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University Health Network

University Health Network

Toronto General Hospital

Toronto Western Hospital

The University Health Network comprises the Toronto General Hospital, Toronto Western Hospital, Princess Margaret Cancer Centre, and Toronto Rehabilitation Institute.

Toronto General Hospital is a closed 24 bed medical-surgical intensive care unit. It provides support to the medical and surgical services at the hospital with more than 950 admissions per year – for the most part surgical patients. It has a focus on solid organ transplantation (lung, liver, heart-lung), thoracic surgery, hepatobiliary surgery, and general internal medicine. The ICU is also the regional centre for extracorporeal life support (ECLS) with more than 60 VA-ECMO and VV-ECMO cases per annum. Overall, with the extreme complexity of medical and surgical cases, the unit has the highest acuity in Canada.

Toronto Western Hospital is a closed 24 bed medical-surgical and neurosurgical intensive care unit. It specializes in neurosurgical and orthopaedic patients, and provides support to other medical and surgical programs at the hospital. The unit admits more than 1,000 new cases per year and by comparison admissions from the emergency department and Criticall are more frequent than at Toronto General, and comprise up to 20% of patients in the ICU.

 Both sites provide all aspects of ICU care and have full resources including conventional and non-conventional modes of ventilatory support, hemodialysis and plasmapharesis.

In addition to providing consultations in critical care, there is a 24 / 7 Rapid Response Team at each site. This team consists of an Attending (Consultant) intensivist, a specially trained critical care nurse, and a Critical Care Fellow or Resident. The team monitors discharges from the ICU, provides support to medical and surgical teams (nurses, physicians) and intervenes in the management of patients who demonstrate signs of clinical worsening or instability.

At both sites, the residents are not on call for cardiac arrests but routinely provide consultations to the wards and to the emergency department. Critical Care Residents and Clinical Fellows typically provide back up for junior residents rotating through the ICU, and may be responsible for in-house call up to 7 times per month. Given the complexity of cases in the ICU at UHN, many residents rotate through the UHN ICUs near the end of their training programs.

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