Editorial
Editorial
Much has been written about the human reality of error. The aptly named "To Err is Human" report acknowledged the fact that mistakes in the medical environment are all too common and while many safety precautions have been implemented since its' publication more than ten years ago, medical error is still a topic of significant interest and discussion in the world of emergency and critical care. However,...
News - Science
Swine Flu: Influenza A (H1N1) Susceptibility Linked to Common Levels of Arsenic Exposure
The ability to mount an immune response to influenza A (H1N1) infection is significantly compromised by a low level of arsenic exposure that commonly occurs through drinking contaminated well water, scientists at the Marine Biological Laboratory (MBL) and Dartmouth Medical School have found. Their findings are reported in the journal Environmental Health Perspectives. "When a normal person or mouse is i...
Exhibitors @ RSNA 2010
Covidien's New Alarm Management System (AMS) for the Nellcor "OxiMax"
N-600x™ pulse oximeter identifies and alerts staff to ongoing developments, such as periods of desaturation and potentially worrisome patterns. AMS includes the OxiMax SPD™ alert, which detects desaturation patterns indicative of repetitive reductions in airflow, even if the patient hasn't crossed the SpO2 threshold. AMS also includes SatSeconds™ alarm management, which provides a safe and practical...
Zeus Infinity Empowered Drager's Most Advanced Anaesthesia Workstation
The new Zeus Infinity Empowered (IE) provides seamless integration of ventilation, volatile and intravenous anaesthesia, patient monitoring and information management in a single, elegant solution. ICU-quality ventilation, Target controlled anaesthesia and an intuitive and simple user interface design philosophy are just some of the innovative features of the Zeus IE. The Zeus IE with its unsurpassed...
Cover Story
Medication Errors in the Intensive Care Unit
Introduction It is estimated that 1.5 million preventable adverse drug events occur annually in the United States (Institutes of Medicine 2006) and have led to 177 billion dollars in estimated costs (Ernst and Grizzle 2001). The intensive care unit (ICU) and emergency department (ED) are particularly complicated considering the level of patient acuity and frenetic work environment. As a result, it is diff...
Disclosure of Adverse Events in Healthcare
The disclosure of medical harm is now the standard of care. The ICU environment challenges clinicians to recognise and disclose adverse events affecting critically ill patients. This article reviews the literature on adverse events and offers suggestions for disclosing medical harm. Introduction It is now well established that patients commonly suffer injuries on account of medical treatment. Studies don...
Series
The Polycompartment Syndrome
Introduction A Compartment Syndrome (CS) exists when the increased pressure in a closed anatomic space threatens the viability of surrounding tissue. Within the body there are 4 compartments, the head, the chest, the abdomen and the extremities. Within each compartment; an individual organ or a region with multiple organs can develop a CS. A CS is not a disease, as such it can have many causes and it can d...
Hypothermia Series
From Ambulance to ICU
The continuum of care is best divided into five distinct areas in order to identify all of the key roles. These areas include: prehospital care, emergency department care, specialty care (i.e. cardiac catheterisation lab, critical care transport teams), general inpatient care areas, and intensive care. We have also identified eleven possible points for patients to enter the hospital protocol (Figure 1). Pr...
Matrix
Variation in ICU Resources Across Countries
Intensive care resources vary greatly across countries and impact delivery of care. Better understanding of these differences is needed to improve quality of care while minimising costs. The delivery of healthcare occurs at the local level, yet the economics of healthcare and the resources for a given society are often shaped at a national level. While variation in healthcare resources and spending exis...
Management
Interview with Jeffrey Lipman
Jeffrey Lipman is Director of the Department of Intensive Care Medicine, Royal Brisbane and Womens' Hospital, Professor and Head of Anaesthesiology and Critical Care, University of Queensland. Sherry Scharff asked this ICU Management Editorial Board Member to share his thoughts on management challenges, the effects of economic downturn in his part of the world and the future of intensive care medicine. Can...
Interview
US Healthcare Overview
Organisation of the Health System The United States' health system is actually a cluster of health systems of diverse complexity. Federal, state, and local governments have defined, often in concert with one another, their roles in protecting the public's health. State public health departments are not under the jurisdiction of federal health agencies and administrations, and, in many states, city and cou...
Is the US Ready for Obama
It has been described as the beginning of a new era in the US; one of change with a push towards equality and balance among citizens. Critics of the new President and his proposed platform have even gone so far as to call it a "socialist agenda" (Daily Herald – Utah; November 1, 2008). Given this pretence, are we to expect the birth of universal healthcare on American soil within the new administration's...
Medical Errors: A Nurses Role
Nurses have a genuine impact on patient safety. Studies have found a link between patient safety and RN staffing and an increase rate of error when the hospital nursing staff with a smaller proportion of RNs (Ramsey 2005). Other studies have shown that increasing the nurse to patient ratio by 1 can significantly impact the 30-day mortality in surgical patients (Aiken et al. 2002). Errors have also been lin...
ISICEM Review
29th International Symposium on Intensive Care and Emergency Medicine (ISICEM)
ISICEM 2009 welcomed more than 5000 participants from over 78 countries around the world to a buffet of controversial topics and debate. Here is just a taste of some of the topics covered at this years groundbreaking meeting: Tight Glucose Control: Yes or No? The debate about tight glucose control continues. Hyperglycaemia is associated with increased mortality but does achieving normoglycemia influence o...
ESICM Preview
The 22nd Annual Congress of the European Society of Intensive Care Medicine
As one of the biggest and most successful annual critical care meetings in the world, this ESICM will surely once again not disappoint its' participants. Held over three days, the congress will feature ten parallel sessions with over 800 lectures, presentations, debates, round table discussions, tutorials and interactive educational sessions. A faculty of more than 220 internationally recognised experts fr...
3rd International Hypothermia Symposium Preview
Therapeutic Hypothermia to Protect the Brain and the Heart
The clinical use of therapeutic hypothermia and temperature management to prevent or reduce neurological injury is gaining interest and is increasingly used throughout the world. In the experimental setting, the protective effect of hypothermia after tissue injury seems to be applicable to many different tissues. In the clinical setting, however, it has been difficult to prove a beneficial effect of therap...