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ICU Management

Pre-ICU

2018 01 Jun

What happens before patients arrive in the ICU? We know that status pre-ICU is associated with outcomes after patients leave the ICU. We also know that we want patients to come to the ICU only if it is needed. This ties in to having an adequate emergency medicine system and innovative techniques in trauma as well as monitoring hospital patients... Read more

ICU Management

Rapid response teams

2018 01 Jun

This article reviews the RRT system concept and provides an update on the current state of such systems, their challenges, their performance, the evidence supporting their usefulness and their evolution. Rapid Response Teams (RRTs) are the key components of Rapid Response Systems. RRT-based rescue systems were developed in response to... Read more

ICU Management

Is pre-hospital coagulation management in trauma feasible?

2018 01 Jun

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 increasing worldwide, particularly in less well-resourced nations. There are an estimated 5 million deaths per year, more... Read more

ICU Management

Pre-ICU health organisation in Norway

2018 01 Jun

Presents the main principles of the Norwegian acute healthcare system. Norway is a rather small country with a population of about 5.3 million. More than half of these inhabitants are located in and around the larger cities, with about a million in the capital region of Oslo. Hence, significant parts of the country are rural, with fjords... Read more

ICU Management

Emergency pre-hospital care challenges: Greece

2018 01 Jun

The ongoing economic crisis in Greece and inflow of refugees has led to changes to the pre-hospital emergency medicine services. Greece is a country of 10.1 million inhabitants, half of whom live in six cities: Athens, Thessaloniki, Heraklion, Patra, Larissa and Ioannina. In recent years the country drew media attention because of the financial... Read more

ICU Management

The Accelerate Pheno™ system in clinical practice: fast and accurate turnaround for critical results

2018 01 Jun

Our clinical experiences of using the Accelerate Pheno™ system have greatly benefited patient care, providing earlier diagnostic certainty. Two complex sepsis cases are discussed, where the impact of rapid identification, with antibiotic sensitivities, of the causative organism from blood cultures is described. At Hampshire Hospitals NHS... Read more

ICU Management

Point-of care ultrasonography in critical care

2018 01 Jun

A brief overview of point-of-care ultrasound (POCUS) in the ICU: for the already converted, a reminder of how POCUS has changed ICU practice; for the ultrasound naïve, an aperitif to leave the reader with interest in this evolving paradigm shift of patient care. As intensivists, we have all faced this scenario: a 28-year-old woman, 35... Read more

ICU Management

Management of bleeding in visceral surgery and liver transplantation

2018 01 Jun

The implementation of patient blood management programmes led to reduced blood product usage. However, haemorrhage secondary to major surgery remains a major cause of potentially preventable death. Considering the heterogeneity of procedures and technical approaches, it is not surprising that the bleeding risk stratification for visceral surgery... Read more

ICU Management

Liver support in the intensive care unit: mechanism of action and science

2018 01 Jun

The idea of liver assist is extremely attractive for patients with liver failure, as the liver possesses huge capacity to regenerate. The hypothesis behind the use of extracorporeal liver assist is to enhance the regenerative environment by removing or replacing toxic molecules while the liver can regenerate. Extracorporeal liver assist devices are... Read more

ICU Management

Immediate-type hypersensitivity reactions in the ICU

2018 01 Jun

For the ICU patient, correct and timely diagnosis of drug hypersensitivity is required to administer emergency epinephrine treatment, and retrospective allergological investigation is needed to identify the culprit drug and safe alternatives. For ICU departments, epidemiological data regarding the incidence of drug-induced immediate-type hypersensitivity... Read more

ICU Management

Results of antimicrobial stewardship programme implementation in multidisciplinary hospital

2018 01 Jun

The interventional single-centre with historical control study was conducted in a 600-bed multidisciplinary hospital to evaluate 4 years’ results of an antimicrobial stewardship programme. We found a significant reduction in average duration of courses of antimicrobial therapy, length of stay of patients with infection in ICU, mortality in patients... Read more

ICU Management

The role of speech and language therapy in critical care

2018 01 Jun

The role of speech and language therapists (SLTs) in critical care can be unclear so this article sets out the scope of practice to increase awareness of the value of SLTs as part of the wider multidisciplinary team. Speech and language therapists (SLT) are trained to deliver specialist clinical services to adults with a broad range of disorders,... Read more

ICU Management

Making the case for social work practice in the care of critically ill ICU patients

2018 01 Jun

The role of the ICU social worker End-of-life issues occur frequently in the intensive care unit (ICU). The specific training and skills received by social workers provides them with the necessary tools to collaborate with the interdisciplinary team and provide holistic care to the patient and family. Research has shown that there is great variation... Read more

ICU Management

Emirates Critical Care conference: where east meets west

2018 01 Jun

Professor Hussain Al Rahma is Head of the Emergency and Critical Care Services Directorate at Al Zahra Hospital in Dubai, UAE. He is Chairman of the Emirates Critical Care Conference, President of the International Pan-Arab Critical Care Medicine Society and President of the Emirates Intensive Care Society. Dr. Al Rahma studied medicine at King... Read more

ICU Management

Distributing a life source in Africa

2018 01 Jun

Lifebank has developed crucial infrastructure in Nigeria, enabling the efficient transportation and storage of blood, saving thousands of lives. HealthManagement editor Marianna Keen spoke to CEO and founder Temie Giwa-Tubosun about her journey. To what degree has the blood shortage in Nigeria been tackled so far, due to the work of LifeBank?... Read more

ICU Management

Highlights from the I-I-I Blog

2018 01 Jun

(I expert, I question, I answer) Have you got something to say? Visit https://healthmanagement.org/c/icu/list/blog or contact [email protected] Rana Awdish Director of the Pulmonary Hypertension Program, Henry Ford Hospital; Medical Director of Care Experience, Henry Ford Health System; Faculty member, Wayne State... Read more

ICU Management

Upcoming events/ courses/ congresses

2018 01 Jun

JUNE 4-8 NeuroIntensive Care: Update 2018 Como, Italy https://iii.hm/jxj 8-11 41st Annual Conference on Shock Coronado, USA https://iii.hm/jxk 9-13 9th World Congress of the World Federation of Pediatric Intensive and Critical Care Societies Singapore https://iii.hm/jxl 10-12 The Future of Critical Care - Brainstorming... Read more

ICU Management

Lighter emergency breathing tubes associated with higher survival after OHCA

2018 01 Jun

When paramedics used a new, more flexible laryngeal breathing tube to give oxygen to patients who had had an out-of-hospital cardiac arrest, these patients survived longer than patients who received oxygen via the traditional endotracheal tube, according to the results of a large randomised controlled trial conducted in the USA.   The results... Read more

ICU Management

Bioengineering approach to artificial tracheas

2018 01 Jun

A new paper reports an approach to growing tracheas by coaxing cells to form three distinct tissue types after assembling them into a tube structure.   The research, led by Eben Alsberg, professor in Biomedical Engineering and Orthopaedic Surgery and director of the Alsberg Stem Cell & Engineered Novel Therapeutics (ASCENT) Lab at Case Western... Read more

ICU Management

Study: Aortic grafts are feasible to rebuild windpipe and airway

2018 01 Jun

A French study of patients with lung cancer or end-stage tracheal lesions has successfully used cryopreserved human aortic grafts to rebuild the windpipe and airway sections removed because of disease. The study is published in JAMA, to concide with its presentation at the American Thoracic Society 2018 conference.   The study, Airway and/or Pulmonary... Read more