Introduction to Critical Care Medicine Glossary

Abdominal compartment syndrome: When the pressure in the abdominal

compartment becomes too high and increases the pressure on the blood
vessels. This means that less blood can be supplied to the intra-abdominal
organs.

Acute exacerbation: When a chronic condition becomes worse for a short

period of time

Acute respiratory disctress syndrome: Widespread inflammation in the lungs

with various causes such as sepsis, trauma, or pneumonia.

Antifibrolytic: Encourages blood to clot by preventing the break down of blood

clots.

Afterload: the pressure at which the heart has to pump the blood into the
peripheral circulation against.

Arterial Line: A tube inserted into an artery, usually at the wrist (radial artery)
or the inner elbow (brachial artery). It is used to measure blood pressure and
is also useful for blood sampling.

Aspiration pneumonia: Lung infection caused by inhaling material from the gut
e.g when vomiting

Atelectasis: The complete or partial collapse of a lung or lobe of the lung

Auscultation: The act of listening with a stethoscope.

Bacteraemia: The presence of bacteria in the blood. This suggests infection in

the blood.

BiPAP: Biphasic Positive Airway Pressure

Blood cultures: When a sample of blood is sent to the laboratory to see if any
bacteria can be grown from it. Used as an investigation in suspected infection
or sepsis.

Bronchial breathing: Harsh sounds heard from the lungs which would normally
be heard from the trachea. This suggests consolidation e.g due to infection.

Bronchoscopy: When a small camera is used to look into the airways

C:

Cannula: A plastic tube, usually inserted into a vein for giving fluid, blood or
medications. This is what a drip is attached to in hospitals.

Cardiac Tamponade: When blood fils the space between the heart and the
layer of tissue that covers it. This means the heart has less space to beat and
will cause the patient to deteriorate clinically.

Cerebral oedema; Swelling of the brain.

Coagulation factors: Components of the blood that make it clot.

Coagulopathy: When the blood doesn’t clot properly.

Colostomy: Where part of the colol (Large bowel) is brought to the surface of
the abdomen and a bag attached to collect waste.

Compliance (Lung): The ability of the lung to stretch

Compound fracture dislocation: when a bone is broken several times and the
joint that the bone is associated with is also dislocated.

Consolidation: With respect to the description of a chest xray, this is when an

area appears more white than the rest of the lung. This suggests lung
pathology resulting in it filling with abnormal material, such as fluid or pus.

COPD: Chronic Obstructive Pulmonary Disease

CPAP: Continuous Positive Airways Pressure-a type of non invasive

ventilation however can also be used as one of the settings on a ventilator
when trying to wean a patient. This exerts continues positive pressure to the
airway so that they remain open as opposed to collapsing in expiration.
Critical Care: Intensive care and high dependency care

Creatinine: A breakdown product of skeletal muscle. It is used as a marker of

kidney function

Crepitations:The crackling sound heard upon chest auscultation, signifying

underlying lung disease

Cricoid pressure: When pressure is exerted to the cricoid cartilage during

intubation. This compressed the oesophagus in an effort to prevent aspiration
of gastric contents during intubation.

CRP: C Reactive Protein. An acute phase protein made by the liver which is a
marker of inflammation.

Crystalloid: A type of IV fluid e.g 0/9% saline

Cytokine: Small proteins involved in cell signalling.

DDAVP: Desmopressin

Decarboxylate: Remove carbon dioxide

eGFR: Estimated Glomerular Filtration Rate. A formula using the level of

creatinine in the blood is used to calculate the eGFR. It is another marker of
kidney function

ECMO: Extracorporeal Membrane Oxygenation (also known as

Extracorporeal Life Support) provides support to those with cardiac and
respiratory failure when they are no longer able to provide enough gas
exchange or perfusion to sustain life. This works by removing the blood from
the patients body via a large bore line and artificially removing the carbon
dioxide and oxygenating the red blood cells before returning it to the body via
a second large bore line

ECOR: Extracorporeal Membrane Carbon Dioxide Removal provides support

for those with acute respiratory failure. This technique reduces the level of
carbon dioxide in the blood to reduce the risk of lung injury associated with
mechanical ventilation

Encephalopathy: A broad term used to describe abnormal brain function.

