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Basic ICU

Drhyo 2025.11.16 19:27 Views : 15

A. Life-Threatening Priorities

Airway → Breathing → Circulation → Disability → Exposure

B. Ventilator Basics

  • Mode: AC/VC or AC/PC (most common)

  • Lung protective strategy: 6 mL/kg ideal body weight

  • Goals:

    • Plateau < 30

    • Driving pressure < 15

    • SpO₂ > 88–94% (ARDS)

    • Gradually lower FiO₂ → increase PEEP as needed

  • SBT criteria: FiO₂ ≤ 40–50%, PEEP ≤ 5–8, low sedation, hemodynamic stable

C. Shock Types & Management

Type Clues First Steps
Septic Fevers, warm, high CO Fluids (if needed), norepi → vasopressin, abx
Cardiogenic Elevated JVP, crackles, cold Pressors + inotropes (dobutamine), avoid fluids
Hypovolemic GI bleed, dehydration Fluids + blood products
Obstructive PE, tamponade, tension PTX Resolve obstruction (lysis, pericardiocentesis, needle decompression)

D. Drips to Know

  • Pressors: norepi → vaso → epi

  • Sedation: propofol, dexmedetomidine

  • Analgesia: fentanyl gtt or intermittent

  • Arrhythmias: amiodarone, lidocaine

  • Renal: CRRT (consult renal early)

E. ICU Essentials

  • Daily SAT/SBT

  • I/Os, UOP, weights

  • DVT/GI prophylaxis

  • Maintain K > 4, Mg > 2, Phos > 3

  • Cultures before antibiotics

  • Daily discussion: goals of care, disposition

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5 ICU Morning Checklist Drhyo 2025.11.16 15
4 ICU Night Drhyo 2025.11.16 16
3 ICU daily must to do Drhyo 2025.11.16 12
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