training the next generation of physicians. Division faculty attend in the Emergency Departments at UC San Diego, Rady’s Children Hospital, and El Centro Regional Medical Center, as well as our Medical, Surgical and Cardiothoracic Intensive Care Units. Faculty hold leadership positions within UC San Diego Health and on various regional and national committees. Our division prides itself on performing NIH-funded research to ultimately improve patient-centered outcomes of critically ill patients along their continuum of care from the ED to the ICU to post-discharge care. We offer a variety of fellowship training programs through collaborations with our colleagues in Anesthesia Critical Care and Pulmonary, Critical Care and Sleep Medicine as detailed below. The Division is strongly committed to achieving equity, diversity, and inclusion in all clinical, educational, and research activities. Please find our mission statement below and explore our website - and do not hesitate to contact us about any questions or potential collaborative endeavors.

Mission

The mission of the Division of Critical Care Medicine is to provide outstanding care to critically ill patients throughout their continuum of care from the Emergency Department to the ICU by: 
 
  • Providing world-class bedside care to critically ill patients from the ED to the ICUs in an equitable and just fashion. 
  • Advancing the care of critically ill patients through meaningful and innovative research to improve patient-centered outcomes. 
  • Educating medical students, residents, fellows and faculty on topics necessary to provide exceptional care to critically ill patients. 

Research Activities:

The Division of Critical Care is active in many domains. Faculty have received funding from the National Institutes of Health, the Gordon and Betty Moore Foundation, and the National Foundation of Emergency Medicine to investigate several topics, including sepsis, cardiac arrest, mechanical ventilation, and machine-learning approaches in critically ill patients. Faculty are actively involved in the SIREN network to help improve outcomes of patients with cardiac arrest as well as the DISCOVERY Network within the Society for Critical Care Medicine to improve sepsis care. Pursuit of original research in high-impact domains is a major initiative of the Division, as is a focus on mentoring and training the next generation of physician-scientists. We maintain robust collaborative efforts with the Division of Pulmonary, Critical Care, and Sleep Medicine, the Division of Anesthesia Critical Care, and the Division of Neurocritical Care within UC San Diego. Highlighted publications are listed below:

  • Boussina, A., Shashikumar, S.P., Malhotra, A... Wardi G. Impact of a deep learning sepsis prediction model on quality of care and survival. npj Digit. Med. 7, 14 (2024). https://doi.org/10.1038/s41746-023-00986-6 
  • Wardi G, Owens R, Josef C, Malhotra A, Longhurst C, Nemati S. Bringing the Promise of Artificial Intelligence to Critical Care: What the Experience With Sepsis Analytics Can Teach Us. Crit Care Med. 2023 Aug.
  • Self M, Kennis B, Lafree A, Tainter CR, Lopez J, Malhotra A, Chan T, Wardi G. Disparities Exist in the Application of Low Tidal-volume Ventilation in the Emergency Department. West J Emerg Med. 2023
  • Sobel J, Hayden SR, Wardi G. The Knowledge Gap: Mentorship in Emergency Medicine Residency. Ann Emerg Med. 2023 Jul
  • Pokrajac N, Sbiroli E, Hollenbach KA, Kohn MA, Contreras E, Murray M. Risk Factors for Peri-intubation Cardiac Arrest in a Pediatric Emergency Department. Pediatr Emerg Care. 2022 Jan 1.
  • Wardi G, Carlile M, Holder A, Shashikumar S, Hayden SR, Nemati S. Predicting Progression to Septic Shock in the Emergency Department Using an Externally Generalizable Machine-Learning Algorithm. Ann Emerg Med. 2021.
  • Shashikumar SP, Wardi G, Malhotra A, Nemati S. Artificial intelligence sepsis prediction algorithm learns to say "I don't know". NPJ Digit Med. 2021 
  • Shashikumar SP, Wardi G, Paul P, Carlile M, Brenner LN, Hibbert KA, North CM, Mukerji SS, Robbins GK, Shao YP, Westover MB, Nemati S, Malhotra A. Development and Prospective Validation of a Deep Learning Algorithm for Predicting Need for Mechanical Ventilation. Chest. 2021.

Research Collaborations:

 

Educational Activities

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Fellowships

UC San Diego offers various approaches to critical care fellowships for emergency medicine applicants. The Division of Anesthesia Critical Care offers a fellowship spot each year to a qualified EM applicant. The Division of Pulmonary, Critical Care and Sleep Medicine is not offering any fellowship spots this year, although this may change in coming applications cycles. Fellows in either program have access to robust educational, research and career advancement opportunities. Highlights include access to: a multidisciplinary critical care faculty; world-class clinical and basic science research opportunities; ELSO gold-certified ECMO program; leading regional heart, lung, liver and bone marrow transplant programs; Fellow as Clinical Educator career advancement course; resident and medical student engagement in didactic, simulation and small group settings; expansive regional and national career networking opportunities.

Fellowship Program

Residents

Faculty are actively engaged in multiple facets of resident education, from beside teaching in the ED and ICU to hands-on sessions on high yield, highly applicable critical care topics (ventilator, resuscitative TEE, ECMO, advanced airway management, etc.) and traditional didactics. Residents rotate through a variety of intensive care units as part of the training program. We offer a “Resuscitation and Ventilator” elective for interested residents. We host, along with our ACCM and PCCSM colleagues, a monthly “Combined Critical Care Conference” that includes both local and national experts in various topics. Residents also undergo training in critical care topics (both adult and pediatric) with division faculty in simulation sessions and review recorded airway videos as part of a novel educational initiative to improve airway education.

Residency Program

Critical Care Faculty: