Preface viii Acknowledgements ix Units, symbols and abbreviations x How to use your textbook xvi Part 1 General 1 1 Recognising the unwell patient 2 2 Managing the critically ill patient 4 3 Monitoring in critical care medicine 6 4 The electrocardiogram 8 5 Cardiopulmonary resuscitation 10 6 Oxygen transport 12 7 Shock 14 8 Circulatory assessment 16 9 Fluid management: pathophysiological factors 18 10 Fluid management: assessment and prescription 20 11 Fluid management: fluid choice 22 12 Inotropes and vasopressors 23 13 Failure of oxygenation and respiratory failure 24 14 Oxygenation and oxygen therapy 26 15 Airways obstruction and management 28 16 Non- invasive ventilation 30 17 Endotracheal intubation 32 18 Mechanical ventilation 34 19 Extracorporeal membrane oxygenation 36 20 Respiratory management, weaning and tracheostomy 38 21 Arterial blood gases and acid-base balance 40 22 Analgesia, sedation and paralysis 42 23 Enteral and parenteral nutrition 44 24 Hypothermia and hyperthermia 46 25 Assessment of the patient with suspected infection 48 26 Sepsis and septic shock 50 27 Hospital- acquired (nosocomial) infections 52 28 Fever in the returning traveller 54 29 Fever (pyrexia) of unknown origin 56 30 Coronavirus disease 2019 58 31 End of life issues 60 Part 2 Medical 63 Cardiac 32 Acute coronary syndromes I: clinical pathophysiology 64 33 Acute coronary syndromes II: investigations and management 66 34 Arrhythmias: tachyarrhythmias 68 35 Arrhythmias: bradyarrhythmias 71 36 Heart failure and pulmonary oedema 72 37 Cardiac emergencies 74 38 Deep venous thrombosis and pulmonary embolism 76 Respiratory 39 Chest imaging and bronchoscopy 78 40 Community-acquired pneumonia 80 41 Hospital-acquired (nosocomial) pneumonia 82 42 Asthma 84 43 Chronic obstructive pulmonary disease 86 44 Acute respiratory distress syndrome 88 45 Pneumothorax and air leaks 90 46 Respiratory emergencies 92 Renal and metabolic 47 Acute kidney injury: pathophysiology and clinical aspects 94 48 Acute kidney injury: management and renal replacement therapy 96 49 Electrolyte disturbances: sodium and potassium 98 50 Electrolyte disturbances: calcium 100 51 Electrolyte disturbances: magnesium and phosphate 102 52 Diabetic emergencies 104 53 Endocrine emergencies 106 Gastrointestinal 54 Gastrointestinal haemorrhage 108 55 Jaundice 110 56 Acute liver failure 112 57 Acute pancreatitis 114 58 Vomiting and intestinal obstruction 116 59 Diarrhoea 118 60 Ascites 120 61 Abdominal Imaging 121 Neurological 62 Acute confusional state, coma and status epilepticus 122 63 Stroke 124 64 Other cerebral vascular disorders 126 65 Infective neurological emergencies 127 66 Neuromuscular conditions 128 Infective 67 Specific bacterial infections 130 68 Common adult viral infections 132 69 Common fungal and protozoal infections 134 70 The immune compromised patient 136 Other systems 71 Coagulation disorders and transfusion 138 72 Drug overdose and poisoning 140 73 Dermatology in ICU 142 Part 3 Surgical 145 74 Trauma 146 75 Traumatic brain (head) injury 148 76 Chest trauma 150 77 Acute abdominal emergencies 152 78 Obstetric emergencies 154 79 Burns, toxic inhalation and electrical injuries 156 80 Envenomation, stings and bites 158 Part 4 Self-assessment 161 Case studies and questions 162 Case studies answers 165 Appendices Appendix I: Sequential (sepsis- related) Organ Failure Assessment (SOFA) score 172 Appendix II: Classification of antiarrhythmic drugs (based on Vaughan Williams classification) 173 Appendix III: Pacemaker types and classifications 174 Appendix IV: Acute Kidney Injury Network (AKIN) staging system for acute kidney injury 175 Appendix V: Rockall risk- scoring system for gastrointestinal bleeds 176 Appendix VI: Child-Pugh grading 177 Appendix VII: Typical criteria for liver transplantation 178 Appendix VIII: Royal College of Physicians'' top nutrition tips 179 Index 180.