This best-selling volume in The Secrets Series® is back in an exciting, fully updated 4th Edition! You'll find all of the features you rely on the Secrets for?such as a question-and-answer format · bulleted lists · mnemonics · "Key Points" boxes · and tips from the authors.
Top 100 Secrets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
I. BASIC LIFE SUPPORT
1. General Approach to the Critically Ill Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Manuel Pardo, Jr., MD, and Michael A. Gropper, MD, PhD
2. General Approach to Trauma Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Peter J. Fagenholz, MD, and Hasan B. Alam, MD, FACS
3. Cardiopulmonary Resuscitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
David Shimabukuro, MDCM
4. Assessments of Oxygenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Asheesh Kumar, MD, Michael E. Canham, MD, and Ulrich H. Schmidt, MD, PhD
5. Pulse Oximetry, Capnography, and Blood Gas Analysis . . . . . . . . . . . . . . . . 33
Philip E. Bickler, MD, PhD
6. Hemodynamic Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Daniel Saddawi-Konefka, MD, MBA, and Jonathan E. Charnin, MD
7. Fluid Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Elizabeth Cox, MD, and Keith Baker, MD, PhD
8. Nutrition in Critically Ill Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Renee D. Stapleton, MD, PhD
9. Mechanical and Noninvasive Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Manuel Pardo, Jr., MD
10. Discontinuation of Mechanical Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Theodore W. Marcy, MD, MPH, and Jenny L. Martino, MD, MSPH
II. PROCEDURES
11. Arterial and Central Venous Catheters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Hovig V. Chitilian, MD
12. Ultrasound in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Daniel W. Johnson, MD
13. Extracorporeal Membrane Oxygenation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Michael G. Fitzsimons, MD, FCCP, and Michael N. Andrawes, MD
xi14. Tracheal Intubation and Airway Management . . . . . . . . . . . . . . . . . . . . . . . . . 87
Manuel Pardo, Jr., MD
15. Tracheotomy and Upper Airway Obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . 93
John E. Heffner, MD
16. Chest Tubes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Gwendolyn M. van der Wilden, MSc, and David R. King, MD, FACS
17. Bronchoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Amy E. Morris, MD, and Lynn M. Schnapp, MD
18. Pacemakers and Defibrillators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Scott C. Streckenbach, MD, and Kenneth Shelton, MD
19. Circulatory Assist Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Joseph L. Weidman, MD, Michael N. Andrawes, MD, and Michael G. Fitzsimons, MD, FCCP
III. PULMONARY MEDICINE
20. Acute Bacterial Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Kenneth Shelton, MD, Jeanine P. Wiener-Kronish, MD, and Aranya Bagchi, MBBS
21. Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Ali Al-Alwan, MD, Gilman B. Allen, MD, and David A. Kaminsky, MD
22. Chronic Obstructive Pulmonary Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Anne E. Dixon, MA, BM, BCh
23. Cor Pulmonale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Luca M. Bigatello, MD, and Kay B. Leissner, MD, PhD
24. Acute Respiratory Failure, Acute Lung Injury/Acute Respiratory
Distress Syndrome, and Acute Chest Syndrome . . . . . . . . . . . . . . . . . . . . . 166
Prema R. Menon, MD, and Gilman B. Allen, MD
25. Hemoptysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Michael E. Hanley, MD
26. Venous Thromboembolism and Fat Embolism . . . . . . . . . . . . . . . . . . . . . . . 177
Madison Macht, MD, and Marc Moss, MD
IV. CARDIOLOGY
27. Heart Failure and Valvular Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Martin M. LeWinter, MD, and Neil Agrawal, MD
28. Acute Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Cameron Donaldson, MD, and Harold L. Dauerman, MD
29. Dysrhythmias and Tachyarrhythmias. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Pierre Znojkiewicz, MD, and Peter S. Spector, MD
