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MEDICAL TOPICS
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Medical Topics
Critical Care Medicine
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Approach to the Critically Ill Patient
Introduction to the Approach to the Critically Ill Patient
Monitoring and Testing the Critical Care Patient
General references
Blood Tests
Blood tests references
Cardiac Monitoring
Pulmonary Artery Catheter (PAC) Monitoring
Procedure
Pulmonary artery occlusion pressure (pulmonary artery wedge pressure)
Mixed venous oxygenation
Cardiac output (CO)
Complications
Pulmonary artery catheter monitoring references
Noninvasive Cardiac Output Assessment
Point-of-care ultrasound
Esophageal Doppler monitor (EDM)
Thoracic bioimpedance
Noninvasive cardiac output assessment references
Intracranial Pressure (ICP) Monitoring
Near Infrared Spectroscopy (NIRS)
Near infrared spectroscopy references
Critical Care Scoring Systems
Vascular Access
Peripheral Vein Catheterization
Central Venous Catheterization
Complications of central venous catheterization
Central venous catheterization references
Midline Peripheral Catheterization
Midline peripheral catheterization references
Arterial Catheterization
Complications of arterial catheterization
Intraosseous Infusion
Hypoxia in Hospitalized Patients
Etiology
Evaluation
History
Physical examination
Testing
Treatment
Oxygen therapy
Key Points
Oliguria
Etiology
Evaluation
History
Physical examination
Testing
Treatment
Key Points
Agitation, Confusion, and Neuromuscular Blockade in Critically Ill Patients
Etiology
Evaluation
History
Physical examination
Testing
Treatment
Analgesia
Sedation
Neuromuscular blockade
Treatment references
Key Points
Cardiac Arrest and Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary Resuscitation (CPR) in Infants and Children
General reference
Major Differences Between Pediatric and Adult CPR
Prearrest
Chest compressions
Medications
Blood pressure
Equipment and environment
Temperature management
Airway and ventilation
Defibrillation
Treatment references
More Information
Cardiac Arrest
General references
Etiology
Etiology references
Pathophysiology
Symptoms and Signs
Diagnosis
Diagnosis references
Treatment
Treatment references
Prognosis
Prognosis references
Cardiopulmonary Resuscitation (CPR) in Adults
Overview of CPR
General references
CPR: Airway and Breathing
Airway and breathing references
CPR: Circulation
Chest compressions
Complications of chest compression
Circulation reference
CPR: Defibrillation
CPR: Monitoring and IV Access
CPR: Special Circumstances
CPR: Medications for ACLS
First-line medications
Other medications
Medications for ACLS references
Arrhythmia Treatment in CPR
CPR: Termination of Resuscitation
Termination of resuscitation references
CPR: Postresuscitative Care
Coronary angiography
Neurologic support
Blood pressure support
Post-return of spontaneous circulation arrhythmia treatment
Postresuscitative care references
More Information
How To Do Basic Airway Procedures
How To Insert a Nasopharyngeal Airway
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Reference
How To Insert an Oropharyngeal Airway
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
How To Do Abdominal Thrusts and Back Blows in the Conscious Adult or Child Who Is Choking
Indications
Contraindications
Complications
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
Reference
How To Do Head Tilt–Chin Lift and Jaw-Thrust Maneuvers
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Reference
How To Treat the Choking Conscious Infant
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
Reference
How To Do Bag-Valve-Mask (BVM) Ventilation
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
References
How To Do Other Airway Procedures
How To Do a Percutaneous Needle Cricothyrotomy
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Reference
How To Insert an Esophageal-Tracheal Double Lumen Tube or a Laryngeal Tube
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Reference
How To Do Noninvasive Positive Pressure Ventilation
Indications
Contraindications
Complications
Equipment
Additional Considerations
Positioning
Step-by-Step Description of Procedure
Aftercare
Tips and Tricks
How To Do a Percutaneous Cricothyrotomy
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Tips and Tricks
Reference
How To Do Orotracheal Intubation Using Video Laryngoscopy
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
Reference
How To Insert a Laryngeal Mask Airway
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Warnings and Common Errors
Tips and Tricks
Reference
How To Do Central Vascular Procedures
How To Do Infraclavicular Subclavian Vein Cannulation
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Seldinger (catheter-over-guidewire) technique
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment
Prepare the sterile field
Establish the needle insertion path (subclavian vein, infraclavicular approach)
Anesthetize the cannulation site
Insert the introducer needle (or finder needle, optional)
Assess the blood return
Optional: Use the finder needle to guide insertion of the introducer needle
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Widen the insertion tract
