The aim of this article is to provide the reader with a basic understanding of the physiology and biochemistry of acid base balance and its disturbances. This subject is often made unnecessarily complex and most disturbances of acid base control can be understood with the application of a few key principles.Acid Base Balance (Update 13) - June 1, 2001

This overview is written to give a basic understanding of the blood gas and a step-wise approach to its interpretation. The section on physics is to give a more complete understanding but you can gloss over it and go straight to the clinical significance. Acid Base Balance and Interpretation of Blood Gas Results (Update 16) - June 1, 2003

The anaesthetist’s involvement will range from participating in the resuscitation of patients with polytrauma to the provision of safe anaesthesia to allow surgical treatment for cervical spine or other injuries. The importance of early immobilization is emphasised and strategies used to ‘clear’ the cervical spine are described.Acute Cervical Spine Injury - June 1, 2008

Successful management of this rare but potentially devastating disorder relies on early recognition. The hallmark of acute liver failure (ALF) is encephalopathy (ranging from a subtle alterations in consciousness level to coma) in the context of an acute, severe liver injury.Acute Liver Failure in ICU - June 1, 2007

ARDS is a process of hypoxaemic respiratory failure associated with non-cardiogenic pulmonary oedema. It is the result of diffuse inflammatory damage to the alveoli and pulmonary capillaries from a range of local or systemic insults. ARDS is often associated with multiple organ dysfunction and carries a high mortality and financial cost. Acute Respiratory Distress Syndrome - June 1, 2007

The serious complications of blood transfusion are described. Although immunologically mediated reactions to transfusion products are potentially serious, anaesthetists are most likely to encounter those relating to massive blood transfusion and transfusion related acute lung injury (TRALI). Blood Transfusion – Complications - June 1, 2007

This article desribes the stepwise assessment, resuscitation and management of patients with burns.Burns (Update 16) - June 1, 2003

Cardiac output can be measured in a number of ways, from simple clinical observation to invasive haemodynamic monitoring. Estimation of cardiac output has an important role in patient management during anaesthesia and critical care. This ranges from monitoring the predictable changes of anaesthetic induction to assessing cardiac output during anaesthesia for major surgery or resuscitation of trauma victims and critically ill patients. Advanced monitoring techniques are often used when clinical signs are difficult to interpret.Cardiac Output Monitors - June 1, 2007

Central venous access is the placement of a venous catheter in a vein that leads directly to the heart. This article decribes the technique for CVDC insertion and their use in theatre and ICU.Central Venous Access and Monitoirng - December 1, 2000

The Early Warning Score is a simple physiological scoring system that can be calculated at the patient.s bedside, using parameters which are measured in the majority of unwell patients. It does not require complex, expensive equipment to measure any of the parameters. It is reproducible patients and can be used to quickly identify patients who are clinically deteriorating and who need urgent intervention.Early Warning Scores - June 1, 2003

This article presents modified basic and advanced life support algorithms for use in pregnant women suffering cardiac or respiratory arrest. The indications and timing for perimortem caesarian section are discussed.Emergency management of maternal collapse and arrest - December 1, 2009

Anaesthetists frequently care for patients in haemorrhagic shock, and must be capable of judging its severity. This article will discuss the assessment and clinical signs associated with hypovolaemia and the management of the shock state.Haemorrhagic Shock - June 1, 1992

This is a report of a patient who has suffered a head injury. The purpose is to illustrate the practical application of the basic physiological and pharmacological principles involved in effective management of patients with head injuries. The problem is presented with suggested management and a range of anaesthetic techniques.Head Injury Management - June 1, 2000

This article is largely based on local and published clinical experience gained during the 2009 pandemic of H1N1 influenza.Intensive Care Management of Pandemic (H1N1) Influenza - December 1, 2010

Invasive (intra-arterial) blood pressure (IBP) monitoring is a commonly used technique in the Intensive Care Unit (ICU) and is also often used in the operating theatre. The technique involves the insertion of a catheter into a suitable artery and then displaying the measured pressure wave on a monitor. The most common reason for using intra-arterial blood pressure monitoring is to gain a ‘beat-to-beat’ record of a patient’s blood pressure.Invasive Blood Pressure Monitoring - December 1, 2007

