Critical Care | Hackensack University Medical Center

Keith Rose MD Welcome to our critical care section here at HUMC, and thank you for your interest in our fellowship training program. As Director of critical care services throughout HUMC, I oversee all the ICUs in the hospital. With this structure, it allows these different ICUs to work better together, sharing resources and expertise. This model also helps create a very nurturing environment with high yield learning for our fellows in all the critical care units. As a fellow you will work primarily in the Medical ICU but will also rotate through the Surgical ICU, the Neurology/ Neurosurgical ICU and the Cardiothoracic ICU. You will gain a wide breadth of experience managing critically ill patients in these different environments.

As a large tertiary care center with a large catchment area and a Level 1 trauma center, we manage very complex cases and perform procedures that are unable to be done in most hospitals. The effects of this can be seen in each of the ICUs, enriching your overall experience. As a fellow, the critical care experience here at HUMC is extremely comprehensive and incorporates the latest developments and technology to bring the best possible care to our patients. We hope you will be a part of it!

Keith Rose, M.D.
Director of HUMC ICU Services

ECMO/ARDS Program at Hackensack Meridian Health

Referrals come from throughout New Jersey and are reviewed by our team of physicians including ELSO trained intensivists in the MICU and CT ICU and our cardiothoracic surgeons.
The Director of VV ECMO is Dr. Ronak Shah and VV ECMO patients are managed in the medical ICU.
The Director of VA ECMO is Dr.Vishal Jani and VA ECMO patients are managed in the CT ICU.
In addition to providing high quality care of patients requiring ECMO support, our MICU team prides our ability to provide exceptional care of those patients with severe ARDS, often allowing for patients to improve without ever requiring ECMO support.
Hackensack Meridian Health has recently added eCPR for ED and floor patients for those who require ECMO support after a cardiac arrest.

Fellows Experience in Critical Care

Our fellows receive exceptional and comprehensive training in all fields of critical care.
Their primary unit is our 20 bed Medical ICU where the fellows learn to run the unit under the guidance of our academic team of Intensivists.
At Hackensack Meridian Health the primary service handling airways in the ICU and on the floors is our critical care team. Fellows receive extensive training on intubations and perform hundreds of intubations during their training.
Procedures are common in our complex Medical ICU and include standard procedures such as central lines, arterial lines, dialysis catheters, and chest tubes, to more complex procedures such as cryobiopsies on intubated patients with diffuse lung disease of unknown etiology. All procedures are performed by our fellows with supervision from our faculty.
Fellows will also rotate through the CT ICU, SICU and Neuro-critical care service gaining in depth knowledge and experience in these non-medical units.
Patients on VV ECMO are managed by our faculty and our fellows get experience on the process of deciding who should be put on ECMO, the cannulation process, the management of VV ECMO and how to determine when a patient is ready for decannulation.
Fellows receive extensive training in both basic critical care ultrasound and echocardiography as well as more advanced echo training. Several fellows have already taken and passed the the CCEeXAM for advanced critical care echocardiography. The division also has obtained our own TEE probe and training will be provided on the use of this in critically ill patients.

These are some of the things you will experience in our constantly evolving program.

Airway Management

Here at Hackensack, our critical care team has taken the lead on all emergent intubations in the hospital. We have developed our own airway bag with all the essential tools needed for urgent and difficult intubations. Our fellows have the opportunity to become extremely adept at the management of routine and difficult airways under the supervision of our faculty. Faculty and fellows go through airway courses directed by our faculty and other specialists, including sessions on emergent cricothyroidotomies.

VV ECMO

Dr. Ronak Shah is the director of VV ECMO at Hackensack University Medical Center and leads our team in the management of our ECMO patients in the MICU. The majority of our faculty has gone to training in Sweden on ECMO and Hackensack is now a referral center for patients with ARDS who may require ECMO in New Jersey. Patients on VV ECMO are managed by our faculty and our fellows get experience on the process of deciding who should be put on ECMO, the cannulation process, the management of VV ECMO and how to determine when a patient is ready for decannulation.

Ultrasound and Echocardiography

Fellows participate in our monthly US conference and become adept at routine and more advanced US and echo. Our division recently obtained our own TEE probe and instruction and education will be provided by our faculty.

Pulmonary Embolism Response Team

The PERT team is led by Dr. Taaran Ballachanda and provides exceptional multidisciplinary care for our patients with pulmonary emboli. Our fellows work with our critical care faculty to evaluate high risk cases with pulmonary emboli with an initial POCUS exam and help to coordinate care. Our team works in conjunction with our colleagues in Vascular Surgery and Cardiothoracic Surgery to help determine the most appropriate therapies needed for our patients. Cases in the region are referred to our PERT team for evaluation and possible interventions.