Medical Surgical ICU at Mount Sinai Hospital
Mount Sinai Hospital is a University Hospital with 460 beds that provides secondary and tertiary care for the Greater Toronto Area. Mount Sinai is world-renowned for its Obstetric Medicine and High-risk Pregnancy departments and performs more than 1600 high-risk deliveries per year. The Department of Surgery at the University of Toronto has an international reputation for complex sarcoma surgeries and HIPEC procedures which are also performed at this hospital.
Mount Sinai Hospital has a 16 bed Medical-Surgical Intensive Care Unit that specializes in the care of the high risk oncological and obstetrical patient. It has two additional high dependency units for surgical and coronary care patients. Mount Sinai has a multidisciplinary team for the provision of critical care outside of the MSICU – the ACCESS team – Acute Critical Care Emergency Support Service. It covers not only the Mount Sinai facility but also the adjacent oncology center, the Princess Margaret Cancer Centre.
Since the Princess Margaret Cancer Centre moved to University Avenue, Mount Sinai Hospital has served as the Critical Care (Level 3) resource for Princess Margaret. Critically-ill cancer patients at Princess Margaret are attended to by the Mount Sinai Critical care response team, and if necessary transferred across a bridge to the ICU at Mount Sinai. Our team also provides cardiac arrest team services, respiratory therapy support during nights and weekends for Princess Margaret.
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We want your experience with the ICU to be as positive as it can be. Every day in the morning the interdisciplinary team meets for “rounds”. This is when the team visits the patient’s bedside to discuss the plan of care. Decisions involving all team members will be made at this time. We welcome your presence and participation as a member of rounds. When patients improves and no longer requires continuous monitoring, he or she may be transferred to a step down unit, where care is provided at an intermediate level, a regular ward or to a hospital closer to home.
Visiting in the ICU is flexible. However, you may be asked to wait a little while before going to see the patient when a patient first arrives to the ICU, when the patient is resting or during nursing shift change — at 7:30 each morning and evening. Before visiting, please call, give your name, and the name of the patient you are visiting. The phones located in the waiting room and just outside the door leading to the ICU ring directly through to the unit clerk.
Children are welcome to visit. It is a good idea to tell them in advance what to expect and answer any questions they might have. Please inform the interdisciplinary team if you are planning to bring children to the ICU. We can provide guidance as well as material to help children with the experience.
Occasionally, such as when infection control measures are increased, there are restrictions on the number of visitors. Whenever possible, we will notify you in advance of these changes.
Who can I talk to when I have questions or concerns?
Ongoing communication between patients and families and the critical care team is important. We encourage you to ask questions and share your concerns.
Sometimes, we may arrange family meetings to discuss the patient’s plan of care and to give you the opportunity to have your questions answered. It is helpful if you designate a family member as a spokesperson. This person can be a valuable “communication link” between the family and the health care team.
Please feel free to call us at 416-586-4800 ext. 4610 at any time, even when you are away from the Hospital, if you are concerned about your family member or have questions.
What can I do to help my loved one?
Your caring and support are a vital part of your loved one’s care. Some of the things that you may want to do to help are:
- Visit – short but frequent visits are often the best way to offer comfort.
- Feel free to speak words of encouragement and support, even if your loved one is sedated or unable to speak. Offer reassurance about things that may be on their mind-for example, how children or the family pet are doing.
- If your loved one is awake but has a breathing (ET) tube, he or she will not be able to speak. Communicate by asking questions that require only “yes” or “no” answers or by using a pen and paper or pictures.
- Hold your loved one’s hand or touch their face. Your presence alone shows you care.
- Bring some personal items from home such as family photos or toiletries (but please leave valuables at home)
- Remember to take the time to take care of yourself.
Who are the health professionals taking care of my loved one?
There are four physicians on the ICU team. They are called intensivists and are specialists in intensive care. They rotate on a weekly basis and can be reached 24 hours a day. The Director of the ICU is responsible for the overall medical care of patients.
