Surgical Intensive Care Unit

The Surgical Intensive Care Unit (SICU) cares for critically ill patients recovering from general, thoracic, trauma, vascular, orthopedic, gynecologic and obstetric surgeries.

Most patients recuperating immediately after elective or emergency surgery receive around-the-clock care in the 20-bed Surgical Intensive Care Unit (SICU). Heart surgery and some transplant surgical patients are cared for in the Cardiac SICU and Blake 12 ICU units. A collaborative, multidisciplinary team of health professionals cares for approximately 1,200 patients annually who are recovering from conditions that require surgical intervention.

14 attending physicians with qualifications and credentials in critical care rotate for 24-hour coverage of the SICU, alongside a nursing staff of 78. These surgeons, anesthesiologists and nurses are complemented by surgical specialists in neurology, orthopedics, emergency medicine and other subspecialties, as well as two fellows and a rotation of six residents.

Multidisciplinary Approach to Care

Under the leadership of Medical Director Jean Kwo, MD, and Nursing Director Veronica Erasquin, RN, the medical and nursing staff, including clinical nurse specialists, collaborates with a multidisciplinary team of health care providers who contribute their skilled care in:

• Respiratory therapy
• Clinical pharmacy
• Physical, occupational and speech therapy
• Clinical nutrition
• Mental health, including psychiatry and social work
• Case management
• Chaplaincy

What to Expect

For planned, or elective, surgeries, patients receive a tremendous amount of pre-surgical information. SICU staff work with emergency and trauma patients and their families to familiarize them with the intensive care unit. Length of stay in the unit varies, depending on the complexity of the surgical procedure and the comorbidity and condition of the patient. In all cases, patients and their families participate in discussions and plans, learn about treatment options and are part of all decisions affecting their care. Patients are typically discharged to home, a rehabilitation facility, or a general care floor within Massachusetts General Hospital.

World-renowned Trauma Center

Mass General is a top trauma center in New England and is sought out by patients around the world who require complex aortic, thoracic and pancreatic surgeries. Surgical patients admitted through Mass General’s Emergency Department enjoy a continuum of care through surgery, intensive care and transition to a general care floor or rehabilitation. Attending physicians in the SICU provide individual patient care from the emergency department admission through discharge.

Setting New Treatment Standards

The SICU regularly evaluates its clinical practice to meet the evolving needs of its patient population. In 2010, the staff increased its efforts to get patients moving as early as possible in their recovery. The focus on early mobility also included lighter sedation. The effort is geared toward reducing complications, like pneumonia, delirium or gastrointestinal problems associated with prolonged bed rest.

In addition, new guidelines developed at Mass General for the removal of C-collars from trauma patients has also become an accepted standard nationwide.

Leadership in National Organizations

SICU medical, nursing and skilled leaders influence the direction of surgical critical care through membership and leadership in organizations including the Society for Critical Care Medicine and the American Association of Critical Care Nurses.

Surgical intensivists also devote a portion of their practice in a partnership with Elliot Hospital in New Hampshire, bringing emergency surgery and critical care expertise to northern New England communities.

Research that Makes a Difference

Complications from emergency airway procedures are down to 5.6% of all such procedures, compared with a national average of 28%. Research led the SICU to alter its policies around airway emergencies. Now, an attending physician supervises intubations and other emergency procedures, leading to the decline in complications.

The Next Generation of Surgical Intensivists

Surgical critical care, trauma research and anesthesia critical care fellows-in-training and residents rotate through the SICU, where attending physicians organize lectures and provide mentoring and instruction. Nurses also provide education through a New Graduate in Critical Care program, a six-month orientation to critical care for new nurses, and a three-month orientation for experienced nurses moving into the SICU.