The Intensive Care Unit (ICU) is a 24-hour service department designed to deliver the highest level of medical and nursing care for acutely and critically-ill or -injured patients requiring extensive monitoring and intensive nursing care.
ICU has 6 Cardiac, and 6 Medical/Surgical beds; 6 Special ICU (Isolation A and B) beds; and 4 Pediatric beds. The Telemetry unit (TLM) has five intermediate care beds. Each room in the ICU complex, including the nearby Acute Stroke Unit, is equipped with a top-of-the-line multiparameter physiologic monitor linked to a centralized system with dedicated monitoring personnel. The ICU operates on a 1:1 or 1:2 nurse to patient ratio, complemented by senior-level on-site medical house staff at all times to ensure continuous high quality patient care.
Previously, care for critically-ill pediatric patients has involved a team of Pediatric Intensivist Physicians. Beginning in 2007, a semi-closed two-tier ICU model engaging Adult Intensivist Physicians (co-managing with our traditional medical specialists) has been institutionalized with great success. An intensivist is a doctor trained in critical care who can handle the multiple, often interrelated, problems that happen when the body is shutting down from infection or trauma. This model is currently being adopted by more hospitals in the Philippines.
The Medical City as the Pioneer in Adult CCM
TMC is a pioneer in Adult Critical Care Medicine (CCM) in the country. To date, TMC has a complement of 16 Adult CCM specialists from different base specialties (Medicine, Surgery and Anesthesia). Only specialists who have undergone formal dedicated training in Critical Care/Intensive Care qualify as TMC Intensivists.
TMC was also the first to offer a comprehensive CCM fellowship program, set at international standards, and recognized by the Philippine College of Physicians (PCP). At present, the program has produced 5 graduates. TMC’s fellowship trainees take the annual US Critical Care in-service examination and perform as well as their counterparts in the US Critical Care fellowship programs. This means that TMC’s trainees would be expected to pass the US Critical Care board examinations.
What is Adult Critical Care Medicine?
Adult Critical Care Medicine (CCM) is a multidisciplinary healthcare specialty for adult patients with unstable or life-threatening conditions. It is also known as Intensive Care Medicine. It is the discipline that is dedicated to caring for patients who require admission to an Intensive Care Unit (ICU). A CCM specialist is also known as an “Intensivist.”
CCM is a modern specialty. The first ICUs opened in Europe in the late 1950s and rapidly spread to North America. Certification of physicians in this field did not occur in the United States until 1986. In the Philippines, the Philippine College of Physicians (PCP), the organization of Internists (doctors for adults), recently recognized Adult CCM as a distinct specialty of Internal Medicine. However, many Intensivists worldwide practice with base specialties in Surgery or Anesthesia.
What distinguishes Adult CCM from other specialties?
CCM has been called a “super-specialty,” because while it shares many features with other specialties, it is designed to address the complexities and uncertainties of caring for the sickest patients. CCM aims to align and integrate complex care into a cohesive and comprehensive whole, to maximize long-term survival and to minimize disability.
The primary mission of CCM is to protect the quality of human life in the face of life-threatening illness.
What is an ICU?
Intensive care units (ICU) are places in the hospital where the most seriously ill patients are cared for by specially trained staff. The ICU has the highest density of healthcare providers per square foot in the hospital. It is also defined by high technology and complex care.
ICU patients are the sickest patients. They are those with the most severe disease of one or more organ-systems. Patients who require any of the following are best cared for in an ICU setting: frequent monitoring, special monitoring devices, special medications and technology to support and sustain normal bodily functions.
Multi-parameter physiologic monitoring of all patients in the ICU consists of an advanced electronic modular system at each bedside, integrated into a central monitor. Dedicated nurses man the central monitoring station in the ICU 24 hours daily.
1. General Services
Continuous monitoring of the electrocardiogram (with high/low alarms) for all patients
Automated continuous arterial pressure monitoring (noninvasive)
Transcutaneous oxygen monitoring or pulse oximetry for all patients
Equipment to maintain the airway, including laryngoscopes and endotracheal tubes and suction equipment
Equipment to ventilate, including ambu bags, ventilators, oxygen, and compressed air
Emergency resuscitative equipment including defibrillation
Transcutaneous and transvenous pacing
Equipment to support hemodynamically unstable patients, including infusion pumps, blood warmers, pressure bags, and blood filters
Beds with removable headboard and adjustable position
Adequate lighting for bedside procedures
2. Special Services
Invasive pressure monitoring: arterial, venous, intra-abdominal and intracranial, as well as derived dynamic indices
Therapeutic hypothermia/target temperature management
Continuous temperature monitoring (intravascular or intra-rectal)
Pulmonary artery catheterization and advanced hemodynamic monitoring
Continuous and intermittent dialysis and ultra filtration
Positive and negative pressure isolation rooms
Dr. Jose Emmanuel Palo – Consultant Director, Intensive Care Unit (Medicine / Critical Care)
Dr. Celina Ancheta (Anesthesia / Cardiovascular Critical Care)
Dr. Maria Antoinette Dizon (Anesthesia / Critical Care)
Dr. Marie Karen Jiz (Anesthesia / Vascular Transplant and Critical Care)
Dr. Andres Lipana Jr. (Anesthesia / Critical Care)
Dr. Maria Elena Malong (Anesthesia / Critical Care / Liver Transplantation Anesthesia)
Dr. Emily Rose Nery (Anesthesia / Critical Care)
Dr. Michelle Marie Reyes (Anesthesia / Critical Care)
Dr. Emily Aventura (Pulmonology / Critical Care)
Dr. Gerardo Briones Jr. (Medicine / Critical Care)
Dr. Aaron Mark Hernandez (Medicine / Critical Care)
Dr. Ronald Antonio Reodica (Pulmonology / Critical Care / Sleep Medicine)
Dr. Marian Vita Nova Sodusta (Medicine / Critical Care)
Dr. Jude Erric Cinco (Cardiology / Critical Care)
Dr. Luis Martin Habana (Cardiology / Critical Care)
Dr. Ray Resurreccion (Trauma Surgery / Critical Care)
Dr. William Bayhon Jr. (Pediatric Critical Care)