We frequently consult with specialists such as cardiologists (heart specialists), nephrologists (kidney specialists) and hematologists (specialists in blood diseases) in order to ensure the best possible care.
All the nurses in the ICU are specially trained to provide close monitoring and patient treatments. Each nurse is assigned direct care of one or two patients to allow for very close monitoring.
Some nurses also have specific responsibilities within the unit:
- The Charge Nurse is responsible for the day-to-day running of the unit.
- The Nursing Unit Administrator (NUA) is responsible for administrative duties
- Clinical Nurse Specialist (CNS) is available to support clinical practice and nursing research.
The NUA and CNS are also available for consultation on matters to do with patient and family care and nursing practice.
Respiratory Therapists (RTs) manage ventilators (respirators) — machines that help patients breathe. They are trained to ensure patients receive the appropriate amount of oxygen therapy and support from the ventilator. There are two RTs in the ICU on each shift.
A pharmacist who specializes in critical care assists the team in selecting the best medications for patients and provides ongoing consultation and educational support to physicians and nurses.
During a critical illness, the body has additional nutritional requirements and may require tube feeding. The dietitian assists the team in deciding the best nutritional plan for the patient and provides ongoing consultation to the nurses.
The physiotherapist works with the ICU team and provides ongoing consultation to nurses regarding ways to maintain lung function and physical mobility. This may include helping patients with breathing and coughing techniques to clear secretions from the chest and airway or assisting with exercises to prevent problems that sometimes occur because of immobility.
Having a loved one in the ICU can be a stressful. A social worker is available Monday to Friday to talk with you about your concerns and to connect you with community resources if needed. If you would like, any member of the health team can refer you.
One of the Hospital’s chaplains is assigned to the ICU. Working with other Hospital chaplains and community-based representatives of many different denominations, the ICU chaplain will assist patients and their families in seeking the pastoral care they wish. You are welcome to share your preferences and any cultural and religious practices that help us understand your and your loved one’s needs.
Research Coordinators conduct research in the ICU on an ongoing basis. You may be approached for consent to have your family member enrolled in a research study designed to discover ways to improve care. There is no obligation to participate and patient care will not be affected by your decision.
Unit Clerks work with Charge Nurses to ensure a smooth-functioning unit. They answer the phones, file information in the patient’s chart and organize some supplies.
Service Assistants are available to help the nurses transport patients to and from tests outside the ICU. They are also responsible for cleaning patient rooms and the general areas around the ICU and for running errands such as bringing blood samples to the laboratory.
Mount Sinai Hospital is a teaching centre. Health professionals in training from all disciplines participate in the care of the patient under the supervision of the different team members.
Patients are admitted to the ICU because they require close observation and specialized care. Some patients and families know in advance that they will come to the ICU and, at other times, the admission is unexpected. Immediately upon arrival, it is most important for the staff to work together to stabilize the patient. We appreciate that waiting is extremely difficult and are committed to meeting with you at the earliest possible opportunity.
The ICU has a variety of equipment including monitors, ventilators, and dialysis machines. This equipment can be noisy and alarms may go off. The alarms are safety measures and do not necessarily mean the patient is in danger. We understand that this may be frightening for some family members. Please be assured that there is a nurse available at all times to respond.
Our team is composed of 6 intensivists who collaborate in close relationship with registered nurses, respiratory therapists, physiotherapists, social worker and spiritual care. as well as with other medical and surgical specialties
Allied health professionals
MOUNT SINAI HOSPITAL
The ICU is located on the 18th floor (closest entrance is University avenue entrance)
Main Floor map
You can contact us 24/7 at this number +1 (416) 586 4800 ext. 4610
Mount Sinai Hospital
Joseph and Wolf Lebovic
600 University Avenue
Toronto, ON M5G 1X5
600 University Avenue
60 Murray Street
Queen’s Park subway station, on the University branch of the Yonge-University-Spadina line (Line 1)
506 Carlton – University stop, and walk south
505 Dundas – University stop, and walk north up University Avenue
During rush hour, the 142 bus goes along University Avenue