Endotracheal tube: The tube used to intubate a patient. It allows for

mechanical ventilation whilst protecting the airway.

EPAP: Expiratory Positive Airway Pressure. The pressure set for the period of
expiration when using BiPAP

Epidural analgesia: When anaesthetic is injected into the epidural space

around the spinal cord to provide analgesia. This often runs as an infusion, for
example in the post operative period, or during childbirth.

Epigastric: The area of the abdomen just below the where the ribs join in the
centre.

Euvolaemia: When a patient has a normal volume of circulating blood fluid

volume.

Extracorporeal life support: similar to cardiopulmonary bypass used during

open heart surgery, this allows the tissues to be oxygenated inpatients with
life threatening respiratory or cardiac failure. It is also known as ECMO (see
below)
Extubate: When the endotracheal tube which connects the patient to the
ventilator is removed.

Finger thoracostomy: When a hole is made into a patients chest and a finger
is used to open the hole and let air out. This would be used in the pre-hospital
environment to treat a tension pneumothorax.

GCS: Glasgow Coma Score: A method of assessment of the conscious level

of a patient in response to stimuli.
Gastro-oesophageal reflux: Also known as heartburn. When acid from the
stomach causes a burning sensation in the upper abdomen or lower chest.

Haemodynamic instability: Unstable blood pressure which can be

dangerously low leading to inadequate perfusion of vital organs.

Haemoptysis: When blood or blood stained mucous is coughed up from the

respiratory tract

Haemostatic: A material which is used to stop bleeding.

High Dependency Unit: Also known as ‘level 2 care’. Patients who need closer
observation or intervention including single organ support or post operative
care. They may also have been stepped down from a higher level of care

Hudson Mask: A mask used to deliver oxygen to a patient.

Hypercarbia: An excess of carbon dioxide in the blood (>6.0kPa)

Hyperchloraemia: Too much chloride in the blood.

Hypercoagulable: When the blood has more of a tendency to clot than normal.

Hypovolaemis: When the circulating blood volume in a patients body is less

than normal.

Hypoxaemic respiratory failure: respiratory failure with oxygen levels <9.5kPa

and a normal carbon dioxide level (4.7-6.0kPa) in the blood

Hypoxia: When the oxygen level in the blood is less than normal (<9.5kPa on
arterial blood gas)

Induction of anaesthesia: When an anaesthetist puts a patient to sleep

Inotropes: Drugs which increase blood pressure by increasing the contractility
of the heart.

Intensivist: A doctor who specialises in the care of critically ill patients, who
are competent in intubation

Intensive Care Unit: Also known as ‘level 3 care’. Patients who are intubated
and ventilated or who need support of at least 2 organs are treated here. They
are continuously monitored and usually have complex problems and need
support for multi-organ failure

Intra-osseous: Into the bone

Intubation: When a tube is inserted via the patients mouth into the trachea to
allow them to be mechanically ventilated.

IPAP: Inspiratory Positive Airway Pressure. The pressure set to support

ventilation when using BiPAP

Ischaemic: Damage to an organ or tissues caused by a lack of oxygen supply

to that area.

Jejunostomy: When part of the small bowel (jejunum) is brought to the surface
of the abdomen. A bag is attached to collect waste.

Laparotomy: Any surgical procedure involving a large incision through the

abdominal wall in order to access the abdominal cavity.

Manual in-line immobilisation: When the head is held in line with the spine in
an effort to prevent a spinal injury.

MAP: Mean Arterial pressure=diastolic blood pressure + 1/3 (systolic-diastolic

blood pressure). This is the average blood pressure during a single cardiac
cycle.

Mediastinum: The area in the middle of the thorax which holds all of the
tissues except the lungs and the pleurae.

Meningism: A triad of symptoms-neck stiffness, photophobia and headache. It

is often associated with nausea and vomiting. It is suggestive of meningitis.

MI: Myocardial Infarction. Also known as a heart attack.

Minute Ventilation: The volume of gas inspired and expired in one minute i.e
tidal volume x breathing rate.

Nasal Cannulae: Small tubes which go into the patients nostrils to deliver
oxygen.

