Division of Critical Care in EM

Division of Critical Care in Emergency Medicine

The mission of the Division of Critical Care in the Department of Emergency Medicine is to improve outcomes for critically ill patients requiring emergency care through multidisciplinary education, research collaboration, and integrating the care of the critically ill patient through the prehospital setting, the Emergency Department, and the ICU.

About this Division

Numerous factors in healthcare, including the aging of the population and advances in the care of chronic medical conditions, have led to increasing acuity among patients seeking emergency care. Coupled with hospital overcrowding, these factors mean more critical care is being provided in emergency departments than ever before. To address the need for dedicated critical care in the ED, the Massachusetts General Hospital Division of Critical Care in Emergency Medicine was founded in 2017.

MGH has been training EM physicians in Critical Care Medicine through the Department of Anesthesia Critical Care Fellowship since 2008 and has had EM-Critical Care faculty on staff since 2009. The faculty have a range of clinical backgrounds, with expertise in medical, surgical, and cardiac critical care and experience in academic and community critical care alike. The members of the Division collaborate with Boston MedFlight, Boston EMS, the Surgical ICU, the Medical ICU, and the Heart Center ICU on research and clinical projects. The Division of Critical Care also collaborates closely with the Division of Ultrasound for education and research, given the substantial overlap between these Divisions. The Division is represented in national Emergency Medicine and Critical Care organizations with faculty holding several leadership roles.

Goals of This Division:

  • To educate emergency medicine residents and physicians about state of the art critical care as relevant to the Emergency Department
  • To educate Intensivists on the value of prehospital and emergency care
  • To improve the care of patients in the first minutes to hours of their critical illness
  • To improve the care of patients boarding in the ED, awaiting an ICU bed
  • To collaborate with colleagues in Critical Care research throughout the healthcare system

Division Faculty

Susan Wilcox

Susan Wilcox, MD, attended medical school at Washington University School of Medicine and trained in Emergency Medicine in the Harvard Affiliated Emergency Medicine Residency, graduating in 2008. After residency, she completed an Anesthesia Critical Care fellowship at MGH. From 2009 to 2015, she has divided her time between the Emergency Department and Intensive Care Units, including the Surgical ICU at MGH and the multidisciplinary ICU at North Shore Medical Center. In 2015, she moved to the Medical University of South Carolina, where she attended in the Medical ICU, the ED, and served as the medical director for the inpatient code team and the ground critical care transport team.

In July 2017, she rejoined the faculty of MGH, attending in the Emergency Department and the Heart Center ICU. Her research interests are mechanical ventilation outside the ICU and the emergency care of patients with pulmonary hypertension.

Jarone Lee

Jarone Lee, MD, MPH, is a graduate of St Luke’s Roosevelt Emergency Medicine Residency in New York, NY and also completed a fellowship in critical care at Massachusetts General Hospital in Boston, MD. He is the Medical Director of the Blake 12 Intensive Care Unit and the Quality Director of Surgical Critical Care for the Department of Surgery.

Kamal Medlej

Kamal Medlej, MD, obtained his medical degree from McGill University in Montreal, Canada. He then completed a residency in emergency medicine at St. Luke’s-Roosevelt Hospital Center in New York City, where he had the privilege of serving as chief resident in his final year. This was followed by a fellowship in critical care medicine at the Brigham and Women’s Hospital in Boston.

In 2012, Kamal returned to his home country to help establish the first national emergency medicine residency program at the American University of Beirut Medical Center. He was also appointed to the position of Director of Emergency Department Critical Care, a position he held until he relocated back to the United States in 2014.

Upon returning to New York City, Kamal held appointments in both the Emergency Department and the Division of Pulmonary, Critical Care and Sleep Medicine at Mount Sinai St. Luke’s-West. He divided his clinical time between the Emergency Department, and Medical and Surgical Intensive Care Units.

In January 2017, Kamal returned to Boston to attend in the Emergency Department at the Massachusetts General Hospital. He is also attending in the multidisciplinary Intensive Care Unit of South Shore Hospital.

News & Publications

Recent Publications:

Aaronson EL, Yun BJ, Mort E, Brown D, Raja AS, Kaafarani HMA, Chang Y, Lee J. Association of magnetic resonance imaging for back pain on seven-day return visit to the Emergency Department. Emerg Med J. 2017 Oct;34(10):677-679. doi: 10.1136/emermed-2016-206250. Epub 2017 May 2.

