CICM Fellowship interactive diagrams

Shock & sepsis haemodynamic profiles — Diagnose cardiogenic shock using clinical, biochemical and haemodynamic criteria; differentiate primary cardiogenic from mixed shock states; and describe the management sequence including inotropes, vasopressors, IABP, I…

Frank-Starling curve + Nephron + diuretic sites + Renin-angiotensin-aldosterone system — Manage low cardiac output states using pharmacological support (dobutamine, milrinone, levosimendan) and mechanical circulatory support; describe criteria for escalation to cardiac transplantation or LVAD bridge

Adult bradycardia algorithm + ECG rhythm recognition trainer + ECG identify drill (real 12-leads) + Adult tachycardia (with a pulse) algorithm — Manage atrial fibrillation, ventricular tachycardia and ventricular fibrillation in the ICU setting; apply ARC advanced life support algorithms; and describe the indications and technique for electrical cardioversion and…

Shock & sepsis haemodynamic profiles + Oxygen delivery & consumption (DO₂/VO₂) — Apply advanced haemodynamic monitoring techniques (PAC, PiCCO, echocardiography) to guide resuscitation; interpret waveforms; and describe the clinical utility and limitations of each monitoring modality

Vasopressor & inotrope selector + Frank-Starling curve + Shock & sepsis haemodynamic profiles — Describe the pharmacology and clinical indications for vasopressors (noradrenaline, vasopressin, metaraminol, phenylephrine) and inotropes (adrenaline, dobutamine, milrinone); and outline the approach to refractory vasod…

Lung + chest wall compliance (Campbell diagram) + Mechanical ventilation modes — Apply the Berlin definition of ARDS; describe lung-protective ventilation (low tidal volume 6 ml/kg PBW, plateau pressure <30 cmH2O, PEEP titration using PEEP-FiO2 tables) and the evidence from ARDSNet; and outline rescu…

Mechanical ventilation modes — Describe the mechanisms of ventilator-induced lung injury (barotrauma, volutrauma, atelectrauma, biotrauma); apply strategies to minimise VILI in clinical practice; and outline the pathophysiology of dynamic hyperinflati…

Mechanical ventilation modes — Select and apply modes of mechanical ventilation (VC-AC, PC-AC, PRVC, SIMV, PSV); adjust ventilator settings based on respiratory mechanics; and recognise and manage patient-ventilator dyssynchrony (double triggering, re…

Mechanical ventilation modes — Apply a systematic approach to weaning from mechanical ventilation including daily spontaneous breathing trials (T-piece vs PSV), extubation readiness assessment (RSBI, cough strength, secretion management) and post-extu…

Mechanical ventilation modes — Describe the evidence base for non-invasive ventilation (CPAP, BiPAP) in acute hypercapnic respiratory failure (COPD), cardiogenic pulmonary oedema and immunocompromised patients; and outline criteria for NIV failure and…

Coagulation cascade — Describe the circuit configuration of venovenous (VV-ECMO) and venoarterial (VA-ECMO) ECMO; manage the anticoagulation strategy (heparin, ACT, anti-Xa targets); and outline the approach to ECMO weaning and decannulation

Oxygen cascade — atmosphere to mitochondrion — Apply the physical principles of ECMO: oxygenator gas exchange (sweep gas governs CO2 clearance; blood flow and FdO2 govern O2 delivery), recirculation in VV-ECMO (definition, measurement, mitigation), pre- vs post-membr…

Mechanical ventilation modes — Manage severe asthma in the ICU including inhalational bronchodilators, IV salbutamol, IV magnesium, ketamine and the principles of ventilation in status asthmaticus (permissive hypercapnia, high PEEP limitation)

Mechanical ventilation modes — Manage COPD exacerbation in the ICU including controlled oxygen therapy (target SpO2 88–92%), nebulised bronchodilators, systemic corticosteroids, NIV (BiPAP) and the management of dynamic hyperinflation on mechanical ve…

Nephron + diuretic sites + Acute kidney injury staging — Apply the KDIGO AKI staging criteria in the ICU; differentiate pre-renal, intrinsic renal (ATN, GN, interstitial nephritis) and post-renal causes; and outline the principles of AKI management including fluid optimisation…

