
Subarachnoid Haemorrhage Patient Hot Case
Subarachnoid Haemorrhage Patient Hot Case
Subarachnoid Haemorrhage Patient Hot Case
Leptospirosis is an infection caused by the spirochaete genus of Leptospira. Severe forms may result in critical illness, including Weil disease and severe pulmonary haemorrhage
GENERAL APPROACH Phase of injury— Acute: ileus, cardiovascular, ventilation— Sub-acute: recurrent atelectasis and segmental collapse— Chronic: pain, psychological issues, infection (uro, resp, pressure areas), autonomic dysreflexia, spasm. Stability of spine Tracheostomy Other injuries INTRODUCTION CUBICLE Edgerton spinal bed until spine…
Respiratory Failure Hot Case
GENERAL APPROACH Type of renal failure Acute (usually multi-factorial) Chronic (e.g. dialysis dependent) or Acute on Chronic (e.g. post-renal transplant) Causes Pre-renal – hypovolemia, any cause of shock, sepsis, renovascular disease Intra-renal – nephrotoxins, urine for casts + protein, sepsis,…
GENERAL APPROACH Illness requiring ICU admission Pregnancy + Baby Delivery – when or already done INTRODUCTION CUBICLE CTG presence of midwives INFUSIONS PET: MgSO4, phenytoin, hydralazine, GTN pre-term labour: tocolytics, steroids thromboembolism: heparin bleeding: blood products, fluid boluses, TXA cardiogenic…
GENERAL APPROACH Infectious community acquired nosocomial (surgical site, lines, chest, urine, sinusitis) Non-infectious head injury DVT -> PE drug/toxin SIRS (post surgery, trauma, aspiration, pancreatitis) Hypermetabolic syndromes -> thyroid storm-> NMS-> MH-> heat stroke-> phaeo-> liver failure-> burns-> cocaine toxicity->…
GENERAL APPROACH Initial illness and response to treatment Diagnosis correct Organ failures and support for each organ Complications of stay – nosocomial infection… INTRODUCTION CUBICLE number of organs being supported INFUSIONS resuscitation fluid being administered noradrenaline (sepsis) sedation and neuromuscular…
GENERAL APPROACH Cause Treatment (source control) — complete or ongoing? Nutrition — NBM? route? nutritional status? Complications – ACS, fungal sepsis? How to move forward? Important causes intra-abdominal sepsis pancreatitis abdominal trauma perforation (e.g. ulcer, appendicitis, diverticulitis, tumor, obstruction, anastomotic…
Acute Graft Versus Host Disease: major complication of allogeneic haematopoietic stem cell transplantation
Hepatic veno-occlusive disease aka sinusoidal obstruction syndrome (SOS) important complication of stem cell transplantation (SCT) mortality >30%
Erythropoietin (EPO) is an endogenous hormone that stimulates erythrocytosis. Role in critical illness is unclear and is limited by the complications of hematopoietic activation (e.g. VTE)