Al Ashry HS, Richards JB, Fisher DF, Sankoff J, Seigel TA, Angotti LB, Wilcox SR. Emergency Department Blood Gas Utilization and Changes in Ventilator Settings.Respir Care. 2017 Sep 26. pii: respcare.05590. doi: 10.4187/respcare.05590.

Angotti LB, Richards JB, Fisher DF, Sankoff JD, Seigel TA, Al Ashry HS, Wilcox SR. Duration of Mechanical Ventilation in the Emergency Department. West J Emerg Med. 2017 Aug;18(5):972-979. doi: 10.5811/westjem.2017.5.34099.

Hou PC, Filbin MR, Wang H, Ngo L, Huang DT, Aird WC, Yealy DM, Angus DC, Kellum JA, Shapiro NI; ProCESS Investigators(∗). Endothelial Permeability and Hemostasis in Septic Shock: Results From the ProCESS Trial. Chest. 2017 Jul;152(1):22-31. doi: 10.1016/j.chest.2017.01.010.

Khan S, England P, Lee J, Shah K. The Successes and Challenges of Integrating Emergency Medicine With Critical Care Medicine. Ann Emerg Med. 2017 Nov 23. pii: S0196-0644(17)31803-6. doi: 10.1016/j.annemergmed.2017.10.020. [Epub ahead of print]

McCluskey SM, Schuetz P, Abers MS, Bearnot B, Morales ME, Hoffman D, Patel S, Rosario L, Chiappa V, Parry BA, Callahan RT, Bond SA, Lewandrowski K, Binder W, Filbin MR, Vyas JM, Mansour MK. Serial Procalcitonin as a Predictor of Bacteremia and Need for Intensive Care Unit Care in Adults With Pneumonia, Including Those With Highest Severity: A Prospective Cohort Study.Open Forum Infect Dis. 2017 Jan 4;4(1):ofw238. doi: 10.1093/ofid/ofw238.

Medlej K, Kazzi AA, El Hajj Chehade A, Saad Eldine M, Chami A, Bachir R, Zebian D, Abou Dagher G. Complications from Administration of Vasopressors Through Peripheral Venous Catheters: An Observational Study. J Emerg Med. 2017 Oct 27. pii: S0736-4679(17)30863-6. doi: 10.1016/j.jemermed.2017.09.007. [Epub ahead of print]

Northup A, Wilcox S. Thromboprophylaxis Failure in the Adult Medical Inpatient.Am J Med Sci. 2017 Aug;354(2):107-116. doi: 10.1016/j.amjms.2017.03.011.

Prasad V, Lynch JC, Pasakarnis CL, Thorsen JE, Filbin MR, Reisner AT, Heldt T. Classification models to predict vasopressor administration for septic shock in the emergency department.Conf Proc IEEE Eng Med Biol Soc. 2017 Jul;2017:2650-2653. doi: 10.1109/EMBC.2017.8037402.

Self WH, Rosen J, Sharp SC, Filbin MR, Hou PC, Parekh AD, Kurz MC, Shapiro NI. Diagnostic Accuracy of FebriDx: A Rapid Test to Detect Immune Responses to Viral and Bacterial Upper Respiratory Infections. J Clin Med. 2017 Oct 7;6(10). pii: E94. doi: 10.3390/jcm6100094.

Tainter CR, Nguyen AP, Pollock KA, O'Brien EO, Lee J, Schmidt U, Jahanasouz F, Owens RL, Meier A. The impact of a daily "medication time out" in the Intensive Care Unit. J Crit Care. 2017 Sep 12. pii: S0883-9441(17)30710-4. doi: 10.1016/j.jcrc.2017.09.018. [Epub ahead of print]

Yun BJ, Aaronson EL, Israel E, Greenspan P, Rao S, Lee J. Cost savings associated with decreased emergency department utilization by reporting emergency department visits to specialists. Am J Emerg Med. 2017 Oct;35(10):1578-1579. doi: 10.1016/j.ajem.2017.04.050.

Contact Us

Susan Wilcox, MD
Assistant Professor, Harvard Medical School
Division Chief, Critical Care in Emergency Medicine

Department of Emergency Medicine
Massachusetts General Hospital
0 Emerson Place, Suite 3B
Boston, MA 02114

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