The one-page critical care card and the ten-minute drill
One taped recap card holding four quarter-scale miniatures: the two-axis grid, the escalation ladder, the three-column shock circuit, and the alarm tree's first decision node.
THE FOUR SPINES
GAS. Oxygenation failing gives restlessness, tachypnea, effort, then a falling saturation, and it is treated by adding oxygen or pressure. Ventilation failing gives a slow or shallow chest, drowsiness, headache, and flushed skin, and it is treated by adding breaths. The saturation reports only the first one.
DEVICE. Cannula → simple mask → venturi → non-rebreather → then the split. Type I goes to high-flow nasal cannula and continuous positive pressure. Type II goes to bilevel positive pressure. Both end at the tube.
SHOCK. Neck veins flat or full. Skin cool or warm. Rate fast or slow. Flat, cool, fast is empty. Full and cool is blocked, whether the block is the muscle or the path. Flat, warm, fast is open pipes, and flat, warm, slow is neurogenic.
MACHINE. High pressure means blocked or stiff. Low pressure means leaking. When in doubt, disconnect and bag with high-flow oxygen.
THE FIVE THINGS THAT KILL crit
- A reassuring saturation with a falling respiratory rate.
- Fluid poured into an obstructed circulation.
- The silent chest in a struggling asthmatic.
- A four-sided seal over a chest tube site.
- Blind reinsertion of a fresh tracheostomy tube.
THE TEN-MINUTE DRILL · Pass 1 ☐ date ______ · Pass 2 ☐ date ______
| Prompt | P1 | P2 | |
|---|---|---|---|
| 1 | Name the four mechanisms of hypoxemia. | ☐ | ☐ |
| 2 | Name the one that does not improve with oxygen, and say what does fix it. | ☐ | ☐ |
| 3 | Give three bedside findings of ventilatory failure that the monitor will not show you. | ☐ | ☐ |
| 4 | Name the device that gives two pressures, and say exactly who needs it. | ☐ | ☐ |
| 5 | State the minimum flow for a simple face mask and say why it matters. | ☐ | ☐ |
| 6 | State the pattern for warm hypotension and the first move it demands. | ☐ | ☐ |
| 7 | Name the shock that presents with bradycardia and say why. | ☐ | ☐ |
| 8 | State what makes each of the three shock families worse. | ☐ | ☐ |
| 9 | State the three-second chest tube check. | ☐ | ☐ |
| 10 | State the first move for a fresh dislodged tracheostomy. | ☐ | ☐ |
| 11 | Split six ventilator alarm causes into high pressure and low pressure. | ☐ | ☐ |
| 12 | Name the perfusion endpoints that prove a resuscitation is working. | ☐ | ☐ |
CROSS-LINKS
- Rhythms, acute coronary syndrome, pumps ........... → BOOK 08 · P3
- The four-step gas method .......................... → BOOK 07 · P4
- Every reference range and critical value .......... → BOOK 07 · P7
- Every calculation and titration ................... → BOOK 06 · P5, → BOOK 06 · P7
- Drug classes and adverse effects .................. → BOOK 05 · P6
- Priority and delegation ........................... → BOOK 03 · P4
- Infection prevention bundles ...................... → BOOK 04 · P6
- Spinal cord injury ................................ → BOOK 10 · P5
- Auscultation technique ............................ → BOOK 15 · P6
- The two frame figures ............................. → BOOK 01 · P43, → BOOK 01 · P44
Margin noteif you can say these twelve out loud, this book is done.
Sepsis bundle timing inherits its source citation and its institutional-variation note from page 10.
TakeawayFour decisions, five killers, and twelve prompts is the whole book.