ICU Management & Practice, Volume 19 - Issue 1, 2019

Highlights from the I-I-I Blog

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Stacey Brown

Critical Care Nurse, Canada 


From code cart to comfort cart in the ICU

“When the time has come where having the code cart with the epinephrine and defibrillator is no longer appropriate we trade it out for our end-of-life comfort cart. With donations from families and money from fundraisers we purchased a portable kitchen island. This was important for us as we didn’t want the institutional look of the code carts found throughout our unit. We wanted the presence of the cart to bring peace and not anxiety.

“When a patient gets admitted into our ICU it is always with the intent to return that patient to a meaningful quality of life. When our goals shift from cure to comfort we strive to do it with compassion, grace and respect.” 


Fernando Martinez-Sagasti

Head of the Medical-Surgical ICU

Hospital Clinico San Carlos, Madrid, Spain


Miguel Sanchez Garcia 

Head of Department of Intensive Care

Hospital Clinico San Carlos 

Should "empiric" antibiotic therapy be considered old-fashioned?

"Over the last decade, automated diagnostic tests have been developed, which amplify resistance genes. Some of these assays require bacterial growth in blood culture bottles to allow amplification of resistance genes, a process which may take 8 hours. Other tests may even be used as a point-of-care tool, allowing the physician to test respiratory tract exudates, wound swabs or other type of samples at the bedside for potentially resistant microorganisms (PRM). Because they provide results in approximately one hour, they convert “empiric” therapy to “directed” antibiotic treatment. The purpose of this post is to discuss the need to implement this new approach to choose the most adequate antibiotic treatment from scratch.”

Daniela Lamas


Pulmonary and Critical Care Physician - Brigham & Women’s Hospital 



Stories from critical care: You can stop humming now

“I hope that my readers remember Nancy Andrews, a Maine art professor who spent weeks in the intensive care unit at a Boston hospital, after a near-fatal tear in the wall of her aorta. She made it out of the ICU and though her body healed, she found herself haunted by flashbacks to horrific events that had never actually occurred. The sound of a helicopter terrified her. Nancy was ultimately diagnosed with post-traumatic stress, as a result of her critical illness. Intensive care has inadvertently created a new population of the walking wounded, and post-traumatic stress might affect up to one-in-three of those who require intubation. But Nancy Andrews thought she was alone. As critical care clinicians, we must do more to educate our patients about these possible outcomes, and to build systems that offer the screening and follow-up care they need.”

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I-I-I Blog, comfort cart, Highlights from the I-I-I Blog, Code Cart, Comfort Card, Empiric Antibiotic Therapy, Humming, Post Traumatic Stress Visit or contact [email protected] Stacey Brown Critical Care Nurse, Canada @simplicity4jc Fro...

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