📚 Clinical Reference Library

Pregnancy physiology & recalibrated values, pre-eclampsia/eclampsia & MgSO₄, HELLP, major PPH (4 Ts + TXA, WOMAN trial), amniotic fluid embolism, peripartum cardiomyopathy, maternal arrest & perimortem caesarean.

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Obstetric Critical Care

MgSO₄ · TXA ✦EclampsiaPerimortem C-section

ACLS & BLS — Cardiac Arrest

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High-quality CPR, cardiac arrest algorithm, defibrillation & drug timing, Hs & Ts, peri-arrest brady/tachy, and AHA 2020→latest changes (DSED, early adrenaline, naloxone, TTM).

AHA 2020+ ✦CPR · ACLSBLS

Difficult Airway Management

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DAS 2025 & AIDAA 2025 — Plan A–D, peroxygenation, "Code D" airway emergency, non-hierarchical rescue, RSI drugs, and the surgical cricothyroidotomy.

DAS/AIDAA 2025 ✦Code DCICO

WAO 2020 / RCUK 2021 criteria, IM adrenaline 0.5 mg first-line, positioning (supine — sitting up kills), refractory anaphylaxis infusions, biphasic reactions, β-blocked patients (glucagon).

RCUK 2021 ✦IM AdrenalineTintinalli's

Trauma — Primary Survey & Resuscitation

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ATLS C-ABCDE primary survey, damage control resuscitation, permissive hypotension, massive transfusion 1:1:1, TXA (CRASH-2/3), FAST, tension pneumothorax, pelvic binder.

ATLS 10th ✦Damage ControlRosen's

India's Big Four, 20-minute whole blood clotting test, ASV dosing (same in children), neurotoxic vs haemotoxic syndromes, neostigmine trial, ASV reactions, AKI.

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Snakebite & Envenomation

National Protocol ✦20-WBCTASV

Environmental Emergencies

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Heat stroke (cool first, target 39°C, no antipyretics), accidental hypothermia rewarming ("not dead until warm and dead"), drowning, electrical & lightning injury.

WMS ✦Heat StrokeHypothermia

Acute Undifferentiated Febrile Illness

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Tropical fever approach — dengue (warning signs, fluid management), severe malaria (IV artesunate), scrub typhus (eschar, doxycycline), leptospirosis, empirical therapy.

ICMR ✦Dengue · MalariaScrub Typhus

Acute Poisoning — Toxidromes & Antidotes

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General approach to the poisoned patient: the 5 toxidromes, decontamination (charcoal), enhanced elimination (dialysable toxins), antidote quick-reference, Indian poisons (OP, aluminium phosphide, paraquat).

Toxidromes ✦AntidotesIndia

Methanol & ethylene glycol: the metabolism you block, the osmolar-gap-to-anion-gap crossover, visual vs renal toxidromes, and management with fomepizole/ethanol, cofactors and haemodialysis.

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Toxic Alcohol Poisoning

Fomepizole ✦Osmolar gapDialysis

No topics in this specialty for this category. Switch specialty or category above.

📖 Sources: Marino 5th Ed Ch.29,41–42 (2025) · SSC 2026 · IDSA/ATS 2016 · ISCCM 2020 · WHO India

CNS Infections — Meningitis & Encephalitis

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Bacterial meningitis vs HSV encephalitis, when to CT before LP, CSF interpretation, first-hour empirical antibiotics + aciclovir, and dexamethasone timing.

First-Hour Rx ✦CSFDexamethasone

Sepsis — Antimicrobial Strategy

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SSC 2026: extended infusion beta-lactams now STRONG. De-escalation STRONG. No anaerobic coverage without risk factors. Indian MDR regimens.

SSC 2026 ✦AntibioticsDe-escalation

IDSA/ATS 2016: HCAP abolished, 7-day duration, VAP prevention bundle. Indian XDR organisms — colistin + meropenem protocols. MRSA — linezolid vs vancomycin.

IDSA/ATS 2016VAP PreventionXDR India

OP poisoning (atropine titration, pralidoxime), paracetamol (NAC), antidote quick reference, dialysable toxins. Indian context — ALP, snake bite.

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Toxicology in the ICU

AntidotesOP PoisoningIndia

Acute Undifferentiated Febrile Illness

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Tropical fever approach — dengue, severe malaria (IV artesunate), scrub typhus (eschar, doxycycline), leptospirosis, enteric fever, empirical therapy for the sick AUFI patient.

ICMR ✦Dengue · MalariaScrub Typhus

India's Big Four, 20-WBCT, polyvalent ASV dosing, neurotoxic vs haemotoxic syndromes, neostigmine trial, ASV anaphylaxis, Russell's viper AKI.

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Snakebite & Envenomation

National Protocol ✦20-WBCTASV

No topics in this specialty for this category. Switch specialty or category above.

📖 Sources: Marino 5th Ed Ch.36–38 (2025) · AABB 2023 · ISTH/BSH · TRICC/TRISS/PROPPR · CRASH-2 · Washington Manual

How whole blood becomes PRBC, platelets (RDP/SDP), FFP & cryoprecipitate — what each contains, how it's made, dose & effect, when to use, storage and side effects, with transfusion thresholds and reactions. Flowcharts + master table.

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Blood & Blood Products

Flowcharts ✦ComponentsThresholds

Transfusion & Coagulopathy

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Restrictive Hb thresholds (TRICC/TRISS), massive transfusion 1:1:1 (PROPPR), TXA (CRASH-2), DIC, ICU thrombocytopenia, HIT, anticoagulant reversal, TACO vs TRALI.

AABB 2023 ✦MTP 1:1:1Reversal

Thrombocytopenia in the ICU & HIT

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The four mechanisms of a low platelet count, the 4Ts score for HIT (stop heparin, anticoagulate — never just stop), TTP red flags, and threshold-based platelet transfusion. Flowchart-led.