The medical management of burns is both urgent and predictable - it is discussed in detail in this article.Major Burns (Update 10) - June 1, 1999

Accidental injury is probably the most serious of all the major health problems facing developed as great but has not been as extensively studied. Head injury was the commonest reason for admission to the Intensive Care Unit at the University Teaching Hospital in Lusaka over a ten year period from 1978-1988 with between 90 and 123 cases per year (approximately 20% of all admissions).Major Trauma - June 1, 1996

One of the main functions of an Intensive Care Unit (ICU) is the provision of advanced respiratory support. An understanding of the indications and types of mechanical ventilation is therefore essential for anyone working in this environment. Mechanical Ventilation in the ICU - June 1, 2003

This article will discuss the microbiology, epidemiology, pathophysiology, clinical features and treatment ofthis potentially devastating disease. Meningococcal Disease in Children - June 1, 2007

Organophosphorus compounds are chemical agents in wide-spread use throughout the world, mainly in agriculture. Estimates from the WHO indicate that each year, 1 million accidental poisonings and 2 million suicide attempts involving pesticides occur worldwide. Intoxication occurs following absorption through the skin, ingestion via the GI tract or inhalation through the respiratory tract. Early diagnosis and prompt treatment is required to save the patient’s life.Organophosphorus Poisoning - December 1, 2004

This article describes and explains the Resuscitation Council's algorithms for basic life support in children. Note that these guidlines will be updated in late 2010Paediatric life support - December 1, 2009

Severe acute pancreatitis can be a devastating illness. The principles of management are mainly supportive therapy, however it is vital that the patient benefits from strict attention to detail in their daily critical care management. Rapid recognition and instigation of therapy for complications, such as infection, bleeding or obstruction can lead to good outcomes.Pancreatitis – A Review - June 1, 2009

Tracheostomy is a common surgical procedure performed on critically ill intensive care patients. Reports have documented considerable associated morbidity, with complication rates varying from 6 to 66%. The reports on mortality associated with tracheostomy range from 0 to 5%. Minimally invasive procedures are rapidly transforming many areas of surgical practice. Percutaneous tracheostomy, a minimally invasive alternative to conventional tracheostomy, was first described in 1969.Percutaneous Tracheostomy - December 1, 2002

A ‘vasopressor’ causes vasoconstriction and an ‘inotrope’ increases the force of cardiac contraction. Vasopressors and inotropes work via the Autonomic Nervous System.Pharmacology of Vasopressors and Inotropes - June 1, 1999

This article aims to discuss the general principles behind the management of poisoning and then to review the specific treatment of the more common overdoses.Poisoning – Emergency Management - June 1, 2004

Resuscitation from Cardiac Arrest in Update 10 (1999) described the pathophysiology, aetiology and treatment of cardiac arrest, guided by the Resuscitation Council’s in 2005 by a consensus meeting of the American Heart Association and the International Liaison Committee on Resuscitation. The updates have led to some important changes in patient management.Resuscitation From Cardiac Arrest – Updated Guidelines - June 1, 2000

Sedation is an essential component of the management of intensive care patients. It is required to relieve the discomfort and anxiety caused by procedures such as tracheal intubation, ventilation, suction and physiotherapy. It can also minimise agitation yet maximise rest and appropriate sleep. Analgesia is an almost universal requirement for the intensive care patient.Sedation in Intensive Care Patients - December 1, 2002

The aim of this review is to explain sepsis, the principlesof its management and to describe the major recent advances in this field. Financial limitations make many of the more recent technological developments and expensive interventions impractical in developing countries. These techniques are described briefly for educational value, with an emphasis on how they can be incorporated into practice in a poor-resource setting.Sepsis – Management with Limited Resources - December 1, 2007

This article describes the definitions of sepsis and its related conditions. General and specific management stratefgies are then discussed.Sepsis Management (Update 13) - June 1, 2001

Out of more than 3000 species of snake identifiable world wide, only one tenth of them are dangerous to human beings. Managment of envenomation by the three major families of venomous snakes is discussed in this article. Snake Envenomation - June 1, 2003