Place the catheter
Dress the site
Aftercare
Warnings and Common Errors
How To Do Internal Jugular Vein Cannulation
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Seldinger (catheter-over-guidewire) technique
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment
Prepare the sterile field
Establish the needle insertion path (internal jugular vein, central approach)
Anesthetize the cannulation site
Insert the finder needle
Assess the blood return
Insert the introducer needle, using the finder needle as a guide
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Widen the insertion tract
Place the catheter
Dress the site
Aftercare
Warnings and Common Errors
Tips and Tricks
How To Do Internal Jugular Vein Cannulation, Ultrasound-Guided
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Ultrasound guidance
Seldinger (catheter-over-guidewire) technique
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Preliminary preparation (nonsterile)
Prepare the equipment
Prepare the sterile field
Place a sterile cover over the ultrasound probe
Anesthetize the cannulation site
Insert the introducer needle
Assess the blood return
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Widen the insertion tract
Place the catheter
Dress the site
Aftercare
Warnings and Common Errors
How To Do Femoral Vein Cannulation (Without Ultrasound Guidance)
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Seldinger (catheter-over-guidewire) technique
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment
Prepare the sterile field
Establish the needle insertion path
Anesthetize the cannulation site
Insert the introducer needle (or finder needle, optional)
Assess the blood return
Optional: Use the finder needle to guide insertion of the introducer needle
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Widen the insertion tract
Place the catheter
Dress the site
Warnings and Common Errors
Tips and Tricks
How To Do Infraclavicular Subclavian Vein Cannulation, Ultrasound-Guided
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Ultrasound guidance
Seldinger (catheter-over-guidewire) technique
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment
Prepare the sterile field
Place a sterile cover over the ultrasound probe
Anesthetize the cannulation site
Insert the introducer needle using ultrasound guidance
Assess the blood return
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Widen the insertion tract
Place the catheter
Dress the site
Aftercare
Warnings and Common Errors
How To Do Femoral Vein Cannulation, Ultrasound-Guided
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Ultrasound guidance
Seldinger (catheter-over-guidewire) technique
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Preliminary preparation (nonsterile)
Prepare the equipment
Prepare the sterile field
Place a sterile cover over the ultrasound probe
Anesthetize the cannulation site
Insert the introducer needle
Assess the blood return
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Widen the insertion tract
Place the catheter
Dress the site
Warnings and Common Errors
Tips and Tricks
How To Do Femoral Artery Cannulation, Ultrasound-Guided
Indications
Contraindications
Complications
Equipment
Sterile procedure, barrier protection
Ultrasound guidance
Seldinger (catheter-over-guidewire) technique
Arterial pressure monitoring
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment
Prepare the sterile field
Place a sterile cover over the ultrasound probe
Anesthetize the cannulation site
Insert the femoral artery introducer needle using ultrasound guidance
Insert the guidewire
Remove the introducer needle (after successful guidewire insertion)
Extend the skin insertion site
Place the catheter
Dress the site
Warnings and Common Errors
How To Do Peripheral Vascular Procedures
How To Insert a Peripheral Intravenous Catheter
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Identify and prepare the site
Insert the peripheral venous catheter
Begin the IV infusion/establish the saline lock
Dress the site
Aftercare
Warnings and Common Errors
Tips and Tricks
How To Do Ultrasound-Guided Peripheral Intravenous Catheter Insertion
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the ultrasound device and identify a candidate vein
Insert the peripheral venous catheter using ultrasound guidance
Begin the IV infusion/establish the saline lock
Dress the site
Aftercare
Warnings and Common Errors
Tips and Tricks
Reference
How To Insert a Radial Artery Catheter
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment and the sterile field
Anesthetize the cannulation site
Insert the needle into the artery
Assess the blood return
Thread the arterial catheter
Connect the arterial line
Dress the site
Warnings and Common Errors
Tips and Tricks
Reference
How To Do Ultrasound-Guided Radial Artery Catheter Insertion
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the ultrasound device and identify the radial artery
Prepare the equipment and the sterile field
Place a sterile cover over the ultrasound probe
Anesthetize the cannulation site
Insert the needle into the radial artery using ultrasound guidance
Assess the blood return
Thread the arterial catheter
Connect the arterial line
Dress the site
