Introduction to Critical Care [chapter]

Beverly J. Newhouse
2010 Anesthesia Student Survival Guide  
Review basic concepts of oxygen balance in the body • Understand the diagnosis and treatment of common conditions encountered in the intensive care setting such as shock, sepsis, and acute respiratory failure • Learn the basic principles, indications, and complications associated with hemodynamic monitoring techniques such as arterial line, CVP and pulmonary artery catheter • Discuss the basic modes of mechanical ventilation • Review other supportive therapies in the ICU Initial Assessment of
more » ... e Critically Ill Patient In a seriously ill patient, it is often necessary to provide resuscitation before making a definitive diagnosis. Begin with the ABCs (Airway, Breathing, and Circulation) and focus on stabilization as the work-up and diagnosis are ongoing. Ensure a patent airway and stable vital signs, while proceeding further to work-up with history, physical exam, laboratory and radiographic testing, and other diagnostic procedures. Table 28.1 Complications associated with arterial cannulation. Complication Precautions to Decrease Risk Hematoma Avoid multiple needle punctures/attempts Apply pressure if artery punctured Bleeding Caution in coagulopathic patients Apply pressure to bleeding site Thrombosis Avoid multiple needle sticks Use continuous flush system Avoid prolonged catheterization Vasospasm Avoid multiple or traumatic punctures/attempts at cannulation Air embolism Caution when flushing catheter Nerve damage Avoid sites in close proximity to nerve Infection Use sterile technique Avoid prolonged catheterization Intra-arterial drug injection Keep venous and arterial lines well-organized, separated, and clearly labeled Ischemia Avoid traumatized sites Avoid prolonged catheterization Place pulse oximeter on ipsilateral side to verify perfusion
doi:10.1007/978-0-387-09709-1_28 fatcat:viyp2s3lmvdmrdmnwoltgoze4m