• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
 
 
iGuide
intensive care medicine 2009
From an idea by Tom Woodcock.
"Diseases desperate grown,By desperate appliance are relieved,
Or not at all." 
King Claudius in 'Hamlet' 4.3, Shakespeare,quoted by Patrick Shackleton, Lancet 
 
1958
"Vel parvo, vel magno, in stercore semper."
 MS Neilsen
iGuide 2009page 1
 
Table of Contents
.......................................................................................Good clinical practice in Critical Care
5.......................................................................................................Defining Critical Care
5....................................................................................................................Care bundles
5..........................................................................................................................Outreach
5......................................................................................Quality assurance in ICU practice
5................................................................................................................Practical Procedures
7.......................................................................................................Precautions for all sta
f 
;
7....................................................................................................Infected health workers
7..........................................................................................................................Procedures
7..........................................................................................................Any vascular access
7................................................................................................................Taking samples
7......................................................................................................Read The Instructions.
7.......................Use 2D Ultrasound to visualise the vessel before and after catheterising it
8....................................................................................................................Arterial lines.
8....................................................................................................................Central lines.
9.........................................................................................Cardiac output measurement
10.........................................................................Pulmonary artery (right heart) catheters
10...................................................................................Haemofiltration; vascular access.
12................................................................................................Endotracheal intubation.
12................................................................................................................Tracheostomy
12....................................................................................................Setting up a ventilator
13............................................................................................................Patient transport
13................................................................................................................Thoracostomy
13...............................................................................................Metabolic measurements
13.......................................................................................................................Radiology
13.......................................................................................Management of self poisoning
14....................................................................................................Consent to treatment.
14Withholding and withdrawing life sustaining treatments in the Critical Care Unit; a few..............................................................................................practical and legal points.
14..........................................................................................................................General care
16.................................................................................................................Body position
16..................................................................................................Acute Gastric dilatation
16............................................................................................................Peptic ulceration
16........................................................................................................................Nutrition
16...................................................................................................“Renal dose” dopamine
16........................................................................................................Neither wet nor dry
17....................................................................................Thrombo-embolism prophylaxis
17...........................................................................................Hospital acquired infections
17........................................................................................Breaking the cycle of infection
18..........................................................Nosocomial, or Ventilator associated, pneumonia
18...................................................................................................Urinary tract infections
19..................................................................................................Catheter-related sepsis
19.............................................................................Gut permeability and systemic sepsis
19..........................................................Systemic inflammatory response and septic shock
19................................................................Anti-inflammatory therapies in severe sepsis.
21..........................................................................................Organ dysfunction or failure.
21.................................................................................................Neuromuscular changes
22................................................................................................................Circulatory support
23.................................................................................................................Resuscitation.
23.........................................................Do Not attempt Resuscitation (DNAR) instructions
23................................................................................................................................Shock
23..........................................................................................................Cardiogenic shock
23.......................................................................................................Hypovolaemic shock
23................................................................................Distributive or hyperdynamic shock
24....................................................................................................Assessing shock state
25................................................................................................Principles of shock reversal
25..........................................................................................ANAPHYLAXIS; a special case
26....................................................................................Sequential resuscitation phase 1
26...................................................................................Sequential resuscitation phase 2a
26..................................................................................Sequential resuscitation phase 2b
26....................................................................................Sequential resuscitation phase 3
27....................................................................................Sequential resuscitation phase 4
28iGuide 2009page 2
 
....................................................................................................................Side e
f 
ects
28..................................................................MODS; the multi-organ dysfunction syndrome.
28.....................................................................................................................Small print
29.............................................................................................................Metabolic Acidosis
29.......................................................................................................................Arrhythmias
29.....................................................................................................................Hypertension
30..........................................................................................................The Vascular Pedicle
30...............................................................................................................Respiratory Support
32.....................................................................................Prophylactic respiratory support
32.....................................................................................Therapeutic respiratory support
32.................................................................................................The ventilator care bundle
33.........................................................................................Tracheostomy; if, when, how.
33..................................................................................................Type 1 Respiratory failure
33............................................................................................................Acute lung injury
34...............................................................................Therapy of type 1 respiratory failure
35.....................................................................................Severe acute respiratory failure.
35.....................................................................................................................Small print
38.................................................................................................Type II Respiratory Failure
38..............................................................................Therapy of Type II respiratory failure
38...........................................................................................Humidification, secretions etc.
40.................................................................................Weaning from Mechanical Ventilation
40.........................................................................................................Weaning check-list
40....................................................................................................................Rapid wean
40......................................................................................................................Slow wean
40................................................................................................................‘Classic’ wean
40........................................................................................“Progressive care programme”
41...........................................................................................................Minitracheostomy
41.......................................................................................Fibreoptic Bronchoscopy (FOB)
41.....................................................................................................................Intubation.
41.........................................................................................Fluids, solutes, acid/base balance
42......................................................................................................Essential physiology.
42......................................................................................................................Natraemia
43....................................................................................................................Chloraemia
43........................................................................................................................Kalaemia
43.........................................................................................................Hypomagnesaemia
43.....................................................................................Therapeutic hypermagnesaemia
43.......................................................................................................................Calcaemia
44...............................................................................................................Phosphataemia
44................................................................................................................Albuminaemia
44................................................................................................Colloid osmotic pressure
44.......................................................................................................................Glycaemia
44.....................................................................................................Crystalloid Vs Colloid
46..........................................................................................Comparing available colloids
46....................................................................................Maintenance fluids, and deficits.
46........................................................................................................Resuscitation fluids
48..............................................................................................Blood and clotting factors
48..........................................................................................................Acid-base balance
49........................................................................................................................Renal Support
51..........................................................................Pathophysiology of Acute Renal Failure
51.................................................................................................Management of oliguria
52...................................................................................Renal Replacement therapy (RRT)
52.....................................................................................................Unphysiologic anions
54.............................................................................................................Nutrient balance
54...............................................................................................................Drug clearance
54........................................................................................................................Outcome
54..........................................................................................................................Liver Failure
55...............................................................................Unconjugated hyper-bilirubinaemia
55..................................................................................Conjugated hyper-bilirubinaemia,
55.................................................................................................Acute Liver Failure (ALF)
55...........................................................................................................................Ascites
56............................................................Upper GI tract Bleeding and Portal Hypertension.
56................................................................................................................Nutritional Support
57.........................................................................................................................Vitamins
57iGuide 2009page 3
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...