Hot Case General Approach
Hot Case General Approach
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Hot Case General Approach
GENERAL APPROACH Infectious community acquired nosocomial (surgical site, lines, chest, urine, sinusitis) ‘hidden’ sepsis (endocarditis, neuraxial infection, retroperitoneum, sinusitis) Non-infectious head injury VTE drug/toxin SIRS (post surgery, trauma, burns, ICH, aspiration, pancreatitis, CTD) Hypermetabolic syndromes (e.g. thyroid storm, NMS, MH, heat stroke, pheochromocytoma) INTRODUCTION…
Blood transfusion complications may be early or late
Anemia and blood transfusion is common in the critically ill, and are associated with costs and morbidity/ mortality
Tumour Lysis Syndrome: oncological emergency due to turnover of high cell mass malignancies resulting in severe metabolic derangement
von Willebrand Disease: commonest inherited coagulation disorder (autosomal dominant); protein involved in (1) platelet adhesion and (2) carriage of factor VIII; leads to: factor VIII deficiency, abnormal platelet adhesiveness and abnormal vascular endothelium
Venous thromboembolism (VTE) may contribute to up to 12% of deaths in ICU and is the No.1 preventable cause of hospital death; asymptomatic events range from 10-80% in various medical and surgical groups
Peripheral Intravenous Cannula (PIVC) aka venflon: Uses; IV fluid administration; blood sampling; drug administration; needle thoracostomy for tension pneumothorax; needle cricothyroidotomy
Non-rebreathing (NRB) Oxygen Mask; delivery of high FiO2 in the spontaneously breathing patient
Oropharyngeal Airway (OPA): Lifts the tongue off the posterior pharyngeal wall to prevent airway obstruction; bite block; assist oropharyngeal suctioning; promotes moulding of the face of a mask for manual ventilation
non-invasive blood pressure measurement involves the application of a pressure cuff and can be performed manually (listening for Korotkoff sounds as the pressure is released
Mechanical Circulatory Support