Useful Web Resources

The resources below are helpful for a general overview of ICU topics. 

Resources Specific to Each Clinical Site

Each site has a unique patient population and clinical situations that you will encounter:

  • Toronto General Hospital: ECLS (both VA and VV ECMO), lung transplant, liver transplant, pulmonary endarterectomy for CTEPH
  • Toronto Western Hospital: Subarachnoid hemorrhage, traumatic brain injury, stroke, brain death & organ donor management, status epilepticus
  • Mount Sinai Hospital: Acute leukemia, bone marrow transplant, CAR T-cell therapy, immunotherapy, sarcoma, HIPEC surgery, obstetrical emergencies 

ICU Rounds

Coming soon

ICU Best Practices

Coming soon

Mechanical Ventilation 101

Mechanical ventilation is often one of the most daunting topics for learners who are new to the ICU environment. However, there are a lot of fantastic resources available to help increase your comfort level in caring for intubated patients including the following:

Sometimes the various modes of mechanical ventilation can get confusing as well. It is helpful to start by focusing on the most common modes that you will see on your ICU rotations at Sinai/UHN: Pressure Support, Pressure Control, and Volume Control.

Shock and Vasopressors

The resources below are from the Quick ICU Training website and provide guidance for evaluating patients with shock and initiating vasopressor therapy.  For an excellent review article on this topic, please also consider reviewing the following resources:

Approach to Sepsis

The resources below are from the Quick ICU Training website and provide an initial approach to evaluating patients with sepsis and septic shock. For additional reading on this topic, the following sites may be helpful:

Acute Respiratory Distress Syndrome

The resources below are adapted from the Quick ICU Training website and provide guidance for the initial management of ARDS.

Fever in the ICU

Fever is a common problem in critically ill patients and the work-up and management can be quite different than in other clinical settings. The one page summary below is adapted from the Quick ICU Training website and provides an approach to this commonly encountered clinical issue.

ICU Procedures

Central Line Insertion

Outside of very rare emergency circumstances, all of our internal jugular and femoral central line placements are done under ultrasound guidance. The links to the videos below will provide you with an overview of the procedure and common troubleshooting issues. If you are rotating at TGH, there are special considerations when placing central lines for patients on ECMO. Please speak to the attending before proceeding with central venous access for these patients.  

  • Ultrasound-Guided Access: This is an excellent introductory video to accessing vessels safely using ultrasound. 
  • Easy Central Line Placement: Very helpful step-by-step walkthrough for insertion of an IJ central line. The only caveat is that they don’t show the removal of the guidewire after the line is inserted. DO NOT FORGET THIS STEP. 

Arterial Line Insertion

Every ICU has slightly different equipment for arterial line insertion. In the TGH, TWH, and Sinai ICUs most people use a 20G (pink) angio catheter +/- a guidewire for radial arterial lines. There are also radial arterial line kits with a built-in guidewire if you prefer this approach. There are dedicated kits for femoral arterial lines. 

Death Determination

In Ontario, The Vital Statistics Act requires physicians to complete and certify the medical certificate of death immediately after the death unless there is reason to notify the coroner.

The Medical Certificate of Death (Form 16) can be downloaded here: Form 16 (Central Form Repository)

Helpful tips on completing the Form 16 can be found in the Handbook on Medical Certification of Death