Rudeness in Medical Settings Could Kill Patients

A recent study paints a grim picture of what rudeness does to doctors and nurses performance. The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September... read more

Should Pediatric Intensive Care Be Centralized? Trent vs. Victoria

The mortality rate is lower among children admitted to specialist pediatric intensive care units (ICUs) than among those admitted to mixed adult and pediatric units in non-tertiary hospitals. In the UK, however, few children... read more

Implementing a Standardized Nurse-driven Rounding Protocol in a Trauma-surgical ICU

We instituted several interventions in our trauma and surgical ICU aimed at improving communication and teamwork between RNs and MDs. Informal feedback indicated greater satisfaction among RNs and MDs with the working environment.... read more

Adjunct and Rescue Therapies for Refractory Hypoxemia

Prone position, inhaled nitric oxide, high frequency oscillation, extra corporeal life support. The mortality of severe acute respiratory distress syndrome (ARDS), defined with a PaO2/FiO2 ratio of 100 mmHg... read more

Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics

This issue of Critical Care Clinics focuses on Mechanical Ventilation and Ventricular Assist Devices, with topics including: Targeted management approach to cardiogenic shock; Prevention and treatment of right heart failure... read more

Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics

When ICU Delirium Leads To Symptoms Of Dementia After Discharge

Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes. This dementia,... read more

Navigating Medical Emergencies – An interactive guide to patient management

This free eBook presents emergent clinical situations and the core tasks required of healthcare professionals needing to recognize, navigate and safely manage them. It's really about how to perform the ABCs while protecting... read more

ESPEN Guideline on Clinical Nutrition in the ICU

Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk,... read more

ICU Care Improved with Conflict Management Education

Stressful by nature, the intensive care unit (ICU) inevitably faces conflicts due to immediate and cohesive action from physicians, nurses, respiratory therapists, and advanced practitioners. In an effort to help improve... read more

Alcohol Withdrawal: One Order to Sedate Them All

This is a retrospective cohort study describing 86 admissions to the ICU for alcohol withdrawal between 2011-2015. 86% were treated with benzodiazepines before ICU admission, usually on the general ward. The average dose... read more

Triiodothyronine Replacement in Critically Ill Adults with Non-thyroidal Illness Syndrome

This study suggests that with triiodothyronine (T3) supplementation there was evidence of serum free T3 normalization without evidence of associated harms. A definitive trial is needed to evaluate clinical effectiveness.... read more

Should ICU clinicians follow patients after ICU discharge? No

Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge... read more

Should ICU clinicians follow patients after ICU discharge? Yes

The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the... read more

Organ and Tissue Donation Education for Critical Care Residents

Qualitative data corroborated that residents need more exposure to clinical cases, especially regarding DCD donors. A standardized education curriculum would be beneficial for all residents within the ICU. Developing a better... read more

Abnormal Environmental Light Exposure in the ICU Environment

Patients' environmental light exposure in the intensive care unit is consistently low and follows a diurnal pattern. No effect of nighttime light exposure was observed on melatonin secretion. Inadequate daytime light exposure... read more

Dutch Ambitions on eHealth

Dutch government is encouraging the healthcare sector to expand telehealth (eHealth) services. Dutch government wants eHealth to become more widely available and is encouraging the healthcare sector to develop it further.... 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

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