Multiprofessional Critical Care Review: Adult (2023)-Section 2 Handouts

Section 2 Handouts

Pdf Summary

This multiprofessional critical care review course focuses on various urgent medical conditions encountered in adults, categorized into several key areas:<br /><br />1. **Toxicology and Drug Overdoses**: This section describes the critical steps in assessing and managing patients with substance overdoses, highlighting the importance of history taking, physical examination, vital sign monitoring, and pattern recognition. It emphasizes specific interventions such as GI decontamination methods (activated charcoal, gastric lavage) and elimination of toxins through forced diuresis, hemoperfusion, and hemodialysis. It also covers antidotes for specific agents and therapeutic adjuncts for complications like arrhythmia and hypotension.<br /><br />2. **Management of Hypertensive Crisis**: Key considerations include determining the necessity and extent of blood pressure reduction, selecting appropriate medications (e.g., nitroprusside, labetalol, nicardipine, hydralazine), and balancing the reduction to avoid complications like ischemia. Special attention is given to hypertensive emergencies involving CNS (encephalopathy, hemorrhage) and cardiovascular systems (myocardial ischemia, aortic dissection).<br /><br />3. **Drug Withdrawal Syndromes in the ICU**: Covers managing withdrawal from alcohol, opioids, stimulants, and THC. For each substance, details are provided on withdrawal symptoms, supportive therapies (e.g., hydration, electrolytes, thiamine), and pharmacological treatments (e.g., benzodiazepines for alcohol, methadone for opioids, and neuroleptics for stimulant-induced agitation).<br /><br />4. **Bleeding and Coagulation Disorders**: Discusses identifying thrombocytopenia causes, drug-induced reactions, immune responses, transfusion strategies, and special conditions like TTP, DIC, and HIT. Diagnostic essentials and therapeutic options, including platelet transfusions, plasma exchange, and specific treatments for liver failure-induced coagulopathies, are elucidated.<br /><br />5. **Acute Kidney Injury (AKI)**: Reviews diagnosis, risk factors, and management, emphasizing volume resuscitation, avoidance of nephrotoxins, KDIGO guidelines for prevention, and the role of mechanical interventions. Clarifies proper fluid management strategies and diuretic use to prevent volume overload.<br /><br />6. **Oncologic Emergencies**: Identifies and manages emergent conditions in cancer patients such as tumor lysis syndrome, hypercalcemia, spinal cord compression, SVC syndrome, malignant airway obstruction, and immunotherapy-related toxicities. Emphasizes the need for interdisciplinary approaches and specific pharmacologic and supportive care measures.<br /><br />7. **Electrolyte Emergencies**: Detailed management strategies for disturbances like hyperkalemia, hyponatremia, hypernatremia, and calcium, phosphorus, and magnesium imbalances. The document highlights mechanisms of action, diagnostic strategies, and appropriate interventions.<br /><br />8. **Complex Acid-Base Disorders**: How to diagnose and manage acid-base imbalances using clinical and laboratory methods. Discusses compensation mechanisms, anion gaps, specific conditions like lactic acidosis, ketoacidosis, and the role of novel therapies like ECCO2R.<br /><br />9. **Endocrine Emergencies**: Management strategies for crises such as thyroid storm, myxedema coma, DKA, HHS, hypoglycemia, adrenal insufficiency, pheochromocytoma, and diabetes insipidus.<br /><br />10. **Acute GI Bleed**: This section ensures timely resuscitation and diagnostic interventions for upper, lower, and small bowel bleeds. Emphasizes endoscopic evaluation and management, alongside clinical stability assessment and when to employ surgical or radiological interventions.<br /><br />11. **Obstetric Emergencies**: Highlights pertinent physiologic changes in pregnancy, identifying and managing pregnancy-specific conditions such as preeclampsia, eclampsia, HELLP syndrome, and sepsis. Presents tailored critical care strategies to ensure maternal and fetal safety.<br /><br />This course equips healthcare professionals with critical knowledge and skills essential for managing acute medical conditions across a spectrum of critical health areas.

Keywords

critical care

toxicology

hypertensive crisis

drug withdrawal

bleeding disorders

acute kidney injury

oncologic emergencies

electrolyte emergencies

acid-base disorders

endocrine emergencies

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