Editorial

Providing seamless emergency care is the ideal for those of us who work in emergency medicine and intensive care. In the past, intensive care units were a closed part of the hospital, and admission was strictly controlled. This idea is obsolete now. It is heartening that we are providing more integrated care between emergency and intensive care. Intensivists need to go out of the ICU and take action...

News

When patients present with organ failure to French teaching hospitals, the receiving hospitals have very varied staffing and organisation, according to a survey by the French Society of Anaesthesia & Intensive Care - Sociéte française d’anesthésie et de réanimation (SFAR). The results have been published in the Society’s journal, Anaesthesia Critical Care & Pain Medicine.  When patients present

Cover Story

Defining the Role of the Intensive Care UnitThis review article aims to alter the preconceived mindset that surrounds the intensive care unit (ICU) and the patient with an acute ischaemic stroke (AIS). A contemporary body of evidence is emerging that shows that specific interventions can improve outcomes, and this article highlights key evidence-based strategies in AIS management. More importantly,...

Targeted temperature management is the key intervention for improving neurological outcomes after cardiac arrest. We discuss new data on the optimal timing and modalities of targeted temperature management.  It took nearly half a century, from 1957 to 2002, for therapeutic hypothermia to acquire its current status as a key intervention for improving neurological outcomes in survivors of cardiac ar...

The interdisciplinary nature of burn care has driven centre regionalisation. The role of burn centres in the national trauma system cannot be overstated. Burn centres, essential components of any trauma system, serve a broad base of patients, including potentially those injured in mass casualty events. Over the past fifty years, the field of burn care has made dramatic improvements in patient outcomes...

Switzerland is a country of 8.2 million inhabitants, who mostly live outside one of the six major cities: Zurich (384,786 inhabitants), Geneva (191,557), Basel (174,491), Lausanne (132,626), Berne (128,848) and Winterthur (105,676) (Bundesamt für Statistik 2015). Switzerland is composed of 26 cantons that enjoy a great deal of independence from the federation. The jurisdiction of the emergency service...

What to Expect in Civilian vs. Military ContextsCivilian blast injuries are not rare, but most are not due to military explosives, meaning extrapolation from military texts is often inappropriate. In civilian mass casualty events, emergency departments will see large patient numbers, but few require surgery or intensive care. Survivors of small civilian blasts rarely have blast wave injury and should...

This article focuses on the type of fluid available and respective indications in the course of trauma resuscitation according to the situation: haemorrhagic shock, trauma brain injury.In trauma patients, fluid resuscitation aims at preventing a cardiac arrest due to severe hypovolaemia and at achieving a satisfying level of mean arterial pressure to ensure adequate tissue perfusion. Fluid resuscitation...

Point-of-View

Kristoffer Strålin, MD, PhD, is Associate Professor and Senior Consultant at the Department of Infectious Diseases, Karolinska Institute, Stockholm, Sweden. Karolinska Institute is a world renowned medical university, which has the mission of improving people’s health through research and education. Together with Karolinska University Hospital, it is a leader in healthcare developments and medical...

Series

The ICU ResponseInfection with the Middle East respiratory syndrome coronavirus (MERS-CoV), a recently identified virus, has led to several hundred cases of severe acute respiratory illness requiring admission to the ICU (Saad et al. 2014; Arabi et al. 2014). As of 4 December 2015, the World Health Organization (WHO) reported 1,621 laboratory-confirmed cases, including at least 584 related deaths (WHO...

Matrix

Delirium (acute brain dysfunction) can be a complication of critical illness.Brain organ dysfunction can manifest as a continuum of psychomotor behaviors that are categorised as hyperactive or hypoactive.Delirium can be diagnosed using validated and reliable bedside tools.Implementation of delirium monitoring can be enhanced by scheduled in-depth discussions about brain organ dysfunction via mult...

Without Primary Acute Brain Injury This review focuses on the current experience with clinically available neuromonitoring techniques in critically ill patients at risk for neurological compromise, but without overt acute brain injury (ABI).The field of neuromonitoring has grown rapidly over the past 30 years, which has helped improve pathophysiological understanding, clinical care and outcomes for...

Management

Interview with Professor Daren HeylandThe Canadian Researchers at the End of Life Network (CARENET), directed by Professor Daren Heyland, brings together health professionals from across Canada. The network aims to understand and improve palliative and end-of-life (EOL) care through improving communication and decision making between patients, their families and health professionals. They have several...

A Quality Improvement InitiativeThe Canadian Institutes of Health Research (CIHR) defines knowledge translation (KT) as:“a dynamicand iterative process that includes the synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the healthcare system” (CIHR 2015)Approximately...

Interview

Michael Pinsky is Professor of Critical Care Medicine at the University of Pittsburgh, with secondary appointments in Cardiovascular Diseases, Clinical & Translational Science, Anesthesiology and Bioengineering. He is presently a Visiting Professor, Department of Anesthesiology, University of California, San Diego, USA.  Why is it important to take an applied physiologic approach to understanding...

Country Focus: Egypt

The healthcare system in Egypt has come a long way, but still faces many challenges when it comes to improving the health and wellbeing of its people. Egypt has a high rate of population growth, and it is estimated that the population will reach 92 million by 2020.In order to improve the standards of critical care and to ensure physicians have a greater understanding and knowledge of critical care...

Agenda

DECEMBER2-4German Interdisciplinary Meeting on Intensive Care and Emergency Medicine (DVI)  Leipzig, Germany  divi2015.de/startseite 7-9Intensive Care Society: State of the Art Meeting 2015  London, UK  ics.ac.ukJANUARY 201610-156th Annual Winter Symposium in Intensive Care, Anaesthesia & Emergency Medicine  Vail, Colorado, United States  colloquium.com.au



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