ILLUSTRATIONS
Critical care medicine illustrations by Nick Mark from ICU One Pager based on an understanding of physiology and evidence-based medicine.
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.
Source: ICU One Pager
May 26, 2022
Thromboelastography (TEG)
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.
Source: ICU One Pager
Oct 26, 2020
Ventilator Troubleshooting 1: High Pressure Alarm
Ventilators can be scary, especially when they alarm. One of the most common alarms is the High Pressure Alarm. This #OnePager explains how you can rapidly determine if High Pressures are due to a Resistance Problem, a Compliance Problem, or a PEEP problem.
Source: ICU One Pager
Jan 28, 2022
Approach to Pulmonary Embolism
Pulmonary Embolism is a complex and challenging clinical problem that varies from incidental to immediately life threatening. This OnePager summarizes my approach to PE including diagnosis, prognostication, and how I manage anticoagulation, hemodynamics, and thrombolysis or other therapies.
Source: ICU One Pager
Apr 3, 2020
Approach to Hemorrhagic Shock
Hemorrhage is truly a life-threatening emergency. Here’s an ICU OnePager summarizing how I resuscitate hemorrhagic shock, including selecting infusion catheters, hemostatic resuscitation with balanced blood products, and other considerations (coagulopathy, acidosis, hypothermia, etc). Bonus: we talk about the physics of resuscitation catheters.
Source: ICU One Pager
Apr 20, 2020
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.
Source: ICU One Pager
Oct 7, 2020
Tracheostomy Emergencies
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.
Source: ICU One Pager
Jul 16, 2021
Swans Made Simple
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.
Source: ICU One Pager
Mar 24, 2019
Lobar Collapse on CXR
Lobar collapse is common in intubated ICU patients. Here is a an ICU One Pager on identifying which lobe is collapsed using just a CXR. Bonus: Teaches you how to get the most out of the PA and lateral too.
Source: ICU One Pager
Mar 19, 2020
Understanding & Treating ARDS
Acute Respiratory Distress Syndrome (ARDS) is one of the most serious and challenging conditions we encounter in the ICU. It’s also one of the life threatening complications of COVID-19. Here’s a #onePager that will help you understand ARDS, including its definition, pathophysiology, and the approach I use for treatment. Hint: just remember the Eight P’s: PEEP (lung protective ventilation), Prone positioning, Paralysis (neuromuscular blockade), Prostacyclins (inhaled vasodilators), Peeing (diuresis), Pleural evacuation (thoracentesis), Peripheral oxygenation (ECMO), and Prednisone (corticosteroids).
Source: ICU One Pager
Oct 1, 2020
Weaning from Mechanical Ventilation
We talk a lot about how to intubate people, but we don’t say nearly enough about about how to get the tube out. Here is a #OnePager on how to optimize for success and evaluate readiness to wean from mechanical ventilation.
Source: ICU One Pager
Mar 24, 2020
Chest Drains Made Simple
Chest tubes and drain systems can be confusing. This ICU #OnePager shows you how they work and demonstrates a 5-step tool for assessing positioning, drainage, tidaling, air leak, and suction. Also demonstrates how to build a three bottle drainage system in case you find yourself managing pnuemothoraces on a desert island (or an airplane).
Source: ICU One Pager
Apr 4, 2020