Coagulation cascade + Acute kidney injury staging — Compare the modalities of CRRT (CVVH, CVVHD, CVVHDF) with intermittent haemodialysis; prescribe CRRT (dose, fluid balance, anticoagulation — systemic heparin vs regional citrate); and describe the criteria for RRT cessat…

Nephron + diuretic sites + Renin-angiotensin-aldosterone system + Sodium & water disorders + IV fluid composition — Apply a systematic approach to hyponatraemia and hypernatraemia in the ICU; diagnose and manage SIADH (fluid restriction, vasopressin antagonists); and describe the management of central and nephrogenic diabetes insipidu…

Nephron + diuretic sites + Renin-angiotensin-aldosterone system — Manage life-threatening hyperkalaemia in the ICU (calcium gluconate, insulin-dextrose, salbutamol, sodium bicarbonate, RRT) and hypokalaemia (replacement rate, ECG monitoring); and apply the approach to refractory hypoka…

Davenport acid-base diagram + Anion gap and delta ratio + ABG interpretation algorithm — Apply the Henderson-Hasselbalch equation to complex acid-base disorders; use the Stewart approach (SID, SIG, ATot) where appropriate; and diagnose and manage metabolic acidosis (anion gap, delta ratio, normal AG) and alk…

Acute kidney injury staging — Apply strategies to prevent contrast-associated AKI (volume expansion, N-acetylcysteine, iso-osmolar contrast); describe the management of aminoglycoside and vancomycin nephrotoxicity; and outline cisplatin and amphoteri…

Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Apply the BTF guidelines for severe traumatic brain injury; manage ICP using a tiered approach (HOB 30°, osmotherapy, CSF drainage, CRANIECTOMY); describe CPP targets; and outline multimodal monitoring (ICP, PbtO2, TCD, …

Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Manage spontaneous intracerebral haemorrhage in the ICU including reversal of coagulopathy, blood pressure targets (INTERACT2 data), surgical decompression criteria and ICP management

Status epilepticus algorithm — Apply the SE treatment algorithm (lorazepam, levetiracetam, phenytoin, phenobarbitone, propofol infusion, midazolam infusion, ketamine) to manage convulsive and non-convulsive status epilepticus; and describe continuous …

Spirometry — V-t + flow-volume loop — Manage Guillain-Barré syndrome in the ICU including respiratory monitoring (FVC, NIF thresholds for intubation), IVIG vs plasmapheresis; and describe critical illness polyneuropathy and myopathy recognition and managemen…

Shock & sepsis haemodynamic profiles + Oxygen delivery & consumption (DO₂/VO₂) — Apply the Sepsis-3 definitions (SOFA, qSOFA); implement the SSC Hour-1 Bundle (blood cultures, lactate, antibiotics, fluids, vasopressors); describe the pathophysiology of septic shock; and apply vasopressor dosing and w…

Antimicrobial PK/PD targets — Apply pharmacokinetic and pharmacodynamic optimisation of antibiotic dosing in critical illness (augmented renal clearance, decreased protein binding, altered Vd); use TDM (vancomycin AUC, aminoglycoside Cmax); and apply…

Coagulation cascade — Diagnose DIC using ISTH scoring (platelets, PT, fibrinogen, D-dimer, soluble fibrin monomers); describe the management of bleeding DIC (FFP, cryoprecipitate, platelets) and thrombotic DIC; and distinguish from other caus…

Coagulation cascade — Apply the 4T score for HIT type 2; confirm with PF4-heparin antibody ELISA and serotonin release assay; describe cessation of heparin and initiation of alternative anticoagulation (argatroban, danaparoid, fondaparinux); …

Coagulation cascade — Describe the anticoagulation strategy in the ICU including unfractionated heparin (infusion, APTT monitoring), LMWH dosing in CKD, DOACs and reversal agents (idarucizumab, andexanet alfa, PCC); and outline anticoagulatio…

Iron homeostasis — Apply BCSH guidelines for blood product transfusion in critically ill patients; describe the restrictive transfusion strategy (TRICC trial, Hb threshold 70 g/L); and manage acute haemolytic transfusion reactions, TRALI a…

Glucose homeostasis — Manage DKA in the ICU (ADS (Australian Diabetes Society) / eTG adult DKA protocol: fixed rate IV insulin 0.1 units/kg/hr, NS resuscitation, potassium replacement); describe the management of HHS (slower correction, antic…

