The Mount Sinai Division of Emergency Critical Care was established in 2017 to provide a collaborative home to the growing ranks of Emergency Medicine (EM)-Critical Care Medicine (CCM) physicians working across the Mount Sinai Health System. Staffing both Emergency Departments and intensive care units (ICUs), members of the Division provide specialized neurological, medical, trauma, cardiac surgical, and cardiac critical care in hospitals throughout New York City. In addition to providing care in the ICU, the Division is committed to increasing the recognition of the unique challenges that accompany caring for patients in critical care who interface between the ambulatory, emergency department, and inpatient settings.
Division of Emergency Critical Care Medicine
Critical Care Medicine and Emergency Medicine have been considered natural counterparts since the inception of both specialties in the 1970s, but it wasn’t until 2011 that Emergency Critical Care Medicine was formally recognized by the Accreditation Council for Graduate Medical Education (ACGME) as a subspecialty of Emergency Medicine. In the years immediately following the ACGME decision, the number of EM graduates pursuing CCM fellowships grew rapidly with dual trained EM-CCM physicians currently staffing inpatient intensive care units in hospitals nationwide.
The provision of critical care in the Emergency Department is highly demanding. Unlike inpatient intensive care units, emergency departments are subject to unpredictable, rapid, and often sustained increases in patient volume and acuity. The advent of emergency resuscitation units, referred to by terms such as emergency ICUs or resuscitation and acute critical care units, offer a solution to the dilemma of ED overcrowding and critical care boarding by providing both dedicated staffing and an optimized physical space with the capacity to resuscitate patients from the moment of arrival to ICU transfer. While emergency resuscitation units provide a clear advantage to patient safety and care, they currently remain uncommon due to budgetary and administrative challenges. The Mount Sinai Hospital and its affiliate trauma center Elmhurst Hospital have both demonstrated their foresight and commitment to the delivery of high-quality critical care by establishing emergency resuscitation units, providing the emergency care team with the necessary resources to focus on critically ill patients regardless of ED or hospital census. While the Division plays an important part in the clinical and administrative operations of the resuscitation units at both sites, we also function as vocal advocates for the widespread adoption of the emergency resuscitation unit model to other medical centers nationwide.
Mount Sinai offers a novel, combined Emergency Medicine-Critical Care Medicine Residency. It is a five-year program that integrates the training of two distinct but intricately intertwined specialties. The program’s goal is to cultivate a dynamic and comprehensive environment that trains compassionate physicians adept in managing complex, high-acuity clinical situations, with an emphasis on collaborative efforts and expertise in systems processes between Emergency Medicine and Critical Care. Our institution is uniquely positioned to lead the development of a combined EM-CCM program, thanks to our established and distinct Emergency Medicine and Critical Care training programs. We have a strong team of more than 15 EM-trained intensivists practicing across all subspecialty ICUs within the Mount Sinai Health System, further enhancing the integration of these fields.
Upon completion of the program, our trainees will be eligible to sit for Emergency Medicine (ABEM) and Critical Care Medicine (ABIM) board exams, as well as be prepared to practice both emergency medicine and critical care medicine in any clinical environment. We endeavor to train the next generation of national leaders in both emergency medicine and critical care who will continue to work towards providing seamless critical care between the ED and ICU. Learn more about the combined residency.
Alongside the combined residency, the Division is dedicated to resident, fellow, medical student, and faculty education through didactics, bedside teaching, workshops, simulation, and clinical guideline formulation.
Current and past research within the Division of Emergency Critical Care includes subjects such as guided fluid resuscitation; cardiac arrest; early vasopressors vs. crystalloid in shock; novel anticoagulant use in trauma; simulation in critical care education; and various retrospective studies examining interventions and outcomes in the setting of COVID-19 pneumonia. We continually look for opportunities to collaborate with team members throughout Mount Sinai to improve the ability to care for patients while at their sickest and most vulnerable.