POCUS & FICE governance/peripheral norad

This month’s questions concern POCUS and FICE: Are we recording, quality assuring and governing these procedures correctly or have we just enthusiastically jumped on a bandwagon?  Is there a danger that they are becoming a distraction rather than useful, especially in Resus? This month’s papers, in defence of FICE perhaps https://link.springer.com/epdf/10.1007/s00134-018-5208-7?shared_access_token=PmFuInFdL7kjpNxWj_GZFve4RwlQNchNByi7wbcMAY7KUPqVtt1skPcEa4hxeQEdtapZoBBgZ1lUJ_GKutVMJkByLXSg1tY_8r79JjwoJFkNHDaj2Hk8Iym_rdzUJdEMxgpHvRLwkI54Nepg8DXXCguGHX1BegSpYdKDw36MFPg%3D This months second paper  https://www.journalofhospitalmedicine.com/jhospmed/article/127869/peripheral-administration-vm; … More POCUS & FICE governance/peripheral norad

APRV

This month’s question concerns Airway Pressure Release Ventilation APRV. What conditions or clinical scenarios may benefit from this method of ventilation? And what exactly is the evidence and the harm? This month’s paper is a simple, easy to read,  guest editorial by Anders Perner highlighting what we do and don’t know about the management of hypovolaemia in sepsis https://link.springer.com/epdf/10.1007/s00134-018-5177-x?shared_access_token=VlBksSddmDwoaaBF0p4vufe4RwlQNchNByi7wbcMAY4Hx0KQVBSGHqufEt_80zT0RBpKxtStn3PO379qXydC5lFu54mLvzupEjBvMKoErD7B85LzKhRzxsiMMdag-PFRFCYRuBxbnAHggeUt0yIZ2f9aaAKsiuLcJPshRmsW9F4%3D … More APRV

May 2018 Journal Club

Hi Everyone For this month’s journal club we are going to have a renal theme (Don’t all cheer at once) Have a look at these 2 papers asking the same question;   https://jamanetwork.com/journals/jama/fullarticle/2522434   https://www.nejm.org/doi/full/10.1056/NEJMoa1603017   Prizes will be awarded for those who can spot the difference…… Cheers Rob “Hi Everyone! Sorry about the delay in … More May 2018 Journal Club

April 2018 Journal Club

Hi everyone Have a look at April’s paper (https://www.ncbi.nlm.nih.gov/pubmed/29261565)  something to think about when you are setting your ventilator targets on ICU…. Cheers Rob “Thanks Rob….I love papers about ‘over treating’ patients.   This is a good retrospective analysis and as the authors acknowledge it only proves an association between excessive oxygen therapy and mortality. This … More April 2018 Journal Club

Extubation

This month’s question concerns extubation of the critical care patient. What strategies (if any) do people put in place to try and minimise extubation failure? What do people feel is an acceptable failure rate for extubation attempts on ICU? This month’s paper is a nice FOAM summary of the issues  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760915/​ A – Many thanks for this question, Rather … More Extubation