Latest Blog Posts in ICU

Should “empiric” antibiotic therapy be considered old-fashioned?

The Surviving Sepsis Campaign recommends starting empiric broad-spectrum antibiotics in the initial management of patients with severe sepsis and septic shock (Rhodes et al. 2017). As a consequence, many patients receive unnecessary antibiotics, exposing them to adverse events, while others might be undertreated in spite of broad-spectrum therapy...
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iResuscitate App

Cardiac arrest is one of the major causes of death worldwide. It occurs either in hospital and out of hospital situations with a common variable in the decision making process: time. Each year, according to the AHA (American Heart Association) statistical report , more than 350,000 out-of-hospital cardiac arrests per year occur in the United States...
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Airway triage app

Airway management is of key importance to all critical care providers and their patients. Unanticipated difficulties during airway management can lead to severe complications or death. However, prediction of difficulties with upper airway access is challenging. Until now the accuracy to predict a “difficult airway” with the current methods or classification...
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Trash to treasure: memories from the ICU

A striking mural that hangs at Toronto General Hospital of the University Health Network has an interesting story behind it, which Tilda Shalof explains. The more than 10,000 tabs, lids, pins, stoppers, pipettes, syringes, levers, screws and connectors that make up this mural all were used to deliver patient care. After their one-off purpose, these...
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When a patient dies, take a pause

A young woman is brought to the emergency room after being hit by a sports utility vehicle. After 45 minutes of resuscitation, she is pronounced dead. Jonathan Bartels, RN, recalled the case and the vacancy he felt afterwards . It prompted him to develop "The Pause"—taking a few moments after the patient has died, to acknowledge their passing and the...
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A glimpse into the life of an ICU nurse - 1 - Mr. Stevens

We received a MET call (Medical Emergency Team) from the general ward to immediately come and assist. The patient's name was Mr. 'Stevens'. He was 81 and was in our hospital due to severe exacerbations of chronic obstructive pulmonary disease (COPD). He was in acute respiratory distress and had low blood pressure. There was no time to discuss whether...
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Changing the culture of medicine - one conversation at a time

Lessons from a doctor turned patient What prompted you to write your memoir In Shock? I realised that as a physician in my own institution I was, at least in theory, an empowered minority. I was someone who had a voice, some measure of authority and personal agency. Yet, as a patient, I didn’t feel at all empowered to be vocal about my needs or...
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Time goes by and antibiotics linger on

As I usually do when I'm writing, first I'll throw a random fact--not so random--with a slight relation with our subject. The thing is, I lack good metaphors. Some time ago I stumbled on a fantastic article by Holloway discussing a new approach to treating multi-drug-resistant tuberculosis . The climax is: in Switzerland, England and New York, tuberculosis-related...
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How can we improve gender parity in critical care medicine?

I think what is important is to have the leaders proactively thinking about the gender issue. Examples? Faculty members need to be inclusive and to mentor young women and to include them in their plans, creating the conditions to allow their participation in committees and boards preparing the next generation of leaders. Journals need to include women...
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Recruiting centres for ICP monitoring study (SynapseICU)

SYNAPSE-ICU An international prospective observational StudY on iNtrAcranial PreSsurE in intensive care (ICU) , endorsed by the European Society of Intensive Care Medicine (ESICM), is now enrolling participant centres. What is Synapse-ICU? Intracranial pressure (ICP) monitoring is the most common neuromonitoring modality used in neurocritical...
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