Department-Based ICU Improves Patient Survival Rates

A new Michigan Medicine study found that implementing a dedicated emergency medicine department-based intensive care unit improved patient survival rates and lowered inpatient intensive care unit (ICU) admissions. In the... read more

Effective Goal-Directed Therapy in TBI Patients May Improve Outcomes

The purpose of this study was to estimate the impact of goal-directed therapy on outcome after traumatic brain injury (TBI). Goal-directed therapy was applied to standardize care in patients with moderate to severe traumatic... read more

Risk Factors for Avoidable Transfer to a Pediatric Trauma Center Among Patients Age Two Years and Older

Among injured children age two years and older, those with minor head injuries were at greatest risk for avoidable transfer. Many were transferred because of a perceived need for evaluation by a pediatric neurosurgeon. Future... read more

Predictive Utility of DNI in Patients with MOF After Severe Traumatic Injury

Post-injury multiple organ failure (MOF) is the result of a systemic uncontrolled inflammatory response and it is the one of leading cause of late post-injury mortality. Delta neutrophil index (DNI) may serve useful marker... read more

A Multidisciplinary Idea to STEP UP Resuscitation Effectiveness

Non-technical skills and human factors are increasingly recognized as critical ingredients in the success or failure of acute care delivery in a number of high stakes clinical domains. This is reflected in the evolution of... read more

Withdraw Life-Sustaining Treatments for Patients with Severe TBI

The decision to withdraw life support from patients with severe brain injuries is very difficult. In a study conducted in Canadian Medical Association Journal, critical care physicians were asked about the decision-making... read more

What Happens After a Positive Screen for Depression and PTSD in the Outpatient Burn Clinic?

Multiple reports have demonstrated a wide prevalence of both depression and post traumatic stress disorder (PTSD) within 1 year of burn injury. The purpose of this study is to determine outcomes of burn patients after a positive... read more

Low-value Clinical Practices in Acute Injury Care

This study fills a major knowledge gap on medical procedure overuse in acute injury care. Results will inform research priorities and the development of metrics to measure overuse. This knowledge will provide a solid basis... read more

Holographic Telepresence  – Taking Trauma Care to the Next Level

Advancing technology is all set to bring in a new era of highly-realistic holographic Telepresence. Throughout the history of science fiction and video gaming, we've seen holograms come in various shapes and sizes. Today,... read more

The Glutamine Debate in Surgery and Critical Care

Three recent meta-analyses have confirmed traditional glutamine (GLN)-supplemented (or "GLN-Complemented" – providing GLN for completeness of amino acid content) TPN is safe, reduces mortality and improves outcome in surgical... read more

Psychological and Cognitive Impact of Critical Illness

Hot off the presses. Concise book on PICS, PICS-F and FICUS. Neuropsychiatric problems after critical illness are receiving increasing attention, particularly in the critical care medicine literature, but mental health and... read more

Psychological and Cognitive Impact of Critical Illness

Driving Pressure in Airway Pressure Release Ventilation: a fool’s errand?

In this post I will briefly explain and critique their mathematical approach, propose a simpler equation for estimating PEEPi in APRV [based on far fewer physiological assumptions] and finally reaffirm why, in my opinion,... read more

Early Protocolized Versus Usual Care Rehabilitation for Pediatric Neurocritical Care Patients

A protocol for early personalized rehabilitation by physical therapy, occupational therapy, and speech and language therapy in pediatric neurocritical care patients could be safely implemented and led to more ICU-based treatment... read more

Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged From a Trauma Service

The aims of this study were to evaluate the effects on opioid medication prescribing, patient opioid safety education, and prescribing of naloxone following implementation of a Safer Opioid Prescribing Protocol (SOPP) as... read more

Closed Chest Compressions in Traumatic Cardiac Arrest

This study demonstrated that fluid resuscitation with whole blood is significantly better than resuscitation with compressions alone or with normal saline. It further showed that there was no difference between whole blood... 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

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

Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers

A unique question-and-answer book for surgical residents and trainees that covers all surgical aspects of critical care and acute or emergency medicine. This is a comprehensive, one-of-a-kind question-and-answer text for... read more

Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers

Is Pre-hospital Coagulation Management in Trauma Feasible?

Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more

Reducing Emergency Department Length of Stay

An interdisciplinary team of front-line physicians, nurses, medical assistants, and executives assembled and used value stream mapping to assess the entire ED care process, from patient arrival to admission or discharge.... read more

Teaching the Principles of Pediatric Critical Care to Non-Intensivists in Resource Limited Settings

It is a dismal reality of global health that the vast majority of critically ill or injured children are found in regions of the world least equipped to care for them. Most of these severely ill or injured children are cared... read more

The Effects of Family Functioning on the Development of Posttraumatic Stress in Children and Their Parents Following Admission to the PICU

Both children and parents have alarmingly high rates of acute stress and posttraumatic stress following the child's PICU admission. Although family function did not emerge as a predictor in this study, further understanding... read more