Severe Heart Failure Management
Severe Heart Failure Management
Month January 2019
Right ventricular infarction
Right ventricular infarction. Suspect in all patients with inferior STEMI
Medication Error
Medication error occurs when a medication given inappropriately regardless of whether an adverse clinical outcome occurs; drug error incidence = 1/135 anaesthesia; can cause significant harm to patients; need to recognise and adopt techniques to minimise such events
Fire In ICU
Approach to Fire in ICU has 3 key goals: protect patients and staff; manage fire hazard; identify cause and prevention
Physiotherapy in ICU
Physiotherapists are part of the multidisciplinary ICU team. The traditional focus of treatment has been the respiratory management of both intubated and spontaneously breathing patients. Evidence of the longstanding physical impairment suffered by survivors of intensive care has resulted in physiotherapists re-evaluating treatment priorities to include exercise rehabilitation as a part of standard clinical practice
ICU Ward Round
The Intensive Care Unit (ICU) ward round consists of scheduled discussions in which healthcare providers review clinical information and develop care plans for critically ill patients
Preload
Preload = initial myocardial fibre length prior to contraction; determined by anything that effects ventricular volume at the end of diastole
Pericarditis
Pericarditis = inflammation in the pericardium
Pulmonary Embolus versus Right Ventricular Infarction
Features that distinguish Pulmonary Embolus from Right Ventricular Infarction
Pericardial disease
Pericardial disease
Syncope
Syncope is transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. Such an event without loss of consciousness is often termed “presyncope”. Underlying cause is often not found in the emergency department (~50%)
pCO2 gap
pCO2 gap is a surrogate for cardiac output; pCO2 gap = PcvCO2 - PaCO2; pCO2 gap >6 mmHg suggests a persistent shock state that may be amenable to fluid resuscitation +/- intrope support; a “ScvO2-cvaCO2gap-guided protocol” has been proposed to guide the management of septic shock