CCC Update 003

Here’s an update on the latest updates to the Critical Care Compendium (the quick way to get there is the CCC at the very top of every LITFL page). Thanks to all those who continue to plug holes in the CCC (and my knowledge) which suggestions for improvement, updates based on recent evidence and reworking pages that simply need to be better.

In particular, a special thanks to Dr Sarah Yong who has made a number of valuable contributions and as a result has had to join the CCC team… If you can’t beat ‘em, join ‘em (then beat ‘em, as Peter Safar would say).

LITFLers please keep leaving comments or contact me about any inaccuracies or suggestions for improvement so that the CCC with continue to evolve as a comprehensive critical care learning resource. You may feel like you’re being a pest, but it really is the best way for me to stay on top of this 1500 page behemoth!

Now, on with the updates:

Glycocalyx in critical illness

The FOAM world went crazy about the glycocalyx after Paul Marik’s talk on fluids in sepsis went up on EMCrit. Here is the CCC lowdown on this mysterious structure that may hold the secret to sepsis and capillary leak syndromes and plays a central role in the revised Starling model of capillary filtration.

Septic emboli

  • All you need to know!

Antibiotic Timing

  • The mantra for timing of antibiotics in severe sepsis is ‘hit hard, early and appropriately’. How strong is the evidence for this, and what about other settings such as pneumonia? Why do delays in antibiotic administration occur?

VBG versus ABG

  • A topic close to the heart of every emergency physician. How does a VBG compare to an ABG? Unnecessary ABGs annoy the hell out of me… Also, if you perform an ABG on a conscious patient please use local anaesthetic.

Post-Splenectomy Care

  • The management section is much improved thanks to comments by Matt Mac Partlin. This topic came up in the hot cases of the last FCICM exam – know it!

Storage lesions

  • Being transfused with ‘old RBCs’ may be bad for you… Find out why here. Definitive RCTs are keenly awaited!

Thrombolysis for submassive pulmonary embolus

New article summaries have been added to:

That’s it for now.

Vive la FOAM!

CCC 700 6

Critical Care


Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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