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Sapna Kudchadkar is an Associate Professor of Anesthesiology and Critical Care Medicine, Pediatrics and Physical Medicine and Rehabilitation at the Johns Hopkins University School of Medicine. Prof. Kudchadkar's areas of interest include sleep disturbances in critically ill children, paediatric delirium prevention and management, sedation, and... Read more

Bernd Saugel, MD, EDIC is a Professor of Anesthesiology and works as a consultant in the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Prof. Saugel is a specialist in anaesthesiology, intensive care medicine, and internal medicine and holds a European... Read more

The acute kidney injury service at Lancashire Teaching Hospitals NHS Foundation Trust was launched in October 2015. Key stakeholders were identified and included in the service development from the beginning and throughout which supported the smooth introduction of the service into the hospitals. This included the renal directorate clinical director,... Read more

Introduction Up to 85% of critical care patients may experience some form of delirium, but it can be very easily missed (Inouye et al. 2001; Page 2008) particularly in a very busy 24 bedded General Critical Care Unit that is also the regional centre for Trauma and neurosurgery. The unit admits both level 2 and 3 patients within the same clinical... Read more

Challenges and advantages of engaging a clinical  staffing and management service for your ICU Trusting a third-party partner to staff and manage your ICU isn’t a decision to be made lightly. Your hospital’s reputation is at stake. Even more important, so are your patients’ health and safety. Finding the right partner to help you deliver... Read more

Design for Southmead ICU  It is well established that the Arts have a clear contribution to make in the delivery of an improved healthcare experience for patients, service users and staff. ‘Arts and health are, and should be firmly recognised as being, integral to health, healthcare provision and healthcare environments, including supporting staff.'... Read more

Vital minutes before unconsciousness The myth that anaesthetists pick the specialty ‘because you don’t need to talk to your patients’ persists. Whether said in jest or disdain this concept gains ground because, yes for much of the time, our patients are mostly ‘asleep’. But this ignores the vital communication that occurs prior to anaesthesia;... Read more

The parameters of the Capstesia app are described. After taking a photo of the arterial waveform on the monitor screen, and cropping it to the signal of interest, the picture is sent to the Capstesia server via a mobile Internet connection. The heart rate and systolic and diastolic arterial pressures are manually entered into the app to determine... Read more

Insights from the PARAMEDIC2 trial and future improvements Perkins et al. have advanced the long-awaited PARAMEDIC2 trial (Perkins et al. 2018). They deserve to be congratulated for such a well-interpreted and well-designed contribution. The study’s two main outcomes are as follows: the Epinephrine group had a significantly improved inpatient survival... Read more

Human factors are a well recognised cause of discrepancies in patient care that can lead to adverse outcomes. In a busy Emergency Department (ED) setting, when dealing with the sickest patients at all hours and with a rotating workforce, there is an increased potential for inconsistent care despite clear evidence based protocols and guidelines on... Read more


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