Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Introduction
- The SBAR Tool
- Introduction
- Initial Primary Assessment
- Secondary Assessment
- Continuing Assessment
- Introduction
- Common Immediate Tests
- ECG Modes and Configurations
- Rate
- Cardiac Axis
- Bundle Branch Block
- QT Interval
- Other Abnormalities
- ST Abnormalities and Ischaemic Changes
- Inherited Disorders
- Introduction
- Types of Infection and Related Organisms
- Surveillance
- General Principles of Sampling
- Special Tests – Lumbar Puncture
- Introduction
- Indications for Arterial Blood Gas Samples
- Contraindications
- Sampling Sites
- Technique (Follow Local Hospital Procedure)
- Problems
- Complications
- Potential Sources of Error
- ABG Interpretation
- A Quick Approach to Deciphering the ABG
- Some Caveats
- Stewart’s Physicochemical Approach to Acid–Base
- Plain Film Radiographs (X-ray)
- Computed Tomography
- Magnetic Resonance Imaging
- Radiation
- Introduction
- Challenges of Portable Chest Radiography in ICU
- Systematic Assessment of ICU CXRs
- The ‘LLL’ Approach
- Pneumonia versus Pulmonary Oedema versus ARDS – Which Is It?
- Introduction
- CT Head Anatomy
- Meninges
- CT Checklist: ‘AB BCS’
- Grey–White Matter Differentiation
- CSF Spaces
- Skull/Scalp
- Introduction
- Systematic Assessment of the Abdominal X-ray: BBC
- B: Bones/Soft Tissue
- C: Calcifications/Artefacts
- Abdominal Pathology on CT
- Introduction
- Features of NEWS Scoring Systems
- Updated NEWS 2 Scoring System
- Advantages
- Disadvantages
- Introduction
- Clinical Reasoning and Critical Thinking
- The Clinical Reasoning Process
- Important Steps to Making a Differential Diagnosis
- Acknowledgements
- 2.1 Principles of Obtaining a History
- 2.2 Principles of Performing an Accurate Clinical Examination
- 2.3 How to Undertake Timely and Appropriate Investigations
- 2.4 General Principles of Performing and Interpretation of Electrocardiography Results
- 2.5 General Principles of Obtaining Appropriate Microbiological Samples and Interpretation of Results
- 2.6 Obtaining and Interpretation of Results from Blood Gas Samples (Acid–Base Balance and Disorders)
- 2.7 Principles of Interpreting Imaging Studies (X-ray/CT/MRI)
- 2.8 Imaging of the Chest
- 2.9 Imaging of the Head
- 2.10 Imaging of the Abdomen
- 2.11 Importance of Monitoring and Responding to Trends in Physiological Variables
- 2.12 How to Integrate Clinical Findings with Laboratory Investigations to Form a Differential Diagnosis
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
2.5 - General Principles of Obtaining Appropriate Microbiological Samples and Interpretation of Results
from Section 2 - Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Introduction
- The SBAR Tool
- Introduction
- Initial Primary Assessment
- Secondary Assessment
- Continuing Assessment
- Introduction
- Common Immediate Tests
- ECG Modes and Configurations
- Rate
- Cardiac Axis
- Bundle Branch Block
- QT Interval
- Other Abnormalities
- ST Abnormalities and Ischaemic Changes
- Inherited Disorders
- Introduction
- Types of Infection and Related Organisms
- Surveillance
- General Principles of Sampling
- Special Tests – Lumbar Puncture
- Introduction
- Indications for Arterial Blood Gas Samples
- Contraindications
- Sampling Sites
- Technique (Follow Local Hospital Procedure)
- Problems
- Complications
- Potential Sources of Error
- ABG Interpretation
- A Quick Approach to Deciphering the ABG
- Some Caveats
- Stewart’s Physicochemical Approach to Acid–Base
- Plain Film Radiographs (X-ray)
- Computed Tomography
- Magnetic Resonance Imaging
- Radiation
- Introduction
- Challenges of Portable Chest Radiography in ICU
- Systematic Assessment of ICU CXRs
- The ‘LLL’ Approach
- Pneumonia versus Pulmonary Oedema versus ARDS – Which Is It?
- Introduction
- CT Head Anatomy
- Meninges
- CT Checklist: ‘AB BCS’
- Grey–White Matter Differentiation
- CSF Spaces
- Skull/Scalp
- Introduction
- Systematic Assessment of the Abdominal X-ray: BBC
- B: Bones/Soft Tissue
- C: Calcifications/Artefacts
- Abdominal Pathology on CT
- Introduction
- Features of NEWS Scoring Systems
- Updated NEWS 2 Scoring System
- Advantages
- Disadvantages
- Introduction
- Clinical Reasoning and Critical Thinking
- The Clinical Reasoning Process
- Important Steps to Making a Differential Diagnosis
- Acknowledgements
- 2.1 Principles of Obtaining a History
- 2.2 Principles of Performing an Accurate Clinical Examination
- 2.3 How to Undertake Timely and Appropriate Investigations
- 2.4 General Principles of Performing and Interpretation of Electrocardiography Results
- 2.5 General Principles of Obtaining Appropriate Microbiological Samples and Interpretation of Results
- 2.6 Obtaining and Interpretation of Results from Blood Gas Samples (Acid–Base Balance and Disorders)
- 2.7 Principles of Interpreting Imaging Studies (X-ray/CT/MRI)
- 2.8 Imaging of the Chest
- 2.9 Imaging of the Head
- 2.10 Imaging of the Abdomen
- 2.11 Importance of Monitoring and Responding to Trends in Physiological Variables
- 2.12 How to Integrate Clinical Findings with Laboratory Investigations to Form a Differential Diagnosis
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Infection is an important cause of morbidity and mortality in the ICU.
2. Invasive devices commonly used in the ICU are a significant cause of nosocomial infections.
3. Replacement of indwelling devices in septic patients is guided by the clinical picture.
4. Surveillance is used to limit spread of these infections.
5. Careful specimen sampling is of utmost importance in achieving clinically relevant microbiological therapy advice.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 34 - 36Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Huang, SS, Septimus, E, Kleinman, K, et al. Targeted versus universal decolonization to prevent ICU infection. N Engl J Med 2013;368:2255–65.CrossRefGoogle ScholarPubMed
Kalil, A, Metersky, ML, Klompas, M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016;63:e61–111.CrossRefGoogle Scholar
Marchaim, D, Kaye, K. 2017. Infections and antimicrobial resistance in the intensive care unit: epidemiology and prevention. UpToDate. www.uptodate.com/contents/infections-and-antimicrobial-resistance-in-the-intensive-care-unit-epidemiology-and-preventionGoogle Scholar
O’Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2016;52:e162–93.Google Scholar