Physician Assistant/APRN - Cardiothoracic Surgery - Hartford, CT

Completes thorough but appropriately focused evaluations of pediatric patients (from neonates to adolescents and young adults), including competent and age appropriate histories and examinations. Identifies level of illness severity in a timely manner. Presents thoughtful assessments to the supervising physician and works towards prescribing necessary care plans. Performs appropriate procedures under their responsibility with the appropriate guidance. Knows when and how to seek assistance.

 

Cardiac Critical Care includes the knowledge and skills to diagnose and manage children with life threatening illnesses and injuries. These include conditions that cause respiratory, circulatory, neurologic, renal or hepatic failure, severe infectious, hematologic, or immune disorders, and poisoning. In addition, privileges include care of children needing cardiopulmonary resuscitation, stabilization during transport, complex pre- and post-operative care.

 

A list of specific core management modalities used by the critical care APP includes, but is not limited to (with supervision of CVICU attending, PICU attending, Cardiology attending, and CT Surgery attending):

• Application and regulation of extracorporeal respiratory, renal, and circulatory assist devices (ECCS, ECMO, LVAD)
• Application of cardiac output monitoring
• Application of respiratory therapy
• Anticoagulation
• Bag mask ventilation
• Elective and emergency management of the difficult airway including use of LMA (laryngeal mask airway), lightwand stylet, flexible scope, obturator airway and other techniques
• Enteral nutrition
• Brain protective strategies using medications, osmolar agents, temperature regulation, and ventilation-
• Interpretation of continuous EEG monitoring
• Interpretation and management of acid base disturbance
• Interpretation and management of fluid, electrolyte, and metabolic abnormalities
• Interpretation of blood gases
• Interpretation of electrocardiogram and echocardiogram
• Interpretation of intracranial pressure monitoring, and management of intracranial pressure abnormalities
• Interpretation of vascular and cardiac chamber pressure measurement
• Medical management of patients during intra and interhospital transport
• Medical modulation of the autonomic nervous system
• Parenteral nutrition
• Respiratory support weaning techniques
• Thrombolytic therapy
• Tracheal intubation (oral and nasotracheal, emergency perlaryngeal)
• Tracheotomy Care
• Use of blood component therapy
• Use of inotropes, vasoconstrictors, vasodilators
• Use of mechanical ventilation, positive end-expiratory pressure, and continuous position airway pressure
• Use of medications to promote a brief or prolonged state of analgesia, anxiolysis, moderate or deep sedation, or emergency and non-emergency general anesthesia
• Use, zeroing, and calibration of transducers, use of amplifiers and recorders of physiologic parameters

 

Diagnostic and Therapeutic Procedures include:

• Application of hypothermic therapy
• Arterial puncture
• Emergency cardiac pacemaker insertion and application
• Emergency cardioversion, defibrillation, transcutaneous pacing
• Exchange transfusion
• Insertion arterial catheters
• Insertion of hemodialysis and peritoneal dialysis catheters
• Insertion peripheral and central venous catheters
• Insertion pulmonary artery catheter
• Insertion of umbilical catheters
• Interpretation of respiratory mechanics studies tests
• Laryngoscopy
• Lumbar puncture
• Needle and tube thoracostomy
• Paracentesis
• Point of Care Ultrasound for the insertion of vascular catheters, pericardiocentesis, thoracentesis and paracentesis
• Thoracentesis

 

 Consultations and care for adults 21 years of age and over with congenital cardiac anomalies (as approved by the Hospital CMO and Leadership

 Perinatal and fetal consultations for congenital cardiac anomalies.

FPPE Guidelines

• Concurrent observation of one-week on-service/on-call rotation by an Active member of the Department.
• Peer review through the departmental quality assessment activities

Criteria for Reappointment

• Documentation confirming CME activity during the past 24 months consistent with state licensing requirement.
• Provide proof and maintain current ACLS, PALS and BLS
• Sedation
• Sedation is considered a core privilege of Cardiac Critical Care Medicine under the guidelines establi