ICU rotations are really good because you see patients who are very sick, so when you are on the floors and you see a similar patient you know when they might need a higher level of care. You may follow only a few patients, like 1-3, but know EVERYTHING about your patients, i.e. all the meds they are on, what the meds are, what are the adverse events, what all their vitals are and ranges, i.e. Heart Rate 88 t0 133, and the Tmax, i.e. Mr. X spiked a temperature of 101.4 yesterday afternoon, . . . read through the chart a couple times and basically know everything off the top of your head, follow labs and cultures and imaging results very closely, things can change relatively quickly in the ICU so if you are not accostomed to working the ICU you may miss things that happen to your patients, some topics that will be discussed:
1. Management of Ventillator associated pneumoniae
2. SIRS vs. Sepsis Vs. Septic Shock Vs. Multiorgani failure, see survivingsepsis.org
3. Heart Failure
4. Ventillator settings
5. CVP, versus PCWP versus SVo2, alot residents don't even know how to interpret PCWP in the setting of various clinical scenarios, i.e. it is not a straightforward normal or not . . .
6. Renal Failure, when to initiate dialysis, hemodialysis versus other types
7. Hyperglycemia management in the ICU
8. Glasgow coma scale
9. Brain death
10. Differential of Encephalopathy, i.e. anoxic, drugs, . . .
11. Lung Cancer, pulmonary hypertension, Pulmonary function tests
12. Cardiogenic shock versus toxigenic shock, versus septic shock vs. neurogenic shock
13. EKGs, MI, unstable angina,
I would take a look at Marino's ICU book at the following topics briefly, Good Luck!
