Updated July 2026 · Hub page

The ICU Emergencies Library — Every Guide, Organized by System

This library grew one emergency at a time, and it is now large enough that the hardest part is finding the guide you need at 3 a.m. This hub organizes every ICU emergency guide on the site by body system and by the kind of trouble you are looking at. Each guide is written the same way: what the emergency actually is physiologically, what the nurse sees first, what the treatment sequence is and why the order matters, and the specific traps that hurt patients.

Shock, arrest and cardiovascular collapse

The emergencies where minutes matter and the monitor speaks first. Obstructive shock has two great reversible causes — tamponade and tension pneumothorax — and both are diagnosed clinically, not by waiting for imaging. The malignant arrhythmias have their own logic: torsades is an electrolyte-and-QTc story, and Brugada-pattern VF hides in structurally normal hearts.

• Septic shock — recognition, the hour-one bundle, pressors and reassessment
• Cardiac tamponade — Beck's triad in real life and why fluids buy time
• Tension pneumothorax — the clinical diagnosis you never image first
• Torsades de pointes — magnesium first and the pacing/isoproterenol logic
• Acquired long QT & QTc monitoring — catching torsades before it happens
• Brugada syndrome — the ECG pattern that kills healthy hearts
• Hypertensive emergency — controlled reduction, not normalization
• Pulmonary embolism — risk-stratifying and the massive-PE decision tree

Endocrine and metabolic storms

Endocrine emergencies are the great imitators — they arrive looking like sepsis, psychiatric illness, or simple dehydration. Each of these guides pairs a crisis with its mirror image: thyroid storm against myxedema coma, DKA against HHS. The electrolyte emergencies belong here too, because the correction rules are where patients get hurt a second time.

• Thyroid storm — the block-then-wait drug order that must not be reversed
• Myxedema coma — the hypothyroid crash and the steroid-before-levothyroxine rule
• Adrenal crisis — the shock that only steroids fix
• DKA vs HHS — two hyperglycemic crises with different tempos and traps
• Hyperkalemia — stabilize, shift, remove, in that order
• Hyponatremia correction — the speed limits that prevent osmotic demyelination
• Hypercalcemic crisis — fluids first, then the two-speed attack
• Tumor lysis syndrome — the oncologic emergency you can predict and prevent

Toxicology and the hyperthermia look-alikes

Four syndromes present hot, rigid, and altered — malignant hyperthermia, neuroleptic malignant syndrome, serotonin syndrome, and thyroid storm — and the treatments do not overlap. Reading these guides together is the fastest way to build the differential. The overdose guides cover the poisonings where the antidote thinking is counterintuitive: hearts that need insulin, bradycardias that ignore atropine.

• Malignant hyperthermia — the anesthetic trigger and the dantrolene drill
• Neuroleptic malignant syndrome — lead-pipe rigidity on a days-long clock
• Serotonin syndrome — clonus, hyperreflexia, and the hours-long clock
• Beta-blocker overdose — glucagon, high-dose insulin, and bypassing the receptor
• Digoxin toxicity — when potassium tells you how sick the heart is
• High-dose insulin euglycemic therapy — the antidote that feels like a dosing error
• Colchicine toxicity — the poison that kills in three acts
• Baclofen withdrawal — the pump emergency wearing a sepsis mask
• Nerve agents — atropine to a dry chest, pralidoxime before aging
• Vesicant / blister agents — mustard's painless delay vs lewisite's antidote

Obstetric emergencies

OB crises land in adult ICUs whether or not the hospital has an obstetric service, and the physiology of pregnancy rewrites the normal rules — two patients, altered vital-sign baselines, and drug lists that change at delivery.

• Preeclampsia & eclampsia — magnesium, blood pressure, and the delivery decision
• Postpartum hemorrhage — the four Ts and the massive-transfusion trigger
• Amniotic fluid embolism — sudden collapse plus DIC at delivery
• Peripartum cardiomyopathy — heart failure in the new mother

Burns, cold and environmental injury

Thermal injury is a fluid-physiology problem first and a wound problem second. These guides run as a set: the resuscitation math, the airway that swells shut on a clock, the eschar that becomes a tourniquet, and injury made of ice.

• Parkland formula & burn resuscitation — titrate to urine output, not the formula
• Smoke inhalation — three injuries on three clocks, CO and cyanide
• Escharotomy & circumferential burns — the tourniquet you can't see
• Frostbite — rapid rewarming, no-refreeze, and tPA limb salvage
• Accidental hypothermia — not dead until warm and dead

Neurologic crises

Neuro emergencies are exam-driven: the monitor is your serial assessment, and deterioration is measured in subtle changes a scanner won't catch for hours. The neuromuscular pair — Guillain-Barré and myasthenic crisis — share one bedside skill: catching respiratory failure before the blood gas does.

• Status epilepticus — benzodiazepines first, and the timed escalation ladder
• Subarachnoid hemorrhage & vasospasm — the day-4-to-14 watch
• Guillain-Barré syndrome — ascending weakness and the vital-capacity trigger
• Myasthenic crisis — weakness that fails the airway, and the cholinergic mimic
• Wernicke encephalopathy — thiamine before glucose, every time

Everything else that can't wait

• Anaphylaxis — IM epinephrine first and the biphasic watch
• GI bleeding — resuscitation, source thinking, and massive transfusion
• TURP syndrome — when irrigation fluid floods the bloodstream
• Ischemic priapism — a compartment syndrome on a clock
• Neutropenic enterocolitis — abdominal catastrophe without white cells

Keep going

If you work with the machines as much as the emergencies, the companion ICU devices & life-support hub organizes the ECMO, CRRT, ventilator, and hemodynamic-line guides the same way. If the emergencies are your favorite part of the job, that instinct has a career path — the CRNA career hub and the ICU specialty career hub map where ICU mastery can take you.

Educational content for licensed clinicians. Always follow your facility's protocol and provider orders. Not medical advice.