We are going to try to produce regular sections on the best of FOAMed. Here's the first! Sit down with a coffee and enjoy....more to come! Great Papers Fits or frozen?! The Bottom Line Crew (Adrian Wong), debate the HYBERNATUS Study looking at whether we should cool status patients to improve outcome. Thanks again team see... Continue Reading →
Take a look at our Top Papers section to see some of the best evidence out there, as adjudged by us and also from deep perusal of Critical Care Reviews site. Thanks to them!! We will try to keep this as up to date as possible...missing papers you think should be included...let us know?!
Introduction This is a very common scenario on the ICU. Hypertension and what to do about it...if anything? There's a cohort of diversity in front of you: the post-operative patient who had their anti-hypertensives stopped prior to surgery, but now has a blood pressure of 165/95mmHg the elderly patient with a list of comorbidities and an incidental persistently... Continue Reading →
Glycaemic control in Critical Care In the ICU world we obsess and quite rightly, on physiology and correcting what is deranged. There is a vast abundance and ever accumulating bank of research out there focussing on the gold standard...morbidity and mortality and how we can reduce it. As a result we have looked at, to... Continue Reading →
NIGHTMARE SCENARIO - Airway Roulette! Does this scenario sound familiar....? You start your morning ward round and you have already heard on the grapevine that one of the patients is ready to extubate. The numbers say so, the nurses are badgering you to make that decision, and their sedation has been off since 07:00 ready for... Continue Reading →
via National survey and point prevalence study of sedation practice in UK critical care | Critical Care | Full Text Great article on a subject very close to all of our hearts. WHATS IT ALL ABOUT? This was a large survey, conducted from 2 points of view - a point prevalence spot check, as well... Continue Reading →
via Propofol Infusion Syndrome – ICM Case Summaries This is one to read!! I often wonder about this amongst our patients!! How many go awry, treated as MOF secondary to an unknown cause! Please have a read and thanks to ICM case summaries for this. This case highlights a number of points: Potential... Continue Reading →
We have added a section, which we will populate continuously, containing videos of all of the procedures you will ever need to know about for ICU practice. See the right-hand menu bar and click on the 'How-to Procedures' area. Lines to drains etc etc. Enjoy!
via Communicating with conscious and mechanically ventilated critically ill patients: a systematic review | Critical Care | Full Text Topical and in my eyes, an area massively neglected at times. Patients lie in front of us, 'wired for sound' as we massage the monitors and attempt to normalise their physiological parameters. Speaking from my point of... Continue Reading →
Click here to read more, courtesy of critical care. Basically We know that hypothermia leads to poor outcomes, perhaps not in cardiac arrest situations where neuroprotection is the key, granted and perhaps a few other exceptional circumstances. There is evidence that it leads to worse outcome in sepsis which is interesting. There have been many... Continue Reading →
This trial is worth a read. Courtesy of critical care (Click Icon) Basically They wanted to see whether sepsis-associated ARDS patients had better outcomes when given Hydrocortisone therapy. Methods They randomised patients to receive either hydrocortisone 50 mg every 6 h or placebo. What they demonstrated The patients who got hydrocortisone had significant improvement P:F ratios and... Continue Reading →
Click on the menu bar; we have added some brilliant medical calculators to help you all out at the bedside. Click on the image and you will be whisked straight into the Crit Care section. Work out you P/F ratios, A-a O2 gradients and much more. Link to download from the app store too! Enjoy...!! We... Continue Reading →
Shared from: RESEARCH What is the value of regional cerebral saturation in post-cardiac arrest patients? A prospective observational study The aim of this study was to elucidate the possible role of cerebral saturation monitoring in the post-cardiac arrest setting. This is well worth a read through... Critical Care 2016 20:327 Published on: 13 October 2016... Continue Reading →
So we all hang on this as a prognosticator, as well as a gauge of the state of our patients both on the unit and prior to coming up to us. But should we be focussing on Lactate as much as we think we should? Is it the 'magic bullet' to adequate resuscitation? A bit... Continue Reading →
Intro I am always asked by vigilant ITU trainees of all grades, 'should we give some albumin here; what do you think?'. In answer, my response is normally...no, it has no mortality benefit at all. But am I being harsh? Physiology for dummies! So albumin: Maintains the oncotic pressure (+ plasma volume) in blood vessels... Continue Reading →
It's the age old adage...do you or don't you, is the outcome better or worse?? Age, morbidity, mortality, recent surgery....does it save lives?? Are you better to admit them to ITU and watch with advanced monitoring and take the gamble... Thrombolysing someone with M.I used to be done at the drop of a hat. But... Continue Reading →
This is an excellent animation from the CEC and can be found within the right menu bar under LINKS WORTH CLICKING ON. Underlies the work Ron Daniels and his team are doing in the UK. Click here as well to see it..... More to come.....
A recent editorial discusses the thorny issue of fluid resuscitation. Notably, there is still no consensus about the major aspects of fluid resuscitation. It's the usual rigmarole we face....no clarity about when to start and stop fluids, how to guide them or even how much to give. The bulk of the research has been focused on comparing... Continue Reading →
One of the perennial issues in Critical Care is that of the ‘problem patient’ that doesn’t seem to want to wean off ventilatory support. I am sure you know the situation well. You treat a patient and support them through their critical illness to the point where they show all the signs that they are ready... Continue Reading →
Thanks so much to Adrian Wong (I think it was via him we got hold of this)..CCR16 Meeting Booklet FINAL
