This visual aid reviews the basics of tracheostomies and breaks down managing tracheostomy emergencies into three categories: obstruction, decannulation, and bleeding.
This visual aid provides the indications, contraindications, and information about performing a percutaneous dilational tracheostomy (PDT).
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.
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.
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.
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).
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.
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).
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.
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.
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.
This resource reviews basic common troubleshooting for VV ECMO. Issues range from expected complications requiring monitoring (e.g. rising transmembrane pressure) to immediately life-threatening emergencies that require urgent action (air embolism, oxygenator failure, etc). Understanding what can go wrong, and how emergent any of these issues are, is critical in managing people on ECMO.
This resource reviews how to measure CO including invasive techniques (pulse pressure variation, pulse contour analysis, pulmonary artery catheters), ultrasound techniques (LVOT and carotid VTI, IVC distensibility) and less invasive techniques (NICOM, End-Tidal CO2, etc). It also discusses the maneuvers that we can perform to test for fluid responsiveness, including, Passive Leg Raise (PLR), Mini-bolus, PEEP challenge, and End-Expiratory Occlusion (EEO). As a bonus, we talk about emerging techniques (fluid tolerance testing, VEXUS) as well as some techniques that just refuse to die (CVP, IVC size, PCWP, etc)
Rapidly determining the etiology of shock is a core ICU skill, requiring integration of physiology, history, exam, and POCUS. This ICU OnePager provides a framework for thinking about shock that you can use to categorize it.
This visual aid reviews the pathogenesis and differential diagnosis, including ANCA vasculitis (GPA, MPA, EGPA), anti-basement membrane disease (anti-GBM), as well as other diseases that can present similarly (SLE & other rheum diseases), and infections. It also explains how diffuse alveolar hemorrhage (DAH) is diagnosed and how to interpret ANCA testing and renal pathology.
This visual aid reviews the components of transfusions, the special types of blood products that can be ordered, and the reactions that can occur with transfusions.