1. Introduction to Critical Care

2. Critical Care is... An ethos rather than a place. Looking after the sickest patients. Having the resource and equipment to offer full and active management. Doing the little things well. Applied pathophysiology and pharmacology.

3. Organisation of critical care - Terminology Level 1 patients – ward patients Level 2 – 'HDU / CCU etc. One organ supported (not including respiratory) or at risk of deterioration. Level 3 – 'ICU' 2+ organs supported or respiratory support 'Integrated units' – both L2&3 patients with no clear demarcation between the 2. 'Critical care without walls' – the idea that sick patients are found outside of critical care areas, and that the critical care team should take a part in their management.

4. What diseases do we see? Potentially anything if it can be a risk to your life (or if it can co-exist with something that is). The expertise of critical care is experience and knowledge of the most severe forms – e.g. if you have stable COPD you need the experience of a respiratory physician. If you have COPD and pneumonia and a SpO2 of 70% you need the experience of a critical care physician.

5. Who do we admit? Anyone in whom the burden of treatment is not greater than the chance of an 'acceptable outcome' (And who is sick enough)

6. What can we offer ½ to 1 nurse per. patient Monitoring Organ support (renal, cv, resp, GI) Constant medical presence Care not limited by interest in 1 body system Expertise in the care of the critically ill

7. Working in critical care suits people who.... Enjoy working in teams and interacting with other specialities Need instant gratification – no waiting 3 months for the ACEI to work! Have a need to be needed – by patients, families or other doctors. Have an eye for detail and pedantry. Want to remain 'hands on' into their Consultant career.