ILLUSTRATIONS
Critical care medicine illustrations by Nick Mark from ICU One Pager based on an understanding of physiology and evidence-based medicine.
Impella
Impellas are temporary percutaneous cardiac devices assist used for hemodynamic support in patients with severe heart failure. This OnePager explains the function & physiology of LVADs as well as the settings and potential complications. Understanding how to interpret the placement signals is essential.
Jan 18, 2024
73
In Flight Medical Emergencies
Over 2 billion people travel by commercial aircraft every year. When they become unexpectedly sick, it is essential to understand what to do in the austere aerospace medical environment. This OnePager covers the ethics/legality of volunteering, the physiology of the aerospace environment, the resources available (crew, equipment, ground communications) as well as an overview of common medical emergencies seen among passengers on commercial flights.
Jan 18, 2024
21
Hemophagocytic lymphohistiocytosis (HLH)
Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome due to aberrant activation of macrophages. It can be challenging to diagnose & often leads to critical illness with multiple organ system failure. This ICU OnePager reviews the etiology, diagnostic criteria, and treatment approach to this complex illness.
Mar 20, 2023
75
Pain, Anxiety, and Delirium
One of the most important things we do in critical care is manage pain and anxiety while avoiding delirium. Here’s a #OnePager summary of how I assess, prevent, and treat each of these issues. Handy cheat-sheet for RASS & CAM-ICU scoring too
Mar 30, 2020
113
Oxygen Delivery by Masks
Masks are a common method of delivering supplemental oxygen. This OnePager explains the differences between the different masks used in the ICU: Simple (Hudson) Mask, Face Tent, Venturi Mask, and Non-rebreather Mask.
Aug 1, 2022
99
Acid-base Made Easy
Acid base abnormalities are ubiquitous in the ICU, and sometimes multiple can coexist at the same time. This OnePager outlines a stepwise approach and differential diagnosis for each acid base abnormality (RAGES for NAGMA, GOLDMARKeT for AGMA, BLVD PLACE for metabolic acidosis, etc). It also includes those handy formulas & rules so you can figure out if more than acid-base disturbance is present.
Jun 10, 2022
134
Care of the person in the criminal legal system
People in the custody of law enforcement deserve respectful & ethical care, particularly during critical illness. Critical care providers should be aware of their patients right and the law. This ICU OnePager discusses important topics including Privacy (disclosing information in front of LEO can violate HIPAA), Restraints (restraints can cause injury and you can request removal), Surrogate decision makers (patients have a right to choose surrogates), Testing, Visitation rights, and Compassionate Release.
Jan 18, 2024
24
Cardiac Arrest on Mechanical Circulatory Support
Patients undergoing mechanical circulatory support (MCS) are at high risk for cardiac arrest due to their the underlying illness. But when these patients experience cardiac arrest, resuscitation protocols need be modified to reflect device & clinical context. This ICUOnePager describes how to adjust resuscitation in the presence of ECMO, IABP, Impella, or LVAD and what to do in the perioperative setting.
Mar 20, 2023
113
How to Run a Code
Cardiac arrests can be chaotic. Leading resuscitation is a complex skill, involving both a mastery of the knowledge & a structured approach to lead a team. This ICU OnePager presents a framework for clinicians to use: how to assign roles & crucial tasks physically in the room and how to structure events temporally. The goal is a smooth team based resuscitation.
Mar 20, 2023
108
Pleural Manometry
Thoracentesis can rapidly relieve dyspnea, but not every thoracentesis goes according to plan. Pleural manometry can help identify lung pathologies like entrapped lung and trapped lung, and may even predict response to pleurodesis and likelihood of re-expansion pulmonary edema. This #OnePager explains the principles of pleural manometry and pleural elastance and shows you how to interpret the results.
Aug 15, 2020
61
Left Ventricular Assist Devices
Left Ventricular Assist Devices (LVADs) are implanted cardiac devices used for hemodynamic support in patients with severe heart failure. This OnePager explains the function & physiology of LVADs as well as the settings and potential complications. (spoiler: this is one time when it’s normal to not have a pulse!).
Jul 1, 2022
62
Ketoacidosis Disorders: DKA, HHS, & more
Disorders of ketosis (DKA, HHS, AKA, etc) are very common in the ICU, but can have high morbidity if mismanaged. This OnePager covers the differences between these disorders & provides a differential to identify the underlying cause (the 5 I’s mnemonic: infection, ischemia, inflammation, intoxications, insulin deficiency). It also explains the 3 pillars of treating DKA/HHS: Insulin, IV fluids, and aggressive electrolyte replacement.
May 26, 2022
110