Dr Harshit Aggarwal

Anaphylaxis

General ICU Care / /

Anaphylaxis  According to the World Allergy Organization (WAO): Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction characterized by rapidly developing airway, breathing and/or circulation problems, usually associated with skin and mucosal changes. Types of Anaphylaxis Feature IgE-Mediated Anaphylaxis (Classic) Non-IgE Mediated Anaphylaxis (Formerly “Anaphylactoid”) Frequency Most common type Less common Immune Mechanism IgE antibody-mediated hypersensitivity […]

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Cervical Spine injury

Trauma Critical Care / /

Cervical Spine injury  Etiology 1. Traumatic Causes (≈80%) Motor vehicle accidents (most common) Falls (especially in elderly) Sports injuries Violence (gunshot, stab wounds) Industrial accidents 2. Non-traumatic Causes Tumors (intramedullary/extramedullary) Infections (TB, epidural abscess) Ischemia/infarction (e.g., aortic surgery) Degenerative diseases (cervical spondylotic myelopathy) Inflammatory (transverse myelitis, MS) Anatomy  Region Vertebral Levels Function Loss  Cervical (C1–C8)

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Ventilator Asynchronies

Pulmonology Critical care / /

Ventilator Asynchronies  Ventilator asynchrony refers to a mismatch between the patient’s neural respiratory drive and the ventilator’s delivered breath (trigger, flow, cycling, or mode). It leads to: ↑ Work of breathing (WOB) Patient discomfort Sedation escalation Delirium Prolonged mechanical ventilation Increased ICU stay Possibly increased mortalityAsynchrony is present in up to 20–40% of ventilated ICU

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WEANING FROM MECHANICAL VENTILATION

Pulmonology Critical care / /

WEANING FROM MECHANICAL VENTILATION WHY WEANING IS IMPORTANT Complications of Delayed Weaning Ventilator-associated pneumonia (VAP) Diaphragmatic disuse atrophy (VIDD) ICU-acquired weakness (CIP/CIM) Increased ICU length of stay Higher mortality Increased sedation exposure Complications of Premature Weaning Reintubation Aspiration Hemodynamic instability Increased mortality (especially if reintubation within 48 hrs) CLASSIFICATION OF WEANING  1️⃣ Simple Weaning Successful

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Tracheostomy Emergencies

General ICU Care / /

Tracheostomy Emergencies Classification  Early (<7 days) Late (>7 days) Hemorrhage Tracheo-innominate fistula Tube obstruction Granulation tissue Accidental decannulation Tracheal stenosis False passage Tracheomalacia Pneumothorax Tracheoesophageal fistula Surgical emphysema Infection Tube displacement Mucus plugging Wound infection Tube fracture “DOPES Approach” Cause What to Check Management D Displacement ETT/tracheostomy tube displaced, accidental extubation, endobronchial intubation Check tube

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Acute Respiratory Distress Syndrome

Pulmonology Critical care / /

Acute Respiratory Distress Syndrome (ARDS)  ARDS (Acute Respiratory Distress Syndrome) is a diffuse inflammatory lung injury characterized by: Increased alveolar-capillary permeability Non-cardiogenic pulmonary edema Severe hypoxemia Reduced lung compliance Leading to acute respiratory failure requiring oxygen or ventilatory support. Berlin Definition (2012) — Diagnostic Criteria Criterion Requirement Timing Within 1 week of clinical insult or

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Hyperkalemia

Fluid and Electrolytes / /

Hyperkalemia  Hyperkalemia is defined as:Serum potassium > 5.0 mEq/L(this value is different in different guidelines i.e >5.2mEq/L,>5.5mEq/L) Severity Classification(even this is not universal) Severity Potassium Level Mild 5.1 – 5.5 mEq/L Moderate 5.6 – 6.4 mEq/L Severe ≥ 6.5 mEq/L or ECG changes Clinical severity correlates more with rate of rise rather than absolute level.

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Tuberculoma

Neuro Critical Care / /

Tuberculoma (CNS Tuberculoma) A tuberculoma is a localized granulomatous mass lesion caused by infection with Tuberculosis in the central nervous system (CNS). It represents a focal immune response to Mycobacterium tuberculosis and appears as an intracranial or spinal space-occupying lesion. Unlike tuberculous meningitis (TBM), tuberculoma is predominantly a parenchymal disease and may occur with or

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HYPOMAGNESEMIA

Fluid and Electrolytes / /

HYPOMAGNESEMIA  Serum magnesium < 1.7 mg/dL/< 0.7 mmol/L/< 1.4 mEq/L Serum magnesium represents <1% of total body magnesium → normal serum levels do not exclude intracellular depletion. Severity Classification Severity Serum Mg Level Mild 1.6–1.8 mg/dL (0.66–0.74 mmol/L) Moderate 1.2–1.5 mg/dL (0.49–0.62 mmol/L) Severe <1.2 mg/dL (<0.49 mmol/L) Normal serum magnesium: 1.8–2.4 mg/dL (0.74–1.0 mmol/L)

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