Essential reading for intensive care equipment and procedures

The objective of this small collection of links and recommendations is to shield the CICM Second Part Exam candidates against a wide range of possible written and viva questions about a diverse range of what can only be described as practical and pragmatic topics. Unlike the evidence-dense subjects like cardiology or neurosurgery, there are not a lot of trial acronyms to memorise here. Instead one should create an inventory of commonly used devices and procedires, and be familiar with the principles. 

The past papers are no longer such a good guide to this material, and cannot be relied upon to describe the boundaries of the expected content. The syllabus document is probably a better guide, and it leaves us with some specific items,  listed here in the same order and structure as they appear in the official syllabus: 

This is one of those few situation where a book can be recommended for this exam, as equipment in critical care tends to be stable and solid against the flowing current of evidence-based medicine:

  • Dorsch and Dorsch's Understanding Anaesthesia Equipment of any edition would therefore still be relevant, as the most important modification we have made to the endotracheal tube in the last hundred years was to add a cuff.
  • The time-poor candidate should also get a hold of "Examination Intensive Care Medicine, 2nd Edition" by Carole Foot et al. The hard copy of this book had with a DVD which contains detailed information on the routinely used ICU equipment, all presented in an easily digested format. This is the best resource for detailed short-form notes on equipment and procedures. Unfortunately the reader would also have to visit an antiques dealer to get a DVD reader, as the commercially available ebook does not seem to have a modernised version of this resource (though the illegally available pirated PDF version does). 
  • Emergency Procedures is an online resource as well as a mobile app, available also on all the major mobile platforms, and which contains excellent videos for people who learn best through watching
  • Falter's Bedside Procedures in the ICU (2012) is somehow available as a free full-text book from https://capcuuamateur.wordpress.com, bless 'em.

How do you study for this? Everybody has a different structure. The current gold standard is the college syllabus, but it is not definitive, as anyone who has ever done one of the equipment vivas will attest that things were asked which do not neatly fit into these categories.  Foot et al, the historic gold standard, also could not possibly cover every possible variation. Falter has a good structure for quick revision but it would be unsuitable for a lot of the ICU procedures (eg. prone ventilation or leading a CALS cardiac arrest).

Possible Structure for Notes on ICU Equipment and Procedures
CICM Syllabus Carole Foot's book Falter (2012) Exam through history
  Description   Description
  Safety features   Safety features
Indications Uses/indications Indications Indications
    Contraindications Relative/absolute contraindications
      Alternative options
    Consent Consent
Advantages     Advantages
Disadvantages     Disadvantages
Relevant anatomy     Positioning and anatomy
      Site selection
    Preparation Environment, monitoring
      Staff, team, roles
Insertion Method of insertion/use Technique Procedure technique
      Technical procedural caveats
      Confirmation of success, correct placement, or correct function
Management     Safe maintenance of the device or process
Removal     Safe removal
Interpretation     Interpretation of data/output
Complications   Complications Complications (early, late, etc)
      Strategies for risk mitigation

The Exam through history  column represents some kind of maximalist approach to anybody's description of a practical procedure or equipment item. It would not be necessary, and could even be harmful through time burglary, to apply every single point to every single item. However, given that the author has the luxury of reflecting on these exams from the distant vantage point of his middle age, all effort is made to represent each and every point for each and every item, even when to do so leads the reader into pointless culdesacs.