Design and Implementation of a Pediatric ICU Acuity Scoring Tool as Clinical Decision Support

Pediatric in-hospital cardiac arrest most commonly occurs in the pediatric intensive care unit (PICU) and is frequently preceded by early warning signs of clinical deterioration. In this study, we describe the implementation... read more

Antibiotic timing in Severe Sepsis

Severe sepsis is a time dependent condition and this study builds on previous literature which supports that early identification and treatment of sepsis with antibiotics decreases mortality. Retrospective analysis of a large... read more

Fever Control in Critically Ill Adults

One potential way to protect patients from the physiological demands that are a consequence of fever is to aim to prevent fever and to treat it assiduously when it occurs. Our findings do not support the hypothesis that more... read more

Optimizing Hemodynamic Support in Severe Sepsis and Septic Shock, An Issue of Critical Care Clinics

Guest Editor Dane Nichols, MD, has assembled a panel of experts focusing on Hemodynamic Support in Septic Shock. Topics include: Oxygen Delivery and Consumption: A Macro-Circulatory Perspective; Mean Arterial Pressure: Therapeutic... read more

Optimizing Hemodynamic Support in Severe Sepsis and Septic Shock, An Issue of Critical Care Clinics

ICU Utilization for Patients With Acute Exacerbation of COPD Receiving Noninvasive Ventilation

There is wide variability in the rate of ICU utilization for noninvasive ventilation across hospitals. Chronic obstructive pulmonary disease (COPD) patients receiving noninvasive ventilation had similar in-hospital mortality... read more

Why Do Bleeding Trauma Patients Die?

It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That's a great thing of course, but we should not be complacent. It's also worth looking at where and how patients die.... read more

Neuro ICU Nurse Tips for Newbies

This episode discusses a few diseases processes that are typically seen by the neuro ICU nurse as well as a neuro floor. We chat about subdural hematomas, epidural hematomas, seizures, brain tumors, and diffuse axonal injury.... read more

DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning

Traditional methods for assessing illness severity and predicting in-hospital mortality among critically ill patients require time-consuming, error-prone calculations using static variable thresholds. These methods do not... read more

Prehospital Intravenous Fentanyl Administered by Ambulance Personnel

Prehospital acute pain is a frequent symptom that is often inadequately managed. The concerns of opioid induced side effects are well-founded. To ensure patient safety, ambulance personnel are therefore provided with treatment... read more

Reducing Catheter-associated Urinary Tract Infections in the ICU

Patients in the ICU are at higher risk for catheter-associated urinary tract infection (CAUTI) due to more frequent use of catheters and lower threshold for obtaining urine cultures. This review provides a summary of CAUTI... read more

ICU May Be Overused for Some COPD, Acute MI, HF Patients

For patients with COPD, heart failure and myocardial infarction, who are not critically ill, a stay in the ICU may be no more beneficial than staying on a ward, according to an analysis just published in the Annals of the... read more

The effects of performance status one week before hospital admission on the outcomes of critically ill patients

PS impairment was associated with worse outcomes independently of other markers of chronic health status, particularly for patients in the medium range of severity of illness. PS impairment was moderate in 17.3 % and severe... read more

Hypertriglyceridemic pancreatitis: Can we defuse the bomb?

Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more

Ultrasound-guided Pleural Effusion Drainage With a Small Catheter Using the Single-step Trocar or Modified Seldinger Technique

Ultrasound-guided pleural effusion drainage by catheter insertion is a safe and effective procedure. The success rate is low when the effusion is loculated and septated. Both the trocar and the modified Seldinger techniques... read more

One of the Deadliest Hospital-Acquired Infections Is Preventable

Johns Hopkins Study Shows One of the Deadliest Hospital-Acquired Infections Is Preventable. For some hospital patients, going on a ventilator is often the difference between life and death. About 800,000 hospital patients... read more

Antifungal Treatment in the ICU

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in critically ill patients. Almost 80% of IFIs are due to Candida spp., which are the third most common isolated microorganisms in the intensive... read more

Critical Care Pharmacotherapeutics

Critical Care Pharmacotherapeutics presents information on the fundamentals of critical care practice from a pharmacist's point of view. This accessible text is an excellent introduction to critical care pharmacy. Pharmacy... read more

Critical Care Pharmacotherapeutics

Enough is Enough (O2 Saturation of 94-96%)

The liberal use of supplemental oxygen therapy in acutely ill adults has a long history in the hospital, but high-quality therapy supporting its practice is unclear. Recently, the role of oxygen therapy in non-hypoxic patients... read more

Penn Medicine Shortens ICU Stays with Real-time Data

Leveraging real-time data streams from its EHR platform, Penn Medicine has created a dashboard and alerting system to speed the process of getting ICU patients breathing on their own. Many patients in hospital intensive care... read more

Hoopla Aside, hs-cTnI is Not Catching Missed Mis

We have been searching for a tool to identify myocardial infarction patients who are truly safe for discharge ever since Pope, et al., found that we were discharging two percent of patients with MIs from the emergency department.... read more

The Artificial Intelligence Clinician Learns Optimal Treatment Strategies for Sepsis in Intensive Care

Sepsis is the third leading cause of death worldwide and the main cause of mortality in hospitals but the best treatment strategy remains uncertain. In particular, evidence suggests that current practices in the administration... read more

Acute Right Heart Failure

The right ventricle is often overlooked in critical care in favour of the attention to the left side of the heart. But acute right heart failure is important and today on the podcast we discuss its implications for critical... read more