Latest Blog Posts in ICU

Communication myths of anaesthetists

Vital minutes before unconsciousness The myth that anaesthetists pick the specialty ‘because you don’t need to talk to your patients’ persists. Whether said in jest or disdain this concept gains ground because, yes for much of the time, our patients are mostly ‘asleep’. But this ignores the vital communication that occurs prior to anaesthesia;...
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How can a smartphone be used for haemodynamic monitoring?

The parameters of the Capstesia app are described. After taking a photo of the arterial waveform on the monitor screen, and cropping it to the signal of interest, the picture is sent to the Capstesia server via a mobile Internet connection. The heart rate and systolic and diastolic arterial pressures are manually entered into the app to determine...
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Epinephrine for out-of-hospital cardiac arrest

Insights from the PARAMEDIC2 trial and future improvements Perkins et al. have advanced the long-awaited PARAMEDIC2 trial (Perkins et al. 2018). They deserve to be congratulated for such a well-interpreted and well-designed contribution. The study’s two main outcomes are as follows: the Epinephrine group had a significantly improved inpatient survival...
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Prompt cards in the Emergency Department

Human factors are a well recognised cause of discrepancies in patient care that can lead to adverse outcomes. In a busy Emergency Department (ED) setting, when dealing with the sickest patients at all hours and with a rotating workforce, there is an increased potential for inconsistent care despite clear evidence based protocols and guidelines on...
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A letter to Kathy - from an intensive care nurse

As a nurse working in intensive care I have moments in which emotions get much deeper than expected. My own vulnerability is confronting. Do I lose control or do I experience the essence of my job as a nurse? Kathy, your story on YouTube and your saying “the touch that isn’t effective or that didn’t hurt” made a deep impression on me. Every...
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INTUBE study: airway management practice in critically ill patients

Why study endotracheal intubation? Endotracheal intubation (ETI) in critically ill patients is a potentially life-threatening procedure, and approximately one-third of ETIs are complicated by severe hypoxia, cardiovascular collapse and cardiac arrest. Critically ill patients are prone to severe complications as the consequence of the underlying...
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Antibiotic decisions in the ICU: a dragon’s tale

Medical decision-making about antibiotic use in critically ill patients is challenging and complex. The need for antibiotic stewardship requires judicious prescription and choice of antimicrobials, as the need for effective therapy has to be put in balance with the need to limit undue selection pressure, and all this must be done in a context of...
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Bright spots: music in the ICU

The intensive care unit (ICU) is a rather obscure place for many people. It is a place where you are exposed to the fragility of existence, where you have to deal with the fine line between life and death. Every day I desperately try to illuminate this dark place, with a conversation, with a joke, with trying to facilitate the patients’ or families’...
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How ICU diaries can help patients and families

I work in a small intensive care unit (ICU) where we have been writing diaries since 1992. Initially, they were just little black books with notes by staff and families on how patients were doing during their ICU stay. In 1999, we began taking photos of the patients to illustrate their critically ill period, to help them understand and see what happened....
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Survey: Models of critical care outreach systems

Critical care outreach teams (CCOTs) were introduced in an attempt to reduce morbidity and mortality through the earlier detection and resuscitation of acutely deteriorating patients. However, there are many different models of critical care outreach systems across the UK and internationally. This online survey aims to take a cross-sectional...
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