DIC & Thrombotic Microangiopathies

Consumptive coagulopathy vs the TMAs — the ISTH DIC score, treat-the-trigger management, and how the coagulation screen separates DIC from TTP, HUS/aHUS and HELLP.

ISTH ✦TTP · HUSSchistocytes

Oncologic Emergencies in the ICU

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Tumour lysis syndrome (Cairo-Bishop, rasburicase, G6PD caveat), neutropenic sepsis (antibiotics within 1 hour), hypercalcaemia of malignancy, plus SVCO and malignant cord compression.

TLS ✦Neutropenic SepsisHyperCa

No topics in this specialty for this category. Switch specialty or category above.

📖 Sources: Marino 5th Ed Ch.6,39–40,48–51 (2025) · PADIS 2018 · ASPEN/ESPEN 2022–2023 · APASL 2019

Acute brain failure: subtypes, RASS → CAM-ICU / ICDSC screening, the reversible-cause hunt, PADIS-based prevention (ABCDEF bundle, light sedation, avoid benzodiazepines) and management.

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ICU Delirium

PADIS 2018 ✦CAM-ICUABCDEF

VV vs VA, indications (EOLIA/CESAR), the sweep-vs-flow physiology, cannulation, anticoagulation, differential hypoxia (Harlequin), LV distension, complications & weaning.

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ECMO — VA & VV Support

ELSO 2021 ✦EOLIAWeaning

Sedation, Analgesia & Delirium

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PADIS 2018: ABCDEF bundle, eCASH, RASS/CPOT scoring, drug comparison (propofol vs dexmedetomidine vs midazolam), CAM-ICU, delirium management.

PADIS 2018RASSCAM-ICU

Nutrition in Critical Illness

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ASPEN/ESPEN 2022 targets, early enteral nutrition, when to start parenteral (EPaNIC), refeeding syndrome, protein 1.2–2.0 g/kg, gastric residual volumes, NUTRIREA.

ASPEN 2022 ✦RefeedingEnteral

The insulin-driven electrolyte shift on reintroducing feed: NICE risk criteria, the hallmark hypophosphataemia (± hypoK/hypoMg), thiamine-first prevention, start-low-go-slow protocol and management.

NICE ✦HypophosphataemiaThiamine

King's College Criteria, hepatic encephalopathy grading, coagulopathy management (no routine FFP), cerebral oedema, AKI in ALF, transplant indications.

APASL 2019KCCTransplant

Oxygen Delivery & Tissue Oxygenation

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The physiology behind all of shock — DO₂ = CO × CaO₂, the DO₂/VO₂ relationship and critical oxygen delivery, and the bedside markers of an oxygen debt: lactate, ScvO₂ and the veno-arterial CO₂ gap.

DO₂/VO₂ ✦Lactate · ScvO₂CO₂ Gap

No topics in this specialty for this category. Switch specialty or category above.

📖 Sources: Marino 5th Ed (2025) · ASGE 2021 · ACG Pancreatitis 2013 · Revised Atlanta 2012 · ESPEN 2020 · WATERFALL Trial 2022

The surgical catastrophes (perforation, mesenteric ischaemia, ruptured AAA, strangulated obstruction, ectopic), pain out of proportion, lactate, CT vs POCUS, and resuscitation + early source control.

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The Acute Abdomen

Source Control ✦Mesenteric IschaemiaWSES

Severe Acute Pancreatitis

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Revised Atlanta severity, BISAP/CTSI, moderate fluids (WATERFALL), early enteral nutrition, when NOT to give antibiotics, infected necrosis & the step-up approach.

WATERFALL ✦Step-upEarly EN

GI Bleed & Acute Pancreatitis

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UGIB: Glasgow-Blatchford, restrictive transfusion (Hb 70), octreotide, PPI infusion, endoscopy timing. Pancreatitis: LR preferred, early EN 24–48h, antibiotics only for infected necrosis.

ASGE 2021 ✦PancreatitisEarly EN

King's College Criteria, hepatic encephalopathy grading, coagulopathy management (no routine FFP), cerebral oedema, AKI in ALF, transplant indications.

APASL 2019KCCTransplant

Abdominal Compartment Syndrome

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Measure it to find it — bladder intra-abdominal pressure, the WSACS grades, APP = MAP − IAP, the multi-organ effects of raised IAP, the five medical levers to lower it, and decompressive laparotomy.

Bladder IAP ✦WSACSDecompress

No topics in this specialty for this category. Switch specialty or category above.

📖 Sources: ADA Standards of Care 2024 · Joint British DKA Guidelines 2023 · Endocrine Society · Marino 5th Ed (2025) · Washington Manual Critical Care 4th Ed

DKA, HHS & Endocrine Emergencies

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ADA 2024 DKA protocol — fixed-rate insulin 0.1 U/kg/h, K⁺ ≥3.5 before insulin, no bicarb unless pH <6.9. HHS, thyroid storm Burch-Wartofsky, adrenal crisis.

ADA 2024 ✦Thyroid StormAdrenal Crisis

Fluid-refractory shock with hyponatraemia/hyperkalaemia/hypoglycaemia — treat with hydrocortisone before you confirm; the random-cortisol caveats, CIRCI, and steroids in septic shock.

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Adrenal Crisis & CIRCI

Treat First ✦CIRCIHydrocortisone

Thyroid Emergencies — Storm & Myxoedema

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Thyroid storm (Burch-Wartofsky, the β-blocker→PTU→iodine sequence and why order matters) and myxoedema coma (T4/T3 plus stress-dose steroid, passive rewarming).

Order Matters ✦Burch-WartofskyMyxoedema