trauma icu

[studyinghard]

Starting my trauma icu month next week. What are some good high yield topics I should look up before starting service?

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[feelingfroggy]

Depends on your SICU. Put a safe bet is ventilator settings, micro/antibiotics, how to place central lines, EKG's, fluids/icu nutrition, post op infection, sedation/analgesia/neuromusk blocker, CXR's

and most importantly

read on how to stroke the ego of your attending.

Good luck

 

[omental caKe]

skimming atls before i started trauma icu was super helpful. surgery on call was great for procedures. and marino's icu book for everything else.

 

[Zanegray]

Just finished my SICU/TICU month. Stuff that was important/came up a lot...
- Vent settings
- Line placement for sure, including art lines
- ARDS, VAP (know common treatments/ sesitivities at your hospital)
- Normal values for central monitoring, eg pcwp, CVP, etc.
- Post surgical infections
- Feeding (?) (important in the sicu, but we don't really use this AT ALL in ED, so maybe not worth your time).

Have fun!

 

[Pinner Doc]

- spine clearance (radiographic vs. clinical, when the two do not correspond)
- ICP management (vent, fluids)
- how to do a good FAST exam
- when to watch and wait (serial exams), when you have time to go to CT, when to go straight to angio/OR
- good neuro exam
- anticoagulation in the trauma patient
- chest tubes, central lines, art lines

 

[The right Path]

For fresh traumas:

ATLS

Airways, intubation, c-spine management, central lines, arterial lines, chest tubes.

The trauma triad: acidosis, coagulopathy, and hypothermia.

DIC and appropriate blood product replacement (inc. Factor VII).

Not so fresh:

Vent management: ARDS, ARDSnet protocol, High Frequency Oscillating Ventilation, prone therapy

ABG interpretation, fluid and electrolyte management, nutrition

Pulmonary Artery Catheter (Swan-Ganz) insertion and calcs

Pressors and dilators,

ICP monitors/ventriculostomies

Sedation/analgesia/NMB

SIRS/Sepsis

Infectious disease/antibiotics

Get familiar with the role that various specialties (trauma, neuro, pulm, renal, ID, cardio) have in managing these patients. Good collaboration and communication is super important.

Woo! Have fun!

 

[leviathan]

Starting my trauma icu month next week. What are some good high yield topics I should look up before starting service?

Aren't you a premed, based on your name? In what capacity are you doing a trauma icu month?

 

[studyinghard]

Aren't you a premed, based on your name? In what capacity are you doing a trauma icu month?

As a 4th year 2 wks from matching in EM.

 

[leviathan]

As a 4th year 2 wks from matching in EM.

Ohh, ok. You've got to update your user status, then. Good luck with your match!

 

[turkeyjerky]

Aren't you a premed, based on your name? In what capacity are you doing a trauma icu month?

Clearly you're not familiar with what it takes to get admitted these days

 

[overthebars]

ACLS
Massive transfusion protocols
Early goal directed therapy for sepsis
Hard and soft signs of vascular injury
Management of aortic Dissection
Xigris
Lines, lines, lines (how to place them, recognize complications)
Burn management & resusc
Resuscitation of the TBI
MAP therapy for spinal cord injuries
Trach wound management
Compartment syndrome
Abdominal compartment syndrome
Rhabdomyolysis
Empyemas
ARDS and ARDSnet protocol
Sedation and analgesia of the ventilated patient

 

[leviathan]

Clearly you're not familiar with what it takes to get admitted these days

Oh yeah...I remember they asked me about the Rivers protocol during my med school interview. It was intense.