Warnings and Common Errors
Tips and Tricks
Reference
How To Place an Intraosseous Catheter, Manually and With a Power Drill
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Prepare the equipment and the insertion site
Anesthetize the needle insertion site
Insert the intraosseous needle
Confirm intramedullary needle placement
Begin intramedullary infusion
Dress the site
Aftercare
Warnings and Common Errors
Tips and Tricks
References
How To Do Venous Blood Sampling
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Identify and prepare the site
Obtain the blood sample
Aftercare
Warnings and Common Errors
Tips and Tricks
Reference
How To Do Other Emergency Medicine Procedures
How To Do Diagnostic Peritoneal Lavage (DPL)
Indications
Contraindications
Complications
Equipment
Additional Considerations
Positioning
Relevant Anatomy
Step-by-Step Description of Procedure
Prepare the patient
Access the peritoneal cavity
Do the peritoneal lavage
Aftercare
Warnings and Common Errors
Tips and Tricks
References
How To Do E-FAST Examination
Indications
Contraindications
Complications
Equipment
Additional Considerations
Positioning
Relevant Anatomy
Step-by-Step Description of Procedure
Pericardial view (cardiac)
Perihepatic view (right upper quadrant)
Perisplenic view (left upper quadrant)
Pelvic view (suprapubic)
Thoracic view
Warnings and Common Errors
Tips and Tricks
References
How To Do Ultrasound
Indications
Contraindications
Complications
Equipment
Step-by-Step Description of Procedure
Choose a probe
Operate the ultrasound console
Maneuver the probe do ultrasound imaging
Warnings and Common Errors
Tips and Tricks
Respiratory Arrest
Airway and Respiratory Devices
Bag-Valve-Mask Devices
Laryngeal Mask Airways (LMA)
Endotracheal Tubes
Other Devices
Tracheal Intubation
Before Intubation
Evaluation of the airway
Preparing for intubation
Before intubation references
Tube Selection and Preparation for Intubation
Tube selection reference
Insertion Technique for Intubation
Insertion technique references
Alternative Intubation Devices
Alternative intubation devices references
Confirming Tube Placement
Nasotracheal Intubation
Complications of Tracheal Intubation
Complications of intubation reference
Surgical Airway
Cricothyrotomy
Tracheostomy
Medications to Aid Intubation
Sedation and analgesia for intubation
Medications to cause paralysis for intubation
Topical anesthesia for intubation
Post-intubation sedation and analgesia
References
Overview of Respiratory Arrest
Etiology
Airway obstruction
Decreased respiratory effort
Respiratory muscle weakness
Etiology references
Symptoms and Signs
Impending respiratory arrest
Symptoms and signs references
Diagnosis
Diagnosis references
Treatment
Treatment reference
Airway Establishment and Control
General references
Clearing and Opening the Upper Airway
Heimlich maneuver (subdiaphragmatic abdominal thrusts)
Respiratory Failure and Mechanical Ventilation
Noninvasive Positive Pressure Ventilation (NIPPV)
Overview of Respiratory Failure
Overview of Mechanical Ventilation
Indications
Respiratory Mechanics
Means and Modes of Mechanical Ventilation
Volume-cycled ventilation
Pressure-cycled ventilation
Ventilator settings
Patient positioning
Means and modes references
Sedation and Comfort for Mechanical Ventilation
Sedation and comfort references
Complications of Mechanical Ventilation and Safeguards
Complications of endotracheal intubation
Complications of mechanical ventilation itself
Complications of immobility
Safeguards to reduce complications of mechanical ventilation
Acute Hypoxemic Respiratory Failure (AHRF, ARDS)
Etiology
Pathophysiology
ARDS
Refractory hypoxemia
Pathophysiology references
Symptoms and Signs
Diagnosis
Treatment
Mechanical ventilation in cardiogenic pulmonary edema
Mechanical ventilation in ARDS
Treatment references
Prognosis
Prognosis reference
Ventilatory Failure
Pathophysiology
Symptoms and Signs
Diagnosis
Determination of cause
Treatment
Status asthmaticus
Acute-on-chronic respiratory failure
Other Types of Respiratory Failure
Liberation from Mechanical Ventilation
References
Sepsis and Septic Shock
Sepsis and Septic Shock
General references
Etiology and Risk Factors
Etiology references
Pathophysiology
Pathophysiology references
Symptoms and Signs
Diagnosis
Diagnosis references
Treatment
Perfusion restoration
Oxygen support
Antibiotics
Infection source control
Other supportive measures
Treatment references
Prognosis
Prognosis references
Key Points
Shock and Fluid Resuscitation
Shock
Pathophysiology
Compensation for shock
Reperfusion following shock
Multiple organ dysfunction syndrome (MODS)
Etiology and Classification
Hypovolemic shock
Distributive shock
Cardiogenic and obstructive shock
Etiology and classification references
Symptoms and Signs
Diagnosis
Identifying etiology
Additional testing
Diagnosis references
Treatment
General management of shock
Treatment of hemorrhagic shock
Treatment of distributive shock
Treatment of cardiogenic shock
Treatment references
Prognosis
Intravenous Fluid Resuscitation
Fluids
Hemorrhage
Nonhemorrhagic hypovolemia
Fluids references
Route and Rate of Fluid Administration
End Point and Monitoring of Fluid Resuscitation
Central venous pressure
Traumatic hemorrhagic shock
Complications
