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Training level
Level 1 = This fundamental material is intended for a broad audience of learners, of multiple cadres, who may provide care for patients with severe or critical illness, but may have little or no experience caring for severe or critically-ill patients and are usually not the primary decision maker for guiding care.
Level 2 = This intermediate material is intended for a more advanced audience of learners than level 1, with some experience caring for patients with severe or critical illness, and may not be essential for all practitioners who provide this level of care.
Level 3 = This advanced material is intended for an audience with significant experience caring for patients with severe and critical illness, including those who guide care decisions these patients.
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Five potentially life-threatening toxidromes (sympathomimetic overdose, anticholinergic overdose, serotonin syndrome, neuroleptic malignant syndrome, and malignant hyperthermia) can all present with overlapping clinical features: hyperthermia, altered mental status/seizures, rhabdomyolysis. Careful history and physical exam are essential to differentiate and a combination of supportive care (ABCs, cooling, etc) and specific therapies can be life-saving. This resource reviews the features of each with historical/exam pearls to differentiate.
v1.0 (2021-10-20)
Neuromuscular blockers (NMBs) can be a useful adjunct to improve oxygenation and (maybe) reduce mortality in severe ARDS. This resource describes the physiology of muscle relaxation in ARDS, explains how to safely use NMBs as well as some basics about associated monitoring equipment: EEG/Bispectral index (BIS) monitors are used to (maybe) reduce over- or under-sedation and Train of Four (TOF) monitors are used to avoid excess blockade.
v1.0 (2021-11-01)
This resource reviews the d/dx (BATTLECAMP) and walks through an approach for workup, airway management, and interventions (bronchoscopic, IR, and surgical) to control hemorrhage.
v1.1 (2020-12-27).
Non-invasive positive pressure ventilation (NIPPV) is a valuable technique to support oxygenation and ventilation in people with respiratory failure to potentially avoid intubation. This resource reviews when to (and when not to) use NIPPV, as well as modes (CPAP, BiPAP/BiLevel, & AVAPS) and interfaces (nasal, partial face, full face, & helmet).
v1.1 (2020-05-30)
External cardiac pacing is a technique for temporarily treating brady- and tachydysryhthmias in the ICU. This resource covers the basics, including types of pacing leads (transvenous vs epicardial, bipolar vs unipolar), pacing modes (VVI, DDD, etc), and a stepwise guide to initiating pacing.
v1.1 (2021-01-25).
Lactate and Lactic acid are frequently used in labs in the ICU. This resource reviews the physiology of why/how we produce lactic acid and breaks lactic acidosis into two categories: Impaired O2 Delivery (Type A Lactic Acidosis) and Impaired O2 clearance/utilization (Type B Lactic Acidosis).
v1.0 (2021-01-25)
Occasionally medical and interventional therapies can’t stop an upper GI bleeds due to esophageal varices. In those rare cases, placement of a Minnesota Tube can be life-saving. This resource reviews how Minnesota Tubes work & shows you how to safely place and secure them. There are also some great how-to videos that walk you through the process step by step.
v1.0 (2021-01-29)
Many conditions can raise intra-abdominal pressure, potentially leading to a life-threatening complication: abdominal compartment syndrome (ACS). This resource reviews the physiology of Abdominal Perfusion Pressure and ACS, shows you how to approximate IAP using bladder pressure measurement, and discusses an approach to diagnosis & approach to management.
v1.0 (2021-02-07)
Renal replacement therapies are commonly used in the ICU to remove excess fluid and clear the blood of endogenous and exogenous toxins. This resource explains the physics & physiology of dialysis, discussing the key concepts (dialysis = diffusion, hemofiltration/ultrafiltration = convection) and the components of the dialysis circuit (pumps, dialyzer, dialysis solution, replacement fluid, etc). It also reviews all the confusing modes of dialysis: IHD, SLED, and CRRT including SCUF, CVVHF, CVVHD, and CVVHDF.
v1.0 (2021-02-17)