Best Resources For ICU Rotations [Full Breakdown]

After working nearly 70 hours in the medical ICU this week, I thought I’d share my favorite resources to help you crush it on your critical care rotation. In this article, we’ll talk about the best resources for ICU rotations!

When I was a medical student as well as a full-time Physician in residency, the most stressful rotation is working in the ICU.

That’s due to a combination of being in an environment where there’s a lot to learn and that the patients who are dependent on you for this knowledge are very sick. So it feels like there’s a time element to it.

In this article, we’re going to talk about some of the best resources on how to prepare for an ICU rotation so that you can acquire the knowledge you need and do it quickly. I will also share how I go about learning and preparing myself as a full-time physician.

Let’s get into it!

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Ventilator Book

Now, I don’t know about you, but for most med students, including myself, as well as residents, one of the things that are the most difficult to master is ventilators.

And that’s simply because as a med student, you may not have a lot of experience working with them, much less making adjustments and changing them.

But on your ICU rotations, you have to know how to look at a ventilator, know if it’s working the way you want it to, evaluate the results, and know how to make adjustments based on those results.

So one of my favorite resources to learn the basics, as well as some of the advanced techniques for doing better on ventilators, is the Ventilator Book. That’s exactly what it’s called.

It is very cheap. It’s also very, very short. But the beauty of it is that it has diagrams of the type of things you’ll be seeing on your ventilator. It’s basically a troubleshooting manual.

If things are going in the right direction in certain settings, then the book can show you how to make adjustments. It’s a really quick read and it’s very conversational. I do find myself holding onto a lot of the principles in this book when I look at the ventilator.

Just a few days ago, I was admitting a patient who was found down. She had lost her pulse at home, and we had no idea why. Simply listening to her lungs and looking at the ventilator, I could quickly tell that this person might be having a COPD exacerbation.

She probably didn’t have her inhaler. And sure enough, when I called her husband who was at home, he said that she had not taken her medications for two to three days.

As soon as we started treating her for a possible COPD exacerbation, all her numbers on the ventilator and on her labs got better. And that’s the beauty of knowing what patterns to look for.

So if you are interested in mastering ventilators, make sure you to check out the  Ventilator Book. It definitely saved my life a few times in residency.

Med Cram

Resource number two also helped me a lot with ventilators as well as other ICU concepts. It is called MedCram.

I talked about MedCram a lot more in this YouTube video: Best Medical YouTube Channels You Need To Know About

MedCram was great for explaining some of the basic concepts even before I had gone through the Ventilator Book.

It was super effective and very easy to follow. If you go through their YouTube channel, you also be able to find other very ICU-friendly topics.

And so if you’re on an ICU rotation or if you’re in residency and you don’t have the time or attention span to read a book, definitely consider checking out free resources like MedCram on YouTube.

The Little ICU Book

In addition to resources like the Ventilator Book and Med Cram, I have tried other books like The Little ICU Book.

You have probably seen this on Amazon. It is very dense. Get this if you want a reference material to have on the side.

Mobile Resources

Later, I’m going to talk about the resources that I go to the most to help me learn. But first, I want to talk about what I do in the situations where I’m asked to evaluate a patient.

Currently, I work at an 800+ bed hospital. And any time I can get a page to evaluate a patient. Sometimes I may get asked to evaluate a patient for a problem that I don’t have a lot of experience with.

So what do I do in those situations?

Typically, because time is so limited and those patients tend to be critical, I use a lot of resources on my phone.

MD On Call

One of the mobile resources that I’ve kept for quite some time is MD on Call. It’s something I paid for once. It’s a big reference material for any problem that I may encounter.

For example, if I have a patient who’s hypotensive and I don’t know how to manage it because I’m a new intern, then I can get an idea of what to do from this app.

I can search for the reasons somebody could be hypovolemic. And as I’m walking to the room, I can think about what labs I should start ordering, how I should manage them, what I should tell my nurses, who I need to call and consult with, and what imaging things I need to order.

This is like a nice little helpful thing. I can also look up hyponatremia. That’s a very common reason that I get called to the emergency room.

