ABSTRACT
The management of patients in a critical care setting requires a subtle integration of applied and theoretical physiology; clinical judgement and understanding of outcomes and outcomes-based medicine; a basic understanding of medical engineering; and, most importantly, dotting the i’s and crossing the t’s, in other words, attention to small details. Patients in the ICU tend to get categorized into flow sheets and it is easy to forget that the care of patients involves evolution of the disease process over a period of time rather than in snippets of time. Attention to minor details is at times exhausting and may even be distracting, but this is probably the most important aspect of intensive care. Some physicians use physiological formulas in understanding the basic science and review collected data as the predominant basis of their management, whereas others use sound clinical judgement and instinct. Both general approaches are valid, but an understanding of both approaches is essential to make rational decisions in the care of patients.