Glucose homeostasis — Apply the NICE-SUGAR trial glucose targets (6–10 mmol/L) in ICU; describe continuous insulin infusion protocols; and manage hypoglycaemia as a healthcare complication

Hypothalamic-pituitary-adrenal axis — Diagnose critical illness-related corticosteroid insufficiency (CIRCI) using random cortisol and the cosyntropin test; describe the hydrocortisone dosing regimen in vasopressor-dependent septic shock (APROCCHSS/ADRENAL t…

Sodium & water disorders + IV fluid composition — Manage sodium and water disorders in the ICU including SIADH (fluid restriction, hypertonic saline, tolvaptan) and central/nephrogenic diabetes insipidus (desmopressin, fluid replacement); and describe the correction rat…

Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Manage severe TBI in ICU applying BTF guidelines: ICP < 22 mmHg, CPP 60–70 mmHg, tier 1 (HOB, sedation, normocapnia) to tier 3 (barbiturate coma, decompressive craniectomy) interventions; and interpret multimodal neuromo…

Acute kidney injury staging — Describe the pathophysiology, diagnosis and management of rhabdomyolysis (forced diuresis, urinary alkalinisation, haemodialysis for refractory hyperkalaemia); and outline crush syndrome management in mass casualty incid…

Anaphylaxis & adrenaline algorithm — Manage tricyclic antidepressant toxicity (sodium bicarbonate for QRS >120 ms, vasopressors, intralipid for refractory cardiovascular collapse) and atypical antipsychotic toxicity in the ICU

Glucose homeostasis — Manage calcium channel blocker and beta-blocker toxicity in the ICU using high-dose insulin euglycaemic therapy (1–10 U/kg/hr), lipid rescue emulsion (intralipid), vasopressors, glucagon and VA-ECMO as rescue

Toxidrome discriminator grid — Differentiate serotonin syndrome (Hunter criteria) from neuroleptic malignant syndrome; describe the management of each (cyproheptadine, supportive care vs bromocriptine, active cooling); and describe the management of s…

Toxidrome discriminator grid — Describe the management of organophosphate poisoning (atropine titration to dry secretions, pralidoxime within 24 hours), carbon monoxide poisoning (100% oxygen, hyperbaric oxygen indications) and Australian snake enveno…

Lung volumes & capacities + Mechanical ventilation modes — Describe the physiological adaptations of pregnancy relevant to ICU care (increased CO, reduced FRC, altered drug pharmacokinetics, hypercoagulable state) and their implications for mechanical ventilation and drug dosing

Adult bradycardia algorithm — Describe the indications for temporary cardiac pacing (transcutaneous and transvenous) in the ICU; describe the pacing modes; and outline management of pacemaker failure and troubleshooting

Train-of-four monitoring — Describe the indications for neuromuscular blockade in the ICU (ventilator dyssynchrony, severe ARDS — ACURASYS data, tetanus, ICP management); outline train-of-four monitoring; and describe the management of ICU-acquire…

Train-of-four monitoring — Describe neuromuscular blockade monitoring and complications — train-of-four with a peripheral nerve stimulator (target T1–T2 of 4), choice of agent (cisatracurium vs rocuronium, reversal with sugammadex), depth of paral…

Vasopressor & inotrope selector — Describe the pharmacology of vasopressors used in ICU: noradrenaline (alpha-1 dominant), vasopressin (V1 receptor, septic shock adjunct), adrenaline (high-dose alpha for refractory shock), metaraminol and dopamine; and o…

Acute kidney injury staging — Apply dose adjustment principles for renally cleared drugs in AKI and during CRRT; describe drugs requiring hepatic dose reduction; and apply the principles of drug dosing during ECMO (increased Vd for lipophilic drugs, …

Diagnostic tests — 2×2, ROC & Bayes — Critically appraise randomised controlled trial design in critical care; apply concepts of randomisation, allocation concealment, blinding, intention-to-treat analysis, Bayesian vs frequentist interpretation; and identif…

Acute kidney injury staging — Manage electrical and lightning injury in the ICU including mandatory cardiac monitoring, management of rhabdomyolysis and AKI, fasciotomy for compartment syndrome; and describe the delayed presentations