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Quality and Patient Safety
45-Minute Session

Difficult Diagnoses in the ICU

Tuesday, January 23, 2024
8:00 AM – 8:45 AM MT
Location: West-301BC
CE: 0.75

This session is a multispecialty perspective on the ICU patient with an unclear underlying diagnosis. Many critically ill patients are treated with empiric or syndrome-based therapy without ever receiving a definitive diagnosis. Speakers will discuss the obstacles to effective diagnosis, offer principles and practical tips for approaching the problem, and review some of the most important and easily missed diagnoses within the specialties of neurology, infectious disease, and toxicology that often challenge the bedside clinician.

Learning Objectives:

  • Explain challenges in diagnosing undifferentiated disorders in the ICU, common pitfalls in diagnosing critically ill patients, and the impact of accurate diagnoses on patient outcomes
  • Prepare a toolkit of techniques to improve the chance of successful diagnosis of occult, complex, or uncommon diseases in ICU patients, including bedside references and checklists
  • Design a diagnostic framework for the ICU patient with altered mental status, including the key diagnostic possibilities and a rational approach to testing and confirmation
  • Recognize the importance of pursuing a definitive diagnosis in the ICU patient with suspected infection, including consideration of risk factors and historical features, and practical application of diagnostic modalities
  • Evaluate the possibility of toxicologic exposure in the undifferentiated ICU patient and apply a rational approach to determining the causative agent, including recognizing common toxidromes, interpreting anion and osmolar gaps, and exploring urine drug screens and serum drug levels

Presentations:

  • Differentiating the Undifferentiated: Principles and Approaches for the Undiagnosed ICU Patient
  • My Patient Just Won't Wake Up: Now What? A Framework and Approach to Mystery Encephalopathy
  • Sick People Deserve a Diagnosis: Identifying Infections in the ICU