STAB (Stabilization) Room
The HCMC STAB (pronounced stabe) room is a modern marvel of critical care space. It contains 4 stabilization bays, each with all of the equipment needed to resuscitate any critical patient, but also with specialized equipment for certain patients (medical bay, trauma bay, burn bay, & pediatric bay). STAB cases are run by Emergency Medicine residents (usually PGY-3) with EM faculty supervision. STAB cases are also run on the Orthosusc rotation in the PGY-2 year, and can be run by any EM PGY-2 residents as needed during times of multiple concurrent STAB cases running.
At HCMC the Emergency Medicine faculty are the airway experts of the hospital. All intubations in the ED are performed by the Emergency Medicine resident that is running the case (usually PGY-3, fairly often PGY-2) with EM faculty supervision. The STAB room has what are likely the best equipped airway carts anywhere. Airway options in the STAB room are incredibly wide. Options include:
- Multiple Storz screens, which can be used for CMAC, nasopharyngoscope, or bronchoscope use.
- CMAC pediatric Miller blades
- CMAC Mac blades
- CMAC radical curve blades
- adult nasopharyngoscopes, adult bronchoscopes, pediatric bronchoscopes
- recording capability
- Glydescope standard and titanium Mac blades
- DL Mac and Miller blades of any needed size
- Intubating LMAs (laryngeal mask airways) and multiple disposable LMAs of multiple types
- King airways
- TTNV (trans-tracheal needle ventilation)
- Retrograde intubation kits
- Cricothyrotomy and tracheostomy kits
Procedures in the STAB room are generally performed by PGY-2 Emergency Medicine residents. Procedures regularly performed by EM PGY-2 residents include, but are not limited to:
- central line placement
- triple lumen, trauma catheters, dialysis catheters, trans-venous pacing catheters, and cooling catheters
- arterial line placement
- thoracostomy (chest tube)
- fracture/dislocation reduction and splinting
- lumbar puncture
Many other procedures are also performed both in the STAB room and in the team centers by Emergency Medicine residents. In cases of traumatic cardiac arrest/peri-arrest, thoracotomy is performed by PGY-3 Emergency Medicine residents. As mentioned above, intubation is performed by the Emergency Medicine resident running the STAB case, which is usually a PGY-3.
Critical Care Ultrasound
Bedside ultrasound is used early and often in the STAB room. It is considered a crucial part of emergency critical care. Each bay has a mounted touchscreen Mindray TE7. Mobile ultrasound machines can also be moved in if multiple ultrasounds are desired concurrently (e.g. simultaneous central line and arterial line insertion). Bedside trans-esophageal echocardiography capabilities are also available.