Let’s say a patient has a sodium level of 118 when 140 is the normal level. If I forget how to treat that, I can quickly search for it in the MD on Call app. Do they need to go to the ICU? What type of diagnostic test do I need to order if I do admit them? And how do I want to start managing them?

MD on Call is something I’ve been using since my intern year. I don’t use it as much now because there are a lot of problems that I’ve seen over and over again. But for things that I haven’t seen, it is a great reference material.

UpToDate

In addition to MD on Call, most medical doctors and medical students are experienced with the UpToDate app.

You can look up any problem, for example, hyponatremia. Sometimes I may not have a lot of time to read about something. UpToDate helps me evaluate my patient’s case.

I can use the algorithms and pathways. Let’s say, their sodium is normal. They don’t have any kidney problems. They’re not in a diuretic. But they look volume overloaded. So you can say that this patient’s sodium is probably due to the fact that they’re really volume overloaded, and you should fix that problem first.

UpToDate will keep asking questions to help me evaluate my patient. It gives me a nice train of thought.

In addition to having those pathways, UpToDate has a very long Wikipedia-style evaluation of the patient. So I can easily check the things I should be doing, what medications they may need, and what type of labs I should be ordering.

It’s a really good resource. And again, it’s just on my phone so it’s so easy to access as I’m walking down to the emergency room to evaluate a patient.

Human Dx App

The last resource is something that I’ve shared throughout multiple videos. I really do enjoy using the Human Dx app to help me improve my critical care function.

Often in ICU, the cases that give us the most head-scratchers are the ones where we don’t know what to do, what type of things we should be considering, and our diagnosis.

For example, here’s a case that I did not that long ago. A 61-year-old showed up with shortness of breath and he has all the symptoms of somebody that I could easily evaluate for the ICU. He has a fever. He’s not really responding. He’s been up to date on all his COVID vaccines, et cetera, but still has shortness of breath despite being on oxygen.

The nice thing about using this app is that you can walk yourself through what type of things you would want to know about a patient.

What labs do they order? What happens in their hospital course. And then it shows me chest x-rays. I can practice a chest x-ray for example, if I’m not really good at it. And then you will get a diagnosis.

Now, this patient had human rhinovirus, which is something that doctors often forget, even in the ICU. Nowadays, we’re used to looking for diagnoses like COVID, pneumonia, and other infections. But we may forget viruses like the rhinovirus.

This tells me that maybe I should order a respiratory viral panel since the patient may not have a bacterial infection, COVID, or heart failure. Adding another diagnosis to my repertoire really helps me become a better physician for these patients as I continue my ICU rotation.

Online Resources

Next, I want to transition to where I really get the bulk of my knowledge.

Initially, when you’re starting on ICU rotation, you want to learn the basics. You want to go through the ventilators, you want to learn basic management of patients who are crashing, and how to treat things like sepsis and shock.

But then you’re going to have a certain phase where you ask, what are the research-based things to do for a certain patient? You want to have those in your repertoire and have those growing over time. And so online resources like the ones I’m about to share have made the biggest difference in terms of my confidence in taking care of any patient in an ICU setting.

EM Crit Website

The first one is the EM Crit project, the resource that I use to learn medicine in general. It’s great for things like emergency medicine, as well as critical care rotations like the ICU.

Every few days, you’re going to have breakdowns of major topics. My favorite place to go to is this PulmCrit area. Just click PulmCrit from the menu and it’s going to take you to a big database.

You can read about any topic. For example, if I want to learn more about pericardial tamponade, I can go ahead and click the link.

This is actually what I read on some of my ICU rotations. There may be a quiet hour or two and there’s nothing really going on, and I want to learn something.

The part that I really enjoy is that not only is it easy to follow, but the recommendations in terms of what type of things I should be doing are very evidence-based. It helps me understand what’s not important to consider and what is important to keep in mind when taking care of the patients.

One of the things I really enjoy is their table of contents.

Let’s say, I am struggling with topics in gastroenterology. I can go into the gastroenterology section and check out the blog articles.

For example, maybe I should know how to manage a patient that has cirrhosis, remember how to take care of SBP, or know how to look at a CTA.