30. Aortic Dissection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Asheesh Kumar, MD, and Rae M. Allain, MD
31. Pericardial Disease (Pericarditis and Pericardial Tamponade). . . . . . . . . . 212
Stuart F. Sidlow, MD, and C. William Hanson, III, MD
V. INFECTIOUS DISEASE
32. Sepsis, Severe Sepsis, and Septic Shock. . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
David Shimabukuro, MDCM, Richard H. Savel, MD, FCCM, and Michael A. Gropper, MD, PhD
33. Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Louis B. Polish, MD
34. Meningitis and Encephalitis in the Intensive Care Unit . . . . . . . . . . . . . . . . 232
Cindy Noyes, MD, and Christopher D. Huston, MD
35. Disseminated Fungal Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Themistoklis Kourkoumpetis, MD, and Eleftherios E. Mylonakis, MD, PhD, FIDSA
36. Multidrug-Resistant Bacteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Christopher Grace, MD, FACP
37. Bioterrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Sarah Mooney, MBBCh, MRCP, and Christopher Grace, MD, FACP
38. Skin and Soft Tissue Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Erica S. Shenoy, MD, PhD, and David C. Hooper, MD
39. Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Christopher Grace, MD, FACP
40. Immunocompromised Host . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Kristen K. Pierce, MD
VI. RENAL DISEASE
41. Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Stuart L. Linas, MD, and Shailendra Sharma, MD
42. Acute Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Dinkar Kaw, MD, and Joseph I. Shapiro, MD
43. Renal Replacement Therapy and Rhabdomyolysis. . . . . . . . . . . . . . . . . . . . 306
Brad W. Butcher, MD, and Kathleen D. Liu, MD, PhD, MAS
44. Hypokalemia and Hyperkalemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Stuart L. Linas, MD, and Shailendra Sharma, MD
45. Hyponatremia and Hypernatremia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322
Brad W. Butcher, MD, and Kathleen D. Liu, MD, PhD, MAS
VII. GASTROENTEROLOGY
46. Gastrointestinal Bleeding in the Critically Ill Patient. . . . . . . . . . . . . . . . . . . 329
George Kasotakis, MD, and George C. Velmahos, MD, PhD, MSEd
47. Acute Pancreatitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336
Neeraj K. Sardana, MD, Jon (Kai) Yamaguchi, MD, FACS,
and David W. McFadden, MD, FACS
48. Hepatitis and Cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343
Zechariah S. Gardner, MD, and Jaina Clough, MD
49. Acute Abdomen and Peritonitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 352
William E. Charash, MD, PhD, and Sarah Pesek, MD
VIII. ENDOCRINOLOGY
50. Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State. . . . . . . . . 359
Joel J. Schnure, MD, and Jack L. Leahy, MD
51. Management of Hyperglycemia in the Critically Ill . . . . . . . . . . . . . . . . . . . . 369
Matthew P. Gilbert, DO, MPH, and Alison Schneider, MD
52. Adrenal Insufficiency in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . 374
Michael Young, MD
53. Thyroid Disease in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Annis Marney, MD, MSCI
IX. HEMATOLOGY/ONCOLOGY
54. Blood Products and Coagulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385
George Kasotakis, MD, and Hasan B. Alam, MD, FACS
55. Thrombocytopenia and Platelets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
Chad T. Wilson, MD, MPH, and Hasan B. Alam, MD, FACS
56. Disseminated Intravascular Coagulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Pavan K. Bendapudi, MD, and David J. Kuter, MD, DPhil
57. Oncologic Emergencies (Including Hypercalcemia) . . . . . . . . . . . . . . . . . . . 404
Marie E. Wood, MD
X. RHEUMATOLOGY
58. Rheumatologic Disease in the Intensive Care Unit. . . . . . . . . . . . . . . . . . . . 411
Lynda S. Tilluckdharry, MB, BCh, BAO, LRCP&SI, and Christine Haas Jones, MD
XI. NEUROLOGY
59. Coma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423
Ala Nozari, MD, PhD, Corey R. Fehnel, MD, and Lee H. Schwamm, MD, FAHA
60. Brain Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428
