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.

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.

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.

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!).

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.

Coagulation, clotting, and thrombolysis are complicated. Did you ever wish there was one test that could evaluate all three holistically? Turns out there is: Thromboelastography (TEG). Here’s a #OnePager that reviews the principles and interpretation of TEG and shows you how you can use it in resuscitation.

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.

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

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.

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.

Tracheostomies are artificial airways that are inserted in the subglottis directly into the trachea. They are used in the setting of prolonged ventilation or as an emergency airway in the event of being unable to intubate from above. This OnePager reviews the components of a tracheostomy and an approach to managing tracheostomy emergencies, broken down into 3 categories: obstruction, decannulation, and bleeding.

As Physiology Nerds we love Pulmonary Artery Catheters, but there are lots of tricky details. How can we tell what chamber it is in? How do we accurately measure PAOP? I made this #OnePager to demystify the Swan and show the expected pressures and waveforms encountered sequentially during placement/wedging.