Preprocedure Indications Pericardial tamponade Pericardiocentesis is the first treatment option in patients with overt tamponade because only the removal of fluid allows normal ventricular filling and restores adequate cardiac output. If the patient is hemodynamically stable, the procedure should be…
Before the procedure Indications Postcardiotomy failure (left ventricular assist device [LVAD]) Elevated left atrial pressure (LAP) and cardiogenic shock despite inotropic support and intraaortic balloon pump (IABP) LAP >25 mm Hg Cardiac index (CI) <2 L/min/m 2 Severe left ventricular…
Before the procedure Indications Treatment of symptomatic bradycardia Sinus bradycardia Second-degree or third-degree atrioventricular block Prophylaxis Bradycardia-induced ventricular tachyarrhythmias (e.g., torsades de pointes) Increased risk of advanced atrioventricular block (e.g., acute myocardial infarction, infective endocarditis, surgery in patients with underlying…
Before the procedure Indications Emergency re-establishment of an organized electrical rhythm Hemodynamically unstable polymorphic ventricular tachycardia Ventricular fibrillation Pulseless ventricular tachycardia Narrow or wide QRS complex tachycardia (ventricular rate >150) associated with hemodynamic instability, chest pain, or pulmonary edema Elective…
Before the procedure Indications Need for continuous monitoring of pulmonary artery (PA) and right atrial (RA) pressures, cardiac output, and mixed venous oxygen saturation (SvO 2 ), providing that: The data collected will help in the management of the patient…
Peripheral artery cannulation is one of the most commonly performed invasive procedures in the intensive care unit (ICU), and the resulting arterial line is an integral part of intensive care patient management. Arterial line usage varies according to unit type,…
Before the procedure Indications Inability to achieve the clinical goal by peripheral intravenous catheterization Relatively fast flow rate is required Rapid, massive intravascular volume resuscitation 3.5-inch, 8.5F introducer catheter offers the fastest flow rate. However, a 2-inch, 16-gauge peripheral catheter…
Advances in ultrasound technology continue to enhance its diagnostic applications in daily medical practice. Constantly evolving, this tool has become invaluable for properly trained cardiologists, anesthesiologists, intensivists, surgeons, obstetricians, and emergency department physicians. Ultrasound can enable rapid, accurate, and noninvasive…
The critically ill patient, particularly the critically ill difficult airway patient, presents unique airway challenges in emergency situations outside the operating room. The risk of life-threatening complications, including anoxic brain injury, death, and long-term disability, are exaggerated in this patient…
Introduction As a specialty, critical care medicine has many unique challenges when it comes to teaching trainees. The intensive care unit (ICU) is an environment with high stakes and time-sensitive decision making for acutely ill patients with multiple competing demands…