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

• A detailed overview to accompany the just released RAGE Session Two podcast on the same controversial topic.

New article summaries have been added to:

• Tracheostomy Literature Summaries
• ARDS Literature Summaries
• Cardiogenic Shock Literature Summaries

That’s it for now.

Vive la FOAM!