ABA Critical Care flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Berlin ARDS criteria

Acute onset within one week, bilateral opacities, PEEP at least 5 cmH2O, and PaO2/FiO2 no more than 300; severity is mild 201-300, moderate 101-200, severe 100 or less.

Lung-protective tidal volume

Set tidal volume at 6 mL/kg predicted body weight, keep plateau pressure at or below 30 cmH2O, and target driving pressure at or below 15 cmH2O.

Rapid shallow breathing index

Divide respiratory rate by tidal volume in liters; a value below 105 predicts successful spontaneous breathing trial, although clinical judgment and other weaning criteria remain necessary.

Auto-PEEP management

Reduce respiratory rate, shorten inspiratory time, and allow longer expiration; treat with lower tidal volume and identify causes such as airflow obstruction or high minute ventilation.

Mean arterial pressure formula

Calculate MAP as diastolic pressure plus one third of the pulse pressure, or as systolic plus twice diastolic divided by three; septic shock targets at least 65 mmHg.

Cardiac tamponade signs

Hypotension, muffled heart sounds, and elevated jugular venous pressure form Beck triad; pulsus paradoxus and echocardiographic diastolic chamber collapse support the diagnosis.

Fluid responsiveness assessment

Passive leg raise or stroke volume variation can predict fluid responsiveness; a rise in stroke volume or cardiac output greater than 10 percent suggests the patient will benefit from volume.

Post-arrest hemodynamic target

After cardiac arrest, target a mean arterial pressure of 65 to 80 mmHg, avoid hyperoxia and hypocapnia, and provide targeted temperature control for comatose survivors.

Cerebral perfusion pressure

CPP equals mean arterial pressure minus intracranial pressure; typical targets are 60 to 70 mmHg while keeping intracranial pressure below about 20 to 22 mmHg.

Status epilepticus sequence

Give a benzodiazepine first, then levetiracetam, fosphenytoin, or valproate; refractory seizures require propofol, midazolam, or pentobarbital infusion with airway support.

CAM-ICU delirium features

Delirium is identified by acute change or fluctuation, inattention, altered level of consciousness, and disorganized thinking; the CAM-ICU applies these features at the bedside.

KDIGO AKI definition

AKI is a creatinine rise of at least 0.3 mg/dL within 48 hours, at least 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/h for 6 hours.

Anion gap formula

Anion gap equals sodium minus chloride plus bicarbonate; normal is about 8 to 12 mmol/L, and the delta-delta helps identify mixed metabolic acid-base disorders.

Winter formula

Expected PaCO2 equals 1.5 times bicarbonate plus 8, with a range of plus or minus 2; deviation suggests an additional respiratory acid-base disorder.

Hyponatremia correction limit

Correct chronic hyponatremia by no more than 8 to 10 mmol/L in 24 hours; faster correction increases the risk of osmotic demyelination syndrome.

Sepsis-3 definition

Sepsis is suspected infection plus a SOFA score increase of at least 2; septic shock adds vasopressor need for MAP at least 65 and lactate above 2 despite fluids.

Neutropenic fever definition

Fever is a single temperature of at least 38.3 degrees Celsius or sustained 38.0 degrees with an absolute neutrophil count below 500 cells per microliter; start anti-pseudomonal antibiotics.

Septic shock fluid bolus

Give 30 mL/kg of intravenous crystalloid within 3 hours for sepsis-induced hypoperfusion, then reassess fluid responsiveness; avoid continued blind fluid loading after adequate resuscitation.

VAP prevention bundle

Elevate the head of bed 30 to 45 degrees, interrupt sedation daily, provide oral care, avoid unnecessary antibiotics, and assess readiness for extubation every day.

HIT management

For heparin-induced thrombocytopenia, stop heparin and start a non-heparin anticoagulant such as argatroban or bivalirudin; avoid platelet transfusion unless there is major bleeding.

Massive transfusion ratio

Use a balanced 1:1:1 ratio of red blood cells, fresh frozen plasma, and platelets for massive hemorrhage; give tranexamic acid within 3 hours when trauma-related bleeding is suspected.

TTP treatment

Thrombotic thrombocytopenic purpura from ADAMTS13 deficiency is treated urgently with plasma exchange and steroids; platelet transfusion is avoided unless life-threatening bleeding occurs.

DKA diagnostic criteria

Diabetic ketoacidosis has glucose above 250 mg/dL, ketonemia or ketonuria, pH below 7.3, bicarbonate below 18, and an elevated anion gap.

Adrenal crisis treatment

Give hydrocortisone 100 mg intravenously followed by 50 mg every 6 hours; use dexamethasone if ACTH stimulation testing is planned, and treat precipitating illness.

Thyroid storm treatment

Give a thionamide first, iodine at least 1 hour later, a beta-blocker, and glucocorticoids; identify and treat triggers such as infection or surgery.

Abdominal compartment syndrome

It is sustained bladder pressure above 20 mmHg with new organ dysfunction; decompress with laparotomy or percutaneous drainage and optimize volume and sedation.

Parkland burn formula

Estimate 2 to 4 mL/kg per percent total body surface area of lactated Ringer over 24 hours, giving half in the first 8 hours and titrating to urine output.

Lethal trauma triad

Hypothermia, acidosis, and coagulopathy worsen each other; damage-control resuscitation treats them with warming, hemorrhage control, balanced transfusion, and correction of acidosis.

Refeeding syndrome prevention

Give thiamine before feeding and monitor phosphate, potassium, and magnesium; refeeding syndrome causes dangerous hypophosphatemia, hypokalemia, and hypomagnesemia after reintroduction of nutrition.

Acetaminophen toxicity antidote

N-acetylcysteine is the antidote and is most effective when started within 8 hours; the Rumack-Matthew nomogram guides treatment after acute overdose.

Decision-making capacity

Capacity requires understanding the information, appreciating consequences, reasoning about options, and expressing a choice; it is decision-specific and not equivalent to refusing care.

ABCDEF ICU bundle

Assess and treat pain, use both spontaneous awakening and breathing trials, choose sedation carefully, monitor delirium, mobilize early, and engage family to improve ICU outcomes.