Blueprint for the development of resuscitation and emergency critical care fellowships

Alexander Bracey; Matthew B Tichauer; Gregory P Wu; Ryan N Barnicle; Christina J Lu; Matthew V Tanzi; Andrew C Pellet; Denis R Pauzé; Scott D Weingart; Luke J Duncan; Brian J Wright

doi:10.1002/aet2.10905

Blueprint for the development of resuscitation and emergency critical care fellowships

AEM Educ Train. 2023 Sep 15;7(5):e10905. doi: 10.1002/aet2.10905. eCollection 2023 Oct.

Authors

Alexander Bracey¹, Matthew B Tichauer^{2

3}, Gregory P Wu^{1

4}, Ryan N Barnicle⁵, Christina J Lu², Matthew V Tanzi⁶, Andrew C Pellet^{1

7}, Denis R Pauzé¹, Scott D Weingart⁸, Luke J Duncan^{1

7}, Brian J Wright^{6

9}

Affiliations

¹ Department of Emergency Medicine Albany Medical Center Hospital Albany New York USA.
² Department of Emergency Medicine Hartford Hospital/University of Connecticut Hartford Connecticut USA.
³ Department of Critical Care Hartford Hospital/University of Connecticut Hartford Connecticut USA.
⁴ Department of Medicine Albany Medical Center Hospital Albany New York USA.
⁵ Department of Emergency Medicine Warren Alpert Medical School of Brown University Providence Rhode Island USA.
⁶ Department of Emergency Medicine Stony Brook University Hospital Stony Brook New York USA.
⁷ Department of Surgery Albany Medical Center Hospital Albany New York USA.
⁸ Department of Emergency Medicine Nassau University Medical Center East Meadow New York USA.
⁹ Department of Neurosurgery Stony Brook University Hospital Stony Brook New York USA.

PMID: 37720309
PMCID: PMC10502636 (available on 2024-09-15)
DOI: 10.1002/aet2.10905

Abstract

The volume of critically ill patients presenting to the emergency department (ED) is increasing rapidly. Continued growth will likely further stress an already strained U.S. health care system. Numerous studies have demonstrated an association with worsened outcomes for critically ill patients boarding in the ED. To address the increasing volume and complexity of critically ill patients presenting to EDs nationwide, resuscitation and emergency critical care (RECC) fellowships were developed. RECC programs teach a general approach to the management of the undifferentiated critically ill patient, advanced management of critically ill patients by disease presentation, and ongoing supportive care of the critically ill patient boarding in the ED. The result is critical care training beyond that of a typical emergency medicine (EM) residency with a focus on the unique features and challenges of caring for critically ill patients in the ED not normally found in critical care fellowships. Graduates from RECC fellowships are well suited to practicing in any ED practice model and may be especially well prepared for EDs that distinguish acuity between zones (e.g., resuscitative care units, ED-based intensive care units). In addition to further developing clinical acumen, RECC fellowships provide graduates with a niche in EM education, research, and administration. In this article, we describe the philosophical principles and practical components necessary for the creation of future RECC fellowships.

Keywords: critical care medicine; emergency critical care; emergency department critical care; emergency medicine fellowship; resuscitation; resuscitation fellowship; resuscitationist.