ABC of Intensive Care

This new and updated edition is a practical guide to intensive care for the non-specialist, and covers the core knowledge and principles of IC patient management. It follows new guidance on end of life care, brain stem death and organ donation, with colour images throughout and includes the basics of physiology and ‘best practice’ management in the ICU and chapters on haematological support and imaging. Endorsed by the Intensive Care Society Graham Nimmo, Western General Hospital, Edinburgh Mervyn Singer, Professor of Intensive Care Medicine, University College London, London, UK Table of Contents (provisional) Chapter 1 What is intensive care?. • Diagram hospital overview. • Short history. • Not just a place: 'without walls' means out-with walls of ICU ward: what do we provide?. • Early warning. • Outreach. • Pre-optimisation. • Transport. • Levels of care in HDU/ICU. • Follow-up. Chapter 2 The Critically Ill Patient. • Recognition: by the individual clinician (links with early warning). • Initial Assessment and Management. • The four domains approach. 1. Initial assessment, treatment, investigation: ABCDE plus extras (see chapter 2 Adult Medical Emergencies Handbook). 2. Monitoring and re-assessment. 3. Definitive diagnosis and treatment. 4. Illness severity assessment. • Presentations: hypotension, hypoxia/respiratory distress, oliguria, coma, sepsis. Chapter 3 General principles of management of the patient in ICU or HDU. • Diagram of patient at centre with different aspects all around: psychological, organ support, comfort, nutrition, end of life, families, monitoring, staff, visiting staff (communication) etc. • Pursuit of definite diagnosis. • Systematic approach to daily assessment and management and re-assessment to achieve goals of the day. • Comfort. • Nutrition. • Physiotherapy/mobilisation. • Monitoring. • Preventing complications. • Avoiding infection. • Ethics including moving patients from ICU to ICU. • Decision making. • Transport: to Radiology/Theatre/within hospital AND inter-hospital. Chapter 4 Patho-physiology of Critical Illness. • Respiratory failure: oxygen transport. air to alveoli. Alveoli to capillaries. Pulmonary capillaries to tissues (Cardiac output/Hb). Tissues: cellular uptake and utilisation. • Shock. • Sepsis. • Multiple organ failure. Chapter 5 Respiratory support. Chapter 6 Cardiovascular support. Chapter 7 Renal support. Chapter 8 Gastro-intestinal/nutrition. Chapter 9 Neurological. Chapter 10 Sepsis management. Chapter 11 Haematology/immuno-compromised patient. Chapter 12 Radiology. Chapter 13 Discharge from ICU, recovery and follow-up. Chapter 14 Outcome of the ICU patient including severity scoring, audit. Chapter 15 End of life care. Chapter 16 Training and education, research, EBM and the 'art of intensive care'. Appendix: sedation