HELLP Syndrome
A triad of:
- Hemolysis,
- Elevated Liver Enzymes and
- Low Platelets
It is considered to represent the extreme end of the pre-eclampsia spectrum of disease
DKA diagnosis
- Blood sugar more 250
- AG >10 -12
- Hco3 <18
- Positive ketone
TSS criteria
- Fever / rash / hypotension and 3 organs involved
- Organ involved: CNS/ GI/ renal / skin / muscle
Status epilepticus
Seizure for > 5 minutes or recurrent seizure with unresolved unconsciousness
Refractory status epilepticus
Seizure for more than 2 hours despite BDZ and non BDZ
Super refractory status epilepticus
Seizure more than 24 hrs despite GA
Delirium
Acute change in mental status with a fluctuating course characterized by inattention, an alteration in consciousness or disorganized thinking. It is a manifestation of brain dysfunction and occurs in up to 70% of the critically ill
Brain death prerequisites
- Clear cause of coma and irreversibility
- Normal core temperature (>36.5ºC)
- Normal SBP (>90 mmHg)
- Exclude confounding factors:
a) CNS Depressants
b) NMBA
c) Electrolyte disorders (Na<160)
d) Hypo, hyperglicemia
e) Acid base disorders
f) Uremia, hepatic failure
g) Endocrine disorders
- Panhypopituitarism
- Adrenal cortical insufficiency
- Mixedema coma
h) Poisoning
Massive transfusion
Definitions vary, they include:
- 10 unit transfusion in 24 h
- Transfusion of an entire blood volume in 24 h
- Replacement of 50% blood volume over 3 h
Damage control resuscitation
Damage control resuscitation has 3 components:
- Permissive hypotension (aka minimal normotension)
- Early hemostatic resuscitation
- Damage control surgery.
Intra-abdominal hypertension (IAH)
A sustained or repeated pathologic elevation of IAP 12 mmHg
Abdominal compartment syndrome (ACS)
A sustained intra-abdominal pressure (IAP) > 20 mmHg (with or without an abdominal perfusion pressure (APP) < 60 mmHg) that is associated with new organ dysfunction/failure. (Note that the normal IAP is approximately 5–7 mmHg in critically ill adults, and APP = MAP – IAP.)
ARDS
The essential components required to diagnose ARDS according to Berlin definition are:
- Development within one week of insult/worsening respiratory symptoms –acute
- Bilateral opacities on radiological studies not explained by effusions, collapse, or nodules
- Respiratory failure not explained by LVF or fluid overload
- PaO2/FiO2 < 300 mmHg on PEEP/CPAP ≥ 5 cmH2O with mention of oxygenation criteria
Febrile neutropenia
- Fever: single oral temp >38.3°C (101°F) or >38°C (100.4°F) for >1 h
- Neutropenia: ANC <500 cells/pL or <1000 cells/j.iL with predicted nadir <500 cells/uL
BPF
- A leakage of inspired air from the airways into the pleural space for more than 24 hours
Massive hemoptysis
> 600 ml of blood (hemoptysis) in 24 hrs
Tumor lysis syndrome (TLS)
The diagnosis of TLS requires ≥ 2 of the following clinical abnormalities:
- hyperuricemia (> 8 mg/dL)
- hyperkalemia (> 6 mmol/L)
- hyperphosphatemia (> 4.5 mg/dL)
- hypocalcemia (< 7 mg/dL)
A TLS diagnosis also requires one of the following:
- acute renal failure
- cardiac arrhythmia
- seizure
Near miss (close call)
Errors that occur in the process of providing medical care that are detected and corrected before reaching the patient. (AHRQ).
Medical error
- Failure of a planned action to be completed as intended.
- Preventable adverse medical offense.
- Act (or omission of an act) that would have been judged wrong by knowledgeable peers at the time it occurred.
Sentinel event
Any unanticipated event in a healthcare setting resulting in death or a serious physical or psychological injury to patient(s), that is not related to the natural course of illness.
Simple weaning
Pass their first spontaneous breathing trial (SBT)
Difficult-to-wean
Fail their first SBT and then require up to three SBTs or seven days to pass an SBT
Prolonged weaning
Patients who require more than three SBT or 7 days of weaning after the first SBT.
