Intro To Critical Care

Question 1

What does SAMPLE stand for?

Answer 1

For history taking
Symptoms
Allergies
Medications
PMH
Last oral intake
Events leading to presentation

Question 2

What does A, B, C, D, E stand for?

Answer 2

Airway
Breathing
Circulation
Disability
Environment/ exposure

Question 3

What are the four things in your differential when you see a person in shock?

Answer 3

Hypovolumic
Distributive
Cardiogenic
Obstructive

Question 4

SIRS
what does it stand for?
criteria

Answer 4

Systemic Inflammatory Response Syndrome

2 or more of the following

• temp greater than 38 or less than 36 C
• HR greater than 90 bpm
• RR greater than 20
• WBC greater than 13,000 or less than 4000 or greater than 10% bandemia

Question 5

Define Sepsis and septic shock

Answer 5

sepsis= infection (suspected or confirmed) + SIRS

severe sepsis= Sepsis + organ dysfunction

septic shock= refractory hypotension or hypoperfusion, despite adequate volume resuscitation

Question 6

Sepsis

-who needs to be in the ICU?

Answer 6

If after recieving 1 L IV fluids or 30cc/kg…

1. systolic BP less than 90
2. lactate greater than 4
3. vasopressors required
4. mechanical ventilation required

Question 7

Sepsis cliff notes- what needs to happen right away?

Answer 7

1. a LOT of fluids early
2. APPROPRIATE Abx
3. source control in less than 12 hours

Question 8

What is ARDS?

Answer 8

Acute Respiratory Distress Syndrome

-an inflammatory lung condition involving both lungs that may complicate severe pneumonia, trauma, sepsis, aspiration, and many other conditions. Inflammation leads to injury of lung tissue and leakage of blood and plasma into the air spaces resulting in low oxygen levels in the blood.

Question 9

What are the direct and indirect causes of ARDS?

Answer 9

Direct:

• pneumonia
• inhalation injury
• aspiration

Indirect:

• sepsis
• pancreatitis
• trauma
• blood transfusion
• shock

Question 10

Tx of ARDS

Answer 10

• Lung protection (Mechanical Ventilation)
• Fluid Conservation
• Treat underlying cause

Question 11

What are two types of mechanical ventilation?

Answer 11

• noninvasive
• -CPAP
• -BIPAP
• invasive

Question 12

What 4 things do we need to remember when managing a vented pt?

Answer 12

• PEEP
• FiO2
• Tidal Volume
• Rate

Question 13

WHat are your 4 main broad categories for DDX of shock

Answer 13

• hypovolumic
• distributive
• cardiogenic
• obstructive

Question 14

What do you do when you dont have time for a full H&P?

Answer 14

a primary survey: ABCDE’s.

Question 15

Minute Ventilation calculation

Answer 15

RR x Tidal Volume

Question 16

What does ARDS look like on CXR?

Answer 16

-white out, or patchy consolidation on both lungs.

Question 17

What is shock?

Answer 17

-inabilty to perfuse the tissues.

Question 18

What is the difference between Sub-massive and Massive PE?

Answer 18

-submassive is hemodynamically stable and massive is not.