Six Reasons to Avoid Fluoroquinolones in the Critically Ill
As an internal medicine resident and pulmonary/critical care fellow, I loved fluoroquinolones. They were effective, easy to prescribe, and had 100% oral bioavailability. However, working full-time in the ICU has forced me... read more
Viral Sepsis in Children
Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although the incidence of viral-induced sepsis is not precisely known,... read more
Silent Space
Exhausted at the end of a busy week on service in the intensive care unit (ICU), the fellow and I are on our way to the conference room to debrief the week. The overhead code alarm disrupts the temporary lull in activity... read more
Prone Positioning for a Morbidly Obese Patient with ARDS
Since the description in the 1970s of external positive end-expiratory pressure for acute respiratory distress syndrome (ARDS), the optimum level of external positive end-expiratory pressure remains unresolved. In the 1990s,... read more
Circulating Biomarkers May be Unable to Detect Infection at the Early Phase of Sepsis in ICU Patients
During the study period, 363 patients with SIRS were screened, 84 having exclusion criteria. Ninety‑one patients were classified as having non‑septic SIRS and 188 as having sepsis. Eight biomarkers had an area under... read more
Intensive Care Medicine in 2050: Vasopressors in Sepsis
Vasopressors are used in sepsis when hypotension is assumed to be mainly due to a decreased arterial tone. However, the appropriate time to initiate vasopressors is not clearly defined, and fluid administration is most... read more
Feng Shui And Emotional Response in the Critical care Environment
The aim of this study was to investigate the relationship between nursing staff emotions and their surrounding environment, using the ancient system of feng shui. Two orientations of critical care bed spaces (wind and water... read more
We Should Avoid the Term “Fluid Overload”
Using the right word or phrase to describe a specific pathologic process/patient diagnosis and/or status is important, not only within the intensive care unit team, but also when we communicate with external consultants.... read more
New World Sepsis Day Infographics
The new World Sepsis Day Infographics are now available for download, just in time for World Sepsis Day this Thursday. Please download them and feel free to use them as you see fit, on your social media channels, printed... read more
Women in Intensive Care
Women in Intensive Care study: a preliminary assessment of international data on female representation in the ICU physician workforce, leadership and academic positions. Despite limited information globally, available data... read more
Sepsis: Learn the Signs and Document
Writing in the MJA, researchers have reported the findings of a prospective cohort study comparing estimates of the incidence and mortality of sepsis using clinical diagnosis or the Australian and New Zealand Intensive Care... read more
Preventing Burnout and Compassion Fatigue
Burnout and compassion fatigue can happen to any healthcare professional, and it can have a negative impact on patients and even your larger nursing career. Fortunately it's very preventable, as our guest this week will attest... read more
Cognitive Function 3 and 12 Months After ICU Discharge
In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge. We included 161 patients, 79 patients had a 3-month and... read more
Withdrawing vs. Not Offering Cardiopulmonary Resuscitation: Is There a Difference?
In light of the SCC's Cuthbertson v. Rasouli decision, the distinction between withdrawing and not offering a medical treatment is increasingly relevant. Because CPR is a "default" treatment for cardiac arrest, it requires... read more
High Flow Nasal Oxygen for Acute Bronchiolitis?
Since bronchiolitis is a clinical diagnosis, there is no test, including viral testing and radiography, which rules it in or out (Schuh et al 2007). Sadly, despite multiple guidelines (NICE, AAP, CPS), there has also been... read more
Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support
Among ICU patients receiving acute ventilatory support for respiratory failure, patient-directed music (PDM) resulted in greater reduction in anxiety compared with usual care, but not compared with NCH. Concurrently, PDM... read more
Using music to stabilize NICU babies as well as their parents
When music therapist Christine Vaskas works with babies in the neonatal intensive care unit, the effect of her interventions are almost always immediately apparent. In 2013, a study led by Joanne Loewy, the Armstrong Center's... read more
Physician Well-Being: The Reciprocity of Efficiency, Resilience, Wellness Culture
The quality and safety of patient care, and indeed the very vitality of our health care systems, depend heavily on high-functioning physicians. Yet recent data have revealed an extraordinarily high - and increasing - prevalence... read more
ICU Usage for Pneumonia Doubles Length of Hospital Stay
A recently released report using data from the National Hospital Care Survey (NHCS) verifies existing data on the prevalence of pneumonia in hospitalizations and emergency department (ED) visits and provides the first-ever... read more
Lumping or Splitting in Pediatric ARDS
Improvements in acute respiratory distress syndrome (ARDS) outcomes in adults have been achieved along-side demonstration of the superiority of low-tidal volume ventilation, the relative advantage of a restrictive fluid strategy... read more
Breaking it Down: Post Intensive Care Syndrome and Recovery – Emotions
The emotional aftermath of critical illness/injury is something that often catches people by surprise but can have a significant impact on daily life. People who have been critically ill/injured often describe difficulty... read more
Preventing Harmful Delays with POCUS During Cardiac Arrest
With the integration of bedside echocardiography into cardiac arrest, we now have a real-time tool to help us glean some of this critical missing information, as well as offer procedural guidance and prognostic data. However,... read more
