General Comments:
Case histories are not included in the text but will be used in slide presentations. Skill station objectives are not included in the book since they are undergoing revision. The number of Key Points was intended to be <15 for consistency between chapters. Web sites have been added for references. A Pediatric appendix has been added.

1. Chapter 1, Assessment of the Seriously Ill Patient
   The goal is to help students recognize seriously ill patients, assess severity, and intervene appropriately. A framework for assessing the patient is proposed using a primary and secondary survey approach. Critical issues such as tachypnea, hypotension, and metabolic acidosis are emphasized.
    
2. Chapter 2, Airway Management
   This chapter includes information on the airway adjuncts, laryngeal mask airway and esophageal-tracheal Combitube. The indications and techniques for insertion are described. These devices can also be demonstrated in the airway skill station. The indications for tracheal intubation are delineated and the assessment of the airway for degree of difficulty has been reorganized. Additional options for safe airway management with a management guideline for the known or unrecognized difficult airway are now included. The associated appendix I on endotracheal intubation now includes information on blind nasotracheal intubation as well as orotracheal intubation.
    
3. Chapter 3, Cardiopulmonary/Cerebral Resuscitation
   This chapter includes a brief discussion of ethical issues regarding resuscitation such as who should be resuscitated and the appropriate documentation of resuscitation level. Information in the section on primary response has been updated to reflect the American Heart Association Guidelines 2000 for ACLS. A section on respiratory arrest in the nonintubated and intubated patient is now included. The current algorithms from the American Heart Association for ACLS and PALS are included in appendices 3 and 4.
    
4. Chapter 4, Diagnosis and Management of Acute Respiratory Failure
   This chapter addresses the differential diagnosis of respiratory failure.  There is an expanded section on noninvasive positive pressure ventilation.
    
5. Chapter 5, Mechanical Ventilation
   This chapter reflects the use of pressure-controlled modes of ventilation. A section has been added on the types of ventilator breaths which is used as a basis to describe the modes of mechanical ventilation. The modes of mechanical ventilation are arranged in order of more common usage. The guidelines for initiation of mechanical ventilation reflect the current practice in regard to tidal volume. The importance of inspiratory plateau pressure is explained in detail with a figure. A short section on humidification of gases has been added.
    
6. Chapter 6, Basic Hemodynamic Monitoring
   This chapter does not emphasize the use of pulmonary artery catheters but rather the principles of hemodynamics.  A table on clinical assessment of determinants of cardiac output has been added. This should help students apply some of the principles in the absence of invasive hemodynamic monitoring.
    
7. Chapter 7, Diagnosis and Management of Shock
   Gelatin colloid solutions, which are not available in the United States, are mentioned in the text.
    
8. Chapter 8, Neurologic Support
   This chapter reflects guidelines for the management of head trauma and management of ischemic (non-hemorrhagic) stroke.
    
9. Chapter 9, Basic Trauma and Burn Management
   The tables on blood volume and vital signs in children have been moved to the pediatric appendix.
    
10. Chapter 10, Acute Coronary Syndromes
    This chapter organized into topics of unstable angina and non Q-wave myocardial infarction and Q-wave myocardial infarction. The treatment algorithms for unstable angina and myocardial infarction include drugs such as GP IIb/IIIa inhibitors and primary angioplasty. The table of drugs used in acute coronary syndromes includes low molecular weight heparins GP IIb/IIIa inhibitors, newer thrombolytic agents, and amiodarone as an antiarrhythmic agent. The revisions are consistent with guidelines from the American College of Cardiology and the American Heart Association.
     
11. Chapter 11, Life-Threatening Infections, Diagnosis and Antibiotic Selection
    In this chapter, less emphasis is placed on the consensus conference definitions. The epidemiologic setting has been included as an important factor in diagnosis of infections. The section on microbiological studies include more specific recommendations. An expanded section on assessment for antimicrobial resistance has been added to the antibiotic therapy general section. Please note that the topics of encephalitis and brain abscess are marked as supplemental and do not need to be presented.
     
12. Chapter 12, Management of Life-Threatening Electrolyte and Metabolic Disturbances
    Please note that the section on other electrolyte abnormalities is marked as supplemental as well as the section on additional metabolic disturbances. It is up to the course director to determine if this information should be presented formally during a lecture.
     
13. Chapter 13, Special Considerations
    In this chapter, the section on pulmonary embolism has been revised to include the use of D-dimer and spiral CT.  
14. Chapter 14, Critical Care in Pregnancy
    Several sections are designated as supplemental material including peripartum cardiomyopathy, severe asthma, and septic pelvic thrombophlebitis. A table of risk categories for selected drugs is incorporated into the chapter rather than as a separate appendix.
     
15. Chapter 15, Medical Ethics
    Only minor changes to content have been made in this chapter.
     
16. Chapter 16, General Pediatric versus Adult Patient Consideration
    Key points have been added.