Critical Care Flashcards
What is critical care?
Management of anyone with organ system failure.
Involves initial assessment and management of respiratory, cardiovascular and/or neurological failure, as well as fluid management
What are the types of respiratory failure?
Type I- failure in oxygenation
Type II- failure in both oxygenation and ventilation
How can ventilation be given in respiratory failure?
High flow nasal canula
Non-invasive ventilation- useful in type II
What is the definition of shock?
Acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in cellular hypoxia
What are the main types of shock?
Distributive Hypovolaemic Anaphylactic Neurogenic Cardiogenic
What is distributive shock?
Most common (50-60% of all shock), vascular tree dilated inappropriately so blood is not returning to heart correctly. Reversible
What is hypovolaemic shock?
Insufficient fluid in vascular tree, can be associated with septic shock
What is anaphylactic shock?
-Profound vasodilation causes pump failure and fluid shift
What is neurogenic shock?
Spinal cord injuries, particularly high ones knock out sympathetic firing and so vasodilation occurs
What is cardiogenic shock?
Heart is not pumping hard enough, can be acute or chronic
What drugs can be given when there is sufficient fluid in the vascular tree but cardiac support is required?
Vasopressors (metaraminol, noradrenaline)
Inotropes (adrenaline, dobutamine)
What are the causes of neurological failure?
Metabolic
Infection
Trauma
Stroke
What are the red flag signs in neurological failure?
- Uneven pupils
- Cushing’s reflex (hypertension, bradycardia + irregular breathing, sign of increased ICP)
- Failure to maintain airway
- GCS <8
