Critical Illness


Critical Illness, Catastrophic Illness, Intensive Care, Critical Care, Unstable Patient, Unstable Status

  • Findings
  • Most significant markers of Critical Illness
  • Imaging
  1. Bedside Ultrasound
    1. Cardiac Ultrasound
    2. Rapid Ultrasound in Shock (RUSH Exam)
    3. Lung Ultrasound for Pneumothorax (Sliding Lung Sign, Lung Point)
    4. Bedside Lung Ultrasound in Emergency (Blue Protocol)
    5. Inferior Vena Cava Ultrasound for Volume Status
    6. Abdominal Aorta Ultrasound
    7. DVT Ultrasound (including Focused Lower Extremity Venous Ultrasound)
  2. Radiology Department Transfer in Unstable Patients
    1. Balance diagnostic yield of imaging (e.g. AAA, Dissection, Sepsis or Hemorrhage source) with risk of decompensation in radiology
      1. Those too unstable for CT, may be too unstable to forego definitive imaging for reversible cause
      2. Consolidate all needed imaging to complete in one trip to radiology (e.g. CT chest, Abdomen and Pelvis)
    2. Nursing and medical provider should accompany critically ill, Unstable Patients to allow for continued Resuscitation
      1. Be prepared for worst case scenarios, and bring protentially needed Resuscitation equipment (including Ambu Bag)
      2. Make use of imaging protocol pauses to perform Resuscitation tasks (e.g. IV medication, transfusion initiation)
      3. Monitor Vital Signs and cardiac rhythm should be easily visualized from imaging control window
    3. Complete critical stabilization procedures prior to imaging (e.g. Endotracheal Intubation, Vascular Access, Chest Tube)
      1. If considering Endotracheal Intubation after imaging, consider instead performing before imaging
    4. References
      1. Weingart and Swaminathan in Swadron (2023) EM:Rap 23(1): 2-3
  • Resources
  1. Internet Book of Critical Care (EMCRIT.org)
    1. https://emcrit.org/ibcc/guide/
  • References
  1. Marino (2014) The ICU Book, p. 901-22