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Critical Care Curriculum

How to use this page: 

Below you will find a list of major topics you should master during your ICU rotation. Each major category, listed in bold blue serve as links to pages with education resources on each topic. 

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​Traumatic Brain Injury

Objectives

  • Know how to determine a patients Glascow Coma Score

  • Understand the pathophysiology of primary and secondary brain injury

  • Be able to list the treatment goals for severe traumatic brain injuries

  • Understand the Monroe - Kelly Statement

  • Know how to calculate a cerebral perfusion pressure

  • Explain "Diffuse Axonal Injury" a.k.a. DAI

  • Understand the different types of monitoring devices used in severe TBI

  • Be familar with treatment options for seizures

  • Be able to recognize and treat

    • Paroxysmal Sympathetic Hyperactivity

    • Central Diabetes Insipidus

    • Cerebral Salt wasting

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Brain Death

Objectives

  • What does 'brain death' mean

  • Know the legal definition of brain death in California​

  • Review and be familar with the WCHGH brain death protocol

  • Understand how to perform a brain death exam

  • Be familiar for the process of Organ Donor referral

    • List criteria for organ donation​

    • Understand the different types of organ donation

  • Describe how to support patient physiology in the setting of brain death

 

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Other causes of neurologic dysfunction:

Delirium

Alcohol Withdrawal Syndrome

Encephalopathies

​Objectives

  • Identify the types of delirium seen in the ICU

  • Propose preventive measures to minimize delirium in ICU patients

  • Describe therapies for delirium

  • Understand the timing for alcohol withdrawal syndrome

  • Describe therapies used in prevention and treatment of alcohol withdrawal syndrome

  • Identify causes of encephalopathy in critically ill patients​​

 

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Spinal Cord Injury

Objectives

  • Be familiar with the Spinal Cord Injury Guidelines

  • Understand purpose of and describe how to complete an ASIA form 

  • Describe the difference between 'Neurogenic' and 'Spinal' shock

  • Autonomic dysreflexia

  • Special risks in spinal cord injured patients

 

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Cardiovascular Physiology

Objectives​

  • Explain the components of heart physiology

    • Pre-load​

    • After load

    • Cardiac Output

    • Cardiac cycle

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Cardiovascular Pathophysiology

  • Understand diagnosis and management of arrhythmias​

  • Know types of antiarrhythmics

    • Indication for use\​

    • Mechanism of Action

    • Risks

  • Know common antihypertensives

    • Indication for use​

    • Mechanism of Action

    • Risks

  • Identify pressor agents

    • Indication for use​

    • Mechanism of action

    • Risks

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Other heart disorders

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Basic Pulmonary Mechanics

Objectives

  • Understand pulmonary physiology as it relates to the anatomy of the lungs

  • Be familiar with forms of pulmonary pathophysiology commonly seen in surgical intensive care patients

  • Be able to choose lung protective ventilator strategies in patients with acute lung injury

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Components of gas exchange physiology​​

Objectives

  • Understand the components of gas exchange and how they can be supported with strategic ventilator settings

    • Oxygenation​

    • Ventilation

    • Minute ventilation

    • A - a gradient

    • P/F ratio

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ABG interpretation 

Objectives

  • Understand the components of an arterial blood gas result

  • Be able to interpret ABG data

 

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Ventilator Management

Objectives

  • Be familiar with ventilator modes, settings and terminology

  • Understand potential complications for each ventilator mode

  • Exhibit ability to trouble shoot ventilator sources for hypoxemia

  • Weaning  guidelines

  • Identify indications for Intubation / Extubation

  • Know advanced ventilator techniques for patients with acute lung injury

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Respiratory Failure & Pulmonary Pathologic States

Objectives

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Sedation and Analgesia

Objectives

  • List indications for using sedation and analgesia ​

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ANALGESIA

  • Be able to list common medications and interventions used in multi-modal pain regimens

    • Describe indications for use​

    • Understand Mechanims of Action

    • Identify specific contraindcations 

    • Know risks of medication / modality

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Sedation

  • Be able to list common sedatives used in the intensive care unit

    • Describe indications for use​

    • Understand Mechanims of Action

    • Identify specific contraindcations 

    • Know risks of medication / modality

 

 

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Shock​ & Resuscitation

Objectives

  • Know the definition of Shock

  • Describe causes of shock

  • Know how to diagnose shock

  • Describe the treatment for specific forms of shock

    • Anaphylactic

    • Septic​

    • Hemorrhagic

    • Hypovolemic

    • Cardiogenic

    • Neurogenic

  • Describe how to assess a patient's fluid status during resuscitation

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Blood and Coagulopathies

​Objectives

  • Identify common causes of coagulopathy in injured or critically ill surgical patients

  • List common reasons for patients to be hypercoagulable

  • Understand the mechanism of action for drugs used for anticoagulation

  • What are the reversal agents for commonly used anticoagulants

 

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Gastrointestinal disorders

Objectives

  • Be able to diagnose and treat the following GI disorders in the ICU

    • Abdominal Compartment Syndrome

    • Diarrhea

    • Ileus​

    • Bowel obstruction

    • Entero-atmospheric fistula

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Nutritional assessment and treatment in the ICU

Objectives

  • Know when / what nutrition is indicated 

  • Understand risk and benefits of different types of nutrition

  • Know how to assess a patient's nutritional status

 

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Renal

Objectives

  • Know how to determine

    • normovolemia

    • hypovolemia

    • hypervolemia

  • Identify signs of acute renal insufficiency and acute renal failure

  • Determine appropriate interventions for acute renal insufficiency and acute renal failure

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Endocrine Dysfunction

Objectives​

  • Identify the main organs involved in endocrine pathology in the intensive care setting

  • Understand the importance of glucose control in critically ill patients

  • Be able to identify signs and symptoms of adrenal insufficiency

  •  Know how to diagnose and treat thyroid storm

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Electrolyte Abnormalities and Acid / Base status

Objectives

  • Understand the causes of and treatments for the following electrolyte abnormalities

    • Hyperkalemia / Hypokalemia

    • Hypernatremia / Hyponatremia​

    • Hyperchloremia / Hypochloremia

  • Understand the causes of and treatments for the following acid / base abnormalities

    • Acute respiratory acidosis and alkalosis​

    • Chronic respiratory acidosis and alkalosis

    • Acute metabolic acidosis and alkalosis

    • Chronic metabolic acidosis and alkalosis

 

 

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Hepatic disorders in the Surgical ICU

  • Understand causes and management of acute hepatic failure

  • Understand management of patients with advanced cirrhosis

  • Describe how to diagnose and treat hepato-renal syndrome

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Medical Ethics in the Intensive Care Setting​​​​​​

Objectives

  • List the four major tenents of medical ethics

  • Describe a scenario where each ethical principle can be applied 

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