An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature

The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is ... read more

Reversal of Oral Anticoagulation in Patients with Acute Intracerebral Hemorrhage

In light of an aging population with increased cardiovascular comorbidity, the use of oral anticoagulation (OAC) is steadily expanding. A variety of pharmacological alternatives to vitamin K antagonists (VKA) have emerged... read more

Pediatric Hypertension and Hypertensive Emergencies: Recognition and Management in the Emergency Department

Pediatric hypertension generally presents to the ED in 2 forms: (1) the otherwise asymptomatic child with elevated blood pressure, and (2) the child with a true hypertensive emergency. This issue provides recommendations... read more

Approaches to Addressing PICS Among ICU Survivors

Critical illness can be lethal and devastating to survivors. Improvements in acute care have increased the number of intensive care unit (ICU) survivors. These survivors confront a range of new or worsened health states that... read more

Reproducibility Trial Publishes Two Conclusions For One Paper

The British Journal of Anaesthesia's unusual experiment is designed to broaden replicability efforts beyond just methods and results. How deeply an anaesthetist should sedate an elderly person when they have surgery is... read more

The Epidemiology of Symptomatic Catheter-associated Urinary Tract Infections in the ICU

Catheter-associated urinary tract infection (CAUTI) occurs frequently in critical illness with significant morbidity, mortality, and additional hospital costs. The epidemiology of symptomatic ward-acquired CAUTI (within 48... read more

Disease History to Predict Mortality Risk in ICU Patients

Patients in the intensive care unit are highly heterogeneous, and include elderly patients who generally have a long history of disease. Prediction of prognosis can often be difficult because of the severity of patient illness... read more

Diaphragm-protective Mechanical Ventilation

Diaphragm dysfunction is common in mechanically ventilated patients and predisposes them to prolonged ventilator dependence and poor clinical outcomes. Mechanical ventilation is a major cause of diaphragm dysfunction in these... read more

Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine

Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of... read more

Translational Simulation: Not “Where?” But “Why?” A Functional View of In SITU Simulation

Healthcare simulation has been widely adopted for health professional education at all stages of training and practice and across cognitive, procedural, communication and teamwork domains. Recent enthusiasm for in situ simulation—delivered... read more

Impact of Mean Arterial Pressure Fluctuation on Mortality in Critically Ill Patients

The purpose of this study was to investigate the association between mean arterial pressure fluctuations and mortality in critically ill patients admitted to the ICU. The reduced mean arterial pressure fluctuation (within... read more

Environment key battle ground in fight to tackle antibiotic resistance

The environment could be as important a battle ground as the clinic in the global fight against the spread of antibiotic resistance, new research has shown. A study conducted at the University of Exeter Medical School concluded... read more

Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients

A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate Clostridium difficile infection (CDI) in adult inpatients. From the hospital... read more

Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation

Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role... read more

Outcomes and Costs of Patients Admitted to the ICU Due to Spontaneous Intracranial Hemorrhage

Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little... read more

Fluid Responsiveness in Sepsis

Fluid challenge is a common practice in the ICU. It is one of the most important resuscitation manoeuvres of acute circulatory failure management in critically ill patients. Adequate fluid resuscitation is very important... read more

Top 10 Perioperative Applications of Point-of-Care Ultrasound for Anesthesiologists

Anesthesiologists have been leaders in the use of point-of-care (POC) ultrasound for intraoperative transesophageal echocardiography (TEE), and to guide vascular access and regional anesthesia procedures. Recently, anesthesiologists... read more

Excited Delirium: Acute Management in the ED Setting

Excited delirium syndrome is a common yet poorly characterized ED presentation with a wide differential diagnosis. Patients are often identified initially by law enforcement, but attempts to control individuals experiencing... read more

Risk Factors at Index Hospitalization Associated With Longer-term Mortality in Adult Sepsis Survivors

In this cohort study of 94 748 adult sepsis survivors, age, male sex, 1 or more severe comorbidities, prehospitalization dependency, nonsurgical status, acute severity of illness, site of infection, and organ dysfunction... read more

Neuromuscular Blockade for ARDS Was No Help, In Supine Patients

Continuous neuromuscular blockade for severe ARDS became common practice after the ACURASYS trial showed it reduced mortality by an absolute 9%. A larger trial, ROSE, now finds no benefit of the therapy over usual care, but... read more

Unsafe Nursing Ratios Incapacitate EDs, Endanger Patients

It's the evening surge at a busy ED where all beds are occupied. Several admitted patients – including 2 critically ill – are waiting for rooms upstairs. A quick glance reveals a full waiting room with multiple potentially... read more

Initial Arterial pH as a Predictor of Neurologic Outcome After Out-of-hospital Cardiac Arrest

Lower pH after out-of-hospital cardiac arrest (OHCA) has been associated with worsening neurologic outcome, with ... read more