There could also be articles on how to manage patients nutrition-wise, something we forget all the time in ICU. And also, how to look at a patient who shows up with pancreatitis and so many more. These are super helpful!

These articles are really easy to follow. You’ll have a bit of knowledge on a specific topic without reading a big textbook or a bunch of journal articles. The EM Crit Website presents them nicely and cohesively. I can look for whatever I want to learn next and add those to my to-do list.

Life In The Fast Lane

Like the EM Crit Website, I really do enjoy the Life In The Fast Lane. This was a website that really taught me a bunch of things, including chest x-rays and EKGs. And it’s still the resource I love using for that.

So if you’re struggling with EKGs and chest x-rays, you can go through this website.

For example, you can go to the ECG library and check out the ECG by diagnosis. You can also do ECG self-assessment quizzes and see if you pick up on what they consider to be important.

You can also go to CCC and find their entire compilation of everything that’s about critical care. You can go through it or you can search for a topic. For example, if you forgot what A-a gradient meant, you can go ahead and quickly read about it, and keep it as reference material.

Notion Method

The next thing I’m going to share with you is not necessarily a resource, but it’s a method of how I go about learning everything.

One thing I do a lot in ICU is learning about different topics like LV Outflow Obstruction, Capnography, and TIPS. I had a patient who went down for a TIPS procedure because they had bad cirrhosis. So I read more about TIPS and add what I read to my notes.

For example, on a recent call day when the schedule is not very busy, I open up my Notion, I pull up the topics in LV Outflow Obstruction, then I look for them on the EM Crit Website.

Not only does it give me a breakdown of what an LVOT is, but it also gives me little frameworks of how to understand what’s going on anatomically and physiologically.

It shows what situations I may find somebody with an LVOT, what it looks like on an ultrasound, what clinical findings they should be using, as well as what type of things should be used to treat it.

What kind of pressors should I be using? Should I be treating them with fluids or not fluids? You can take notes on Notion and add pictures over time.

Now, if I have a patient who has an LVOT obstruction, I can simply pull up my phone and go to this chapter that I made in Notion.

Speed is the matter of the game in the ICU. And as I’m going to go see a patient, if they have LVOT or if that’s something I’m concerned about, I can quickly go through my notes. And then I can check what I can do.

For example, I can use phenylephrine or norepinephrine or consider using a beta-blocker. I pick up all those kinds of things through learning these chapters. This was super effective during my time in ICU. 

Those, my friends, are some of my favorite resources that I love to use in ICU.

Now, if you did enjoy these resources, I do recommend checking out the resources below.

You might be interested to know how I study as a doctor. Check out this YouTube video: How I Learn Medicine As A Doctor [Step-By-Step]

Now, if you’re on your rotations in medical school and you want to do better, consider checking out our Crushing Clinicals program. Here, I show you how to become an honor student and be on your way to getting the residency of your dream.

And last but not least, if you’re about to start residency or if you’re already there and you’re struggling, and you want to become a superstar physician, then consider checking out the Intern Year Survival Guide.

These are the same strategies that I used during my intern year to not only learn medicine, not only do well in patient care, not only be efficient in doing things like pre-rounding and taking notes, but also have balance in my life.

So if you want to be a superstar physician without all the stress that comes from being a brand new doctor, definitely consider checking out those programs.

But as always my friends, hopefully, this gives you a few resources you can use to really make a big difference in terms of your knowledge base for an ICU rotation.

If you did enjoy this episode, consider checking out these other helpful articles:

• How To Study For Rotations In Medical School (Step-By-Step Method)
• [Ultimate Guide] Resources For Your Emergency Medicine Rotation
• How To Give Better Patient Presentations On Your Rotations [How To Get Honors]
• How To Be More Efficient On Your Rotations [Medical Students And Residency]
• How To Study For Shelf Exams For Your Rotations Effectively [How To Get Honors]
• How To Use Picmonic To Study For Clinical Rotations [How To Get Honors]
• Color Codes In Hospitals [What Do They Mean?]
• 10 Best ECG Courses

Until the next one my friend…