Leptospirosis
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
Spinal Injury Patient Hot Case
GENERAL APPROACH INTRODUCTION CUBICLE INFUSIONS VENTILATOR MONITOR EQUIPMENT QUESTION SPECIFIC EXAMINATION -> scars, surgical wounds, drains-> motor level: myotomes, spinal reflexes, limbs and abdominal muscles, return of bulbocaveronsus reflex (resolution of spinal shock)-> sensory level: dermatomes, sensory tracts (dorsal columns,…
Respiratory Failure Hot Case
Respiratory Failure Hot Case
Oliguria and Anuria 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,…
Obstetric Patient Hot Case
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…
Neutropaenic Fever Hot Case
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->…
Multi-organ Failure Hot Case
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…
Intra-abdominal Catastrophe Patient Hot Case
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
Acute Graft Versus Host Disease: major complication of allogeneic haematopoietic stem cell transplantation
Hepatic veno-occlusive disease
Hepatic veno-occlusive disease aka sinusoidal obstruction syndrome (SOS) important complication of stem cell transplantation (SCT) mortality >30%
Erythropoietin
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)
Procedures and Coagulopathy
Procedures and Coagulopathy: many procedures are contra-indicated in the presence of coagulopathy; the degree of acceptable coagulopathy for different procedures is controversial