Critical Care Medicine at a Glance

Richard M. Leach is Medical Director for the Cardiorespiratory and Critical Care Clinical Group at Guys and St Thomas' NHS Foundation Trust and an Honorary Professor of Medicine at Kings College, London, UK.

Preface viii

Acknowledgements ix

Units, symbols and abbreviations x

How to use your textbook xvi

Part 1 General

1 Recognising the unwell patient 2

2 Managing the critically ill patient 4

3 Monitoring in critical care medicine 6

4 The electrocardiogram 8

5 Cardiopulmonary resuscitation 10

6 Oxygen transport 12

7 Shock 14

8 Circulatory assessment 16

9 Fluid management: pathophysiological factors 18

10 Fluid management: assessment and prescription 20

11 Fluid management: fluid choice 22

12 Inotropes and vasopressors 23

13 Failure of oxygenation and respiratory failure 24

14. Oxygenation and oxygen therapy 26

15. Airways obstruction and management 28

16 Non-invasive ventilation 30

17 Endotracheal intubation 32

18 Mechanical ventilation 34

19 Extracorporeal membrane oxygenation

20 Respiratory management, weaning and tracheostomy

21 Arterial blood gases and acid–base balance

22 Analgesia, sedation and paralysis

23 Enteral and parenteral nutrition

24 Hypothermia and hyperthermia

25 Assessment of the patient with suspected infection

26 Sepsis and septic shock

27 Hospital-acquired (nosocomial) infections

28 Fever in the returning traveller

29 Fever (pyrexia) of unknown origin

30 Coronavirus disease 2019

31 End of life issues 56

Part 2 Medical

Cardiac

32 Acute coronary syndromes I: clinical pathophysiology

33 Acute coronary syndromes II: investigations and management

34 Arrhythmias: tachyarrhythmias

35 Arrhythmias: bradyarrhythmias

36 Heart failure and pulmonary oedema

37 Cardiac emergencies

38 Deep venous thrombosis and pulmonary embolism

Respiratory

39 Chest imaging and bronchoscopy

40 Community-acquired pneumonia

41 Hospital-acquired (nosocomial) pneumonia

42 Asthma

43 Chronic obstructive pulmonary disease

44 Acute respiratory distress syndrome

45 Pneumothorax and air leaks

46 Respiratory emergencies

Renal and metabolic

47 Acute kidney injury: pathophysiology and clinical aspects

48 Acute kidney injury: management and renal replacement therapy

49 Electrolyte disturbances: sodium and potassium

50 Electrolyte disturbances: calcium

51 Electrolyte disturbances: magnesium and phosphate

52 Diabetic emergencies

53 Endocrine emergencies

Gastrointestinal

54 Gastrointestinal haemorrhage

55 Jaundice

56 Acute liver failure

57 Acute pancreatitis

58 Vomiting and intestinal obstruction

59 Diarrhoea

60 Ascites

61 Abdominal imaging

Neurological

62 Acute confusional state, coma and status epilepticus

63 Stroke

64 Other cerebral vascular disorders

65 Infective neurological emergencies

66 Neuromuscular conditions

Infective

67 Specific bacterial infections

68 Common adult viral infections

69 Common fungal and protozoal infections

70 The immune compromised patient

Other systems

71 Coagulation disorders and transfusion

72 Drug overdose and poisoning

73 Dermatology in ICU

Part 3 Surgical 139

74 Trauma

75 Traumatic brain (head) injury

76 Chest trauma

77 Acute abdominal emergencies

78 Obstetric emergencies

79 Burns, toxic inhalation and electrical injuries

80 Envenomation, stings and bites

Part 4 Self-assessment

Case studies and questions

Case studies answers

Appendices

Appendix I Sequential (sepsis-related) Organ Failure Assessment score

Appendix II Classification of antiarrhythmic drugs (based on Vaughan Williams classification)

Appendix III Pacemaker types and classifications

Appendix IV Acute Kidney Injury Network (AKIN) staging system for acute kidney injury

Appendix V Rockall risk-scoring system for gastrointestinal bleeds

Appendix VI Child–Pugh grading

Appendix VII Typical criteria for liver transplantation

Appendix VIII Royal College of Physicians’ top nutrition tips

Index