All Articles
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Optimising sleep in the ICU
Disordered sleep is common in ICU patients. While many of the reasons for this are impossible to modify, and others rely on improvement in the underlying condition, many directly depend on the actions of the treating team: for example, exposure to noise, timing of therapeutic procedures, tapering of sedating drug doses, and daytime mobilisation....
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What should we stop doing in the ICU?
In this article, I highlight that the most important thing intensive care physicians should stop doing is ignoring that they are prone to several cognitive biases. I will first support my statement by looking for conceptual caveats and cognitive bias in routine intensive care unit (ICU) care, and then move to specific patient and structural problems....
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Caring for very old patients in the ICU
Describes the epidemiology and outcomes for very old patients as known in 2018, along with a short introduction to the most relevant “geriatric syndromes” important also for intensivists, and discusses where we should increase our body of knowledge to make a more precise triage in this patient group. The very old ICU patient is a term often...
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Humanizing the ICU experience with enhanced communication
Avicenne ICU’s initiative. Decisions to limit therapy (DTLT) are routine for ICU physicians. Although breaking bad news is one of the most difficult tasks clinicians face, ongoing communication is even more crucial as families (not necessary following a legal or genetic definition) of critically ill patients have heightened communication...
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Implementing ECCO2R and vv-ECMO in non-academic centres
Shares experiences of implementing extracorporeal life support in a non-academic hospital. Acute respiratory distress syndrome (ARDS) is a life-threatening disorder characterised by severe impairment of gas exchange. The most common causes are pneumonia, sepsis and acute pancreatitis. It is accurately defined in the Berlin definitions...
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Highlights from the I-I-I Blog
(I expert, I question, I answer) Have you got something to say? Visit https://healthmanagement.org/c/icu/list/blog or contact [email protected] Jean Baptiste Lascarrou Medical Intensive Care Unit, Nantes University Hospital, France @jblascarrou Epinephrine for out-of-hospital cardiac arrest “Epinephrine...
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Key decisions in a goal-directed coagulation management approach
An individualised goal-directed approach to managing coagulopathy is recommended to treat bleeding trauma patients. Severe trauma is a great burden to society, with millions of victims worldwide. If trauma patients are hazardly bleeding, surgical bleeding requires the surgeon to fix the problem, while coagulopathy requires management...
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Evidence for using first-line coagulation factor concentrates for trauma- induced coagulopathy
Fibrinogen limits coagulopathy and massive bleeding, has less transfusion requirements and thereby decreases the risk of multi-organ failure in trauma patients. What stops the bleeding? Haemostatic therapy aims to stop the bleeding, but is it a concentration of coagulation factors, mainly assessed by international normalised ratio (INR)...
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Implementation of a revised trauma management protocol
Goal-directed therapy of coagulopathy is recommended for trauma patients. Can guidelines direct our strategy? When presented with bleeding trauma patients, our management strategy may be directed by guidelines, e.g. the European trauma guideline (Rossaint et al. 2016). This recommends treatment with fibrinogen concentrate or cryoprecipitate...
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Captivate staff with animation
Explainer videos as a communication tool. Whether you want to teach staff, motivate them, alter their perceptions, or simply share an idea, animated video is an engaging and memorable approach. The introduction and evolution of innovative ways to represent concepts and topics via animated video have vitalised the learning environment,...
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