Nasogastric tube: A tube inserted into the nose that extends into the stomach.
It can be used for feeding or to remove gas or liquid from the stomach. This
can relieve nausea.

Nasopharyngeal airway: A small tube inserted into the nose which extends to
the back of the throat to keep the upper airway open. It can also be used to
clear secretions as a suction catheter can be inserted into it to reach the
upper airways.

Neuromuscular blocking agents: Medications which cause muscle relaxation

and so paralysis which can be reversed.

Neutrophils: A type of white blood cell which helps to fight bacterial infections
Normovolaemia: See euvolaemia.

Oropharyngeal airway: En example is a guedel. These are tubes which

inserted into the mouth an extend to the back of the throat in an effort to keep
the airway open.

PEEP: Positive End Expiratory Pressure

Peritonism: Abdominal pain characterised by guarding and rebound or

percussion tenderness.

Photophobia: When the eyes are sensitive to light. This can be a symptom of
meningitis.

Pleural effusion: The build up of fluid around one or both lungs.

Pneumothorax: When air collects in the pleural space between the lung and
the chest wall. This is abnormal and is sometimes referred to as a ‘collapsed
lung’

Pneumomediastinum: When air collects in the mediastinum. This is abnormal.

Preload: The pressure exerted on the ventricle by the volume of blood present
at the end of diastole (end diastolic volume) causing it to stretch before
contracting.

Prone: When a patient is ‘prone’ they are lying on their front

Pulmonary contusion: Essentially, a bruise to the lung.

Rapid sequence induction: When a patient is quickly anaesthetised and

intubated. This usually happens in an emergency situation.

Respiratory Failure: PaO2 less than 8kPa (60mmHg) in the absence of intra
cardiac shunting

Respiratory tract infection: A chest infection. A lower respiratory tract infection

is an infection of the lung, also knows as pneumonia.

Resuscitation: The initial phase of stabilising a critically unwell patient. For

example, a hypotensive person can be resuscitated with IV fluids. This does
not always refer to cardip-pulmonary resuscitation, which involves chest
compressions.

Sinus Tachycardia: a heart rate greater than 100 beats per minute
SpO2: The percentage of haemoglobin saturated by oxygen compared to the
total body haemoglobin. An indication of how much oxygen is being carried in
the blood.

Splenectomy: The removal of the spleen.

Thrombus: Blood clot

Thromboelastography: A test to see how efficiency of blood coagulation.

Tidal volume: The volume of air which passes in and out of the lung during a
normal breath

Tourniquet: In trauma, this is a band which is tied around a limb and tightened
in an attempt to stop the bleeding distal to it.

Trachea: Also known as the windpipe. A tube made of cartilage that joins the
pharynx and the larynx to the lungs.

Trauma mask: A non rebreathe mask which is used to deliver as much

oxygen to the patient as possible. There is also a reservoir bag attached to it.
This provides extra oxygen in case the patient breathes in all of the oxygen
supplied via the mask in one breath.

Triage: The process of prioritising which patients should be seen first

depending on how unwell they are.

Urea: the final breakdown product of amino acids which make up proteins.
This is a waste product which is excreted by the kidneys. It can be used a
marker of kidney function and hydration status.

Vasoconstriction: When the blood vessels constrict and become smaller in

diameter.

Vasodilation: When blood vessels dilate and increase their diameter.

Vasopressors: Drugs which cause the blood vessels to constrict and therefore
increase blood pressure.

Ventilation: When a patient is intubated and attached to a machine that

breathes for them. Ventilation also refers to the process of breathing air into
and out of the lungs.

Ventilation-perfusion matching: When the air moving into and out of the lungs
matched the blood flow to the lungs. This means that the oxygen breathed in
can be transferred into the blood and transported around the body.

Viscus: In medical terms, this means an organ e.g a perforated viscus could
mean a hole in the bowel.

Viral Pneumonitis: Inflammation of the lungs caused by a viral infection

WCC: White Cell Count. White cells are part of the immune system which
help to fight infection. Their count can either rise or fall when infection, or
sepsis, is present.

Wheeze: High pitched, musical noises heard from the lungs due to the
turbulent flow of air from the constriction of the small airways (bronchioles)