Corey R. Fehnel, MD, Ala Nozari, MD, PhD, and Lee H. Schwamm, MD, FAHA
61. Status Epilepticus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434
Ala Nozari, MD, PhD, Corey R. Fehnel, MD, and Lee H. Schwamm, MD, FAHA
62. Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
Corey R. Fehnel, MD, Ala Nozari, MD, PhD, and Lee H. Schwamm, MD, FAHA
63. Guillain-Barre? Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 448
Ala Nozari, MD, PhD, Corey R. Fehnel, MD, and Lee H. Schwamm, MD, FAHA
64. Myasthenia Gravis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452
Corey R. Fehnel, MD, Ala Nozari, MD, PhD, and Lee H. Schwamm, MD, FAHA
65. Alcohol Withdrawal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 456
Bruce A. Crookes, MD, FACS, and William Peery, MD
XII. SURGERY AND TRAUMA
66. Burns and Frostbite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
Shawn P. Fagan, MD, and Jeremy Goverman, MD, FACS
67. Pneumothorax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
Madison Macht, MD, and Michael E. Hanley, MD
68. Flail Chest and Pulmonary Contusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475
Susan R. Wilcox, MD, and Edward A. Bittner, MD, PhD
69. Cardiac Trauma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 482
Ali Y. Mejaddam, MD, and Marc A. DeMoya, MD
XIII. PERIOPERATIVE CARE
70. Liver and Heart Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
Claus U. Niemann, MD, and Abbas Ardehali, MD, FACS
XIV. SEDATION AND PAIN MANAGEMENT
71. Use of Paralytic Agents in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . 497
David W. Miller, MD, and Jean-Franc?ois Pittet, MD
72. Pain Management in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . 504
Philip McArdle, MB, BCh, BAO, FFARCSI, and Jean-Franc?ois Pittet, MD
73. Sedation and Delirium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 512
Pratik Pandharipande, MBBS, MSCI, and Arna Banerjee, MD
XV. EMERGENCY MEDICINE
74. Disaster Medicine: Impact on Critical Care Operations . . . . . . . . . . . . . . . . 521
John R. Benjamin, MD, MSc, and Edward E. George, MD, PhD
75. Allergy and Anaphylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527
Susan A. Vassallo, MD
76. Hypothermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534
Peter J. Fagenholz, MD, and Edward A. Bittner, MD, PhD
77. Heat Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541
William J. Benedetto, MD
XVI. TOXICOLOGY
78. General Toxicology and Toxidromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 545
Aaron B. Skolnik, MD, and Susan R. Wilcox, MD
79. Analgesics and Antidepressants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 552
Aaron B. Skolnik, MD, and Susan R. Wilcox, MD
80. Toxic Alcohol Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 558
Aaron B. Skolnik, MD, and Susan R. Wilcox, MD
81. Poisoning by Cardiovascular Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 562
Aaron B. Skolnik, MD, and Susan R. Wilcox, MD
82. Neuroleptic Malignant Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565
Jennifer M. Hall, DO, and James L. Jacobson, MD
XVII. OBSTETRICS
83. Care of the Critically Ill Pregnant Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571
Stephen E. Lapinsky, MBBCh, MSc, FRCPC
XVIII. ETHICS
84. Ethics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 577
Alexandra F.M. Cist, MD
85. Palliative Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 582
Ursula McVeigh, MD, and Allan Ramsay, MD
86. Organ Donation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 588
Benjamin T. Suratt, MD, and Kapil Patel, MD
XIX. ADMINISTRATION
87. Intensive Care Unit Organization, Management, and Value . . . . . . . . . . . . 593
Daniel Yagoda, MPH, Ulrich H. Schmidt, MD, PhD, and J. Perren Cobb, MD
88. Quality Assurance and Patient Safety in the Intensive Care Unit . . . . . . . 598
Nitin Puri, MD, FACP, Antoinette Spevetz, MD, FCCM, FACP, and
Carolyn E. Bekes, MD, MHA, FCCM
89. Scoring Systems for Comparison of Disease Severity in Intensive
Care Unit Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 603
Benoit Misset, MD, and Islem Ouanes, MD