Everything about ICU education
drnandyala Upper GI Bleeding: Patients with acute upper gastrointestinal (GI) bleeding commonly present with hematemesis (vomiting of blood or coffee-ground like material) and/or melena (black, tarry stools). The initial evaluation of patients with acute upper GI bleeding involves an assessment of hemodynamic stability and resuscitation if necessary. Etiology: The most common causes of upper gastrointestinal bleeding include … Read more
Sedation BIS Monitor: It is used to monitor the depth of sedation or anesthesia. BIS index is a practical processed EEG parameter that measures the direct effects of sedatives on brain. Used mainly in paralyzed patients who can’t communicate and hence, can’t use RASS scale. The sensor on forehead sends raw EEG information to … Read more
Airway Management: Emergency airway management is associated with a high complication rate. Evaluating the patient prior to airway management is important to identify patients with increased risk of failed airways. Induction agents are often required, but most induction agents are associated with hypotension during emergency intubation. Use of muscle relaxants is controversial for emergency intubation, … Read more
Static hemodynamic monitoring variables The utility of each variable as a single absolute value is questionable. Some individual hemodynamic values are useful primarily as threshold monitors. For example, because a primary determinate of organ perfusion is perfusion pressure, systemic hypotension to below a certain threshold is clinically relevant. Furthermore, elevation in central venous pressure (CVP; … Read more
Tachycardia Tachycardia is defined as a heart rate above 100 beats per minute, but symptomatic tachycardia generally involves rates over 150 beats per minute, unless underlying ventricular dysfunction exists. Management of tachyarrhythmias is determined by the presence of clinical symptoms and signs caused by the rapid heart rate. The fundamental approach is as follows: … Read more
Hypertensive Emergencies Patients with a systolic BP (SBP) > 179 mm Hg or a diastolic BP (DBP) > 109 mm Hg are usually considered to be having a “hypertensive crisis.” Severe elevations in BP were classified as hypertensive emergencies in the presence of acute end-organ damage or as hypertensive urgencies in the absence of acute … Read more
Cardiac Arrest Sudden cardiac arrest and sudden cardiac death refer to the sudden cessation of cardiac activity with hemodynamic collapse, typically due to sustained ventricular tachycardia/ventricular fibrillation. Etiology: Coronary artery disease – 70% of sudden cardiac arrests are due to CAD. Other structural heart disease: Heart failure and cardiomyopathy Left ventricular hypertrophy due to hypertension or other causes. … Read more
ARDS ARDS and acute lung injury (ALI) syndromes are forms of type I or acute hypoxemic respiratory failure. This form of lung dysfunction arises from diseases causing the collapse and/or filling of alveoli, with the result that a substantial fraction of mixed venous blood traverses nonventilated airspaces, effecting a right-to-left intrapulmonary shunt. In addition to … Read more
Metabolic Acidosis Acid-base balance is maintained by pulmonary and renal excretion of carbon dioxide and nonvolatile acid, respectively. Renal excretion of acid involves the combination of hydrogen ions with urinary titratable acids, particularly phosphate (HPO42- + H+ —> H2PO4-), or with ammonia to form ammonium (NH3 + H+ —> … Read more
Acute Renal Failure Acute renal failure (ARF) is a syndrome characterized by rapid decline GFR with retention of nitrogenous waste products and perturbation of extracellular fluid volume and electrolyte and acid–base homeostasis. It is defined as a measurable increase in serum creatinine concentration, usually a relative increase of 50% or absolute increase by 0.5–1.0 mg/dL. RIFLE CRITERIA: 1. … Read more