How Do Resuscitation Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest Succeed?
Resuscitation teams at hospitals with high IHCA survival differ from non–top-performing hospitals. Our findings suggest core elements of successful resuscitation teams that are associated with better outcomes and form the... read more
The Dreaded Acute Compartment Syndrome
When obtaining intracompartmental pressures, place the catheter within 5cm of the fracture level, with the transducer secured at the level of the measured compartment. Make sure to keep the catheter tip outside of the actual... read more
Do phenylephrine and epinephrine require central access?
Until recently I believed that prolonged vasopressor administration requires a central line, to avoid extravasation. I lumped together all vasopressors, treating them all as equal. I used the occurrence of an extravasation... read more
PTSD Phenomena After Critical Illness
Experiencing critical illness and intensive care can be extremely stressful. Roughly 1 in 5 critical illness survivors have clinically significant post-traumatic stress disorder (PTSD) symptoms in the year after intensive... read more
Stopping ICU delirium by getting patients moving
Doctor says the treatment plan makes a 'massive difference' to those in critical care. Any hospital stay can be traumatic. But 30 percent of patients in intensive care units experience ICU delirium. The rate for... read more
Haloperidol Serum Concentrations in Critically Ill Patients Included in the REDUCE Study
ICU delirium occurs frequently and is associated with unfavorable outcome. A recent delirium prevention study, the REDUCE study, has assessed the efficacy of prophylactic use of haloperidol. In this subset... read more
pH-guided Fluid Resuscitation and BICAR-ICU
The use of bicarbonate is a source of eternal disagreement. Bicarbonate has a shameful history of being abused in situations where it's unhelpful (e.g. cardiac arrest). This has impugned its reputation, giving it an aura... read more
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
