Families on ICU

Dear all, This months’s questions have been inspired by  the ‘Mastering Intensive Care’ podcast series, they focus on aspects of the non-technical skills in providing care for patients and their families… (1) Should family or NOK be present for the daily ICU ward round? (2) Is it time to put an end to restricted visiting times on the ICU?   … More Families on ICU

Contrast Induced Nephropathy

This month’s question concerns patients with an acute kidney injury requiring a contrast CT scan. How do you judge the risk-benefit ratio? Are there any pre or post scan interventions that should be performed?This month’s paper is a start to the question above. A large meta-analysis of CIN. Does it even exist?http://www.annemergmed.com/article/S0196-0644(17)30881-8/fulltextBig numbers but all … More Contrast Induced Nephropathy

February 2018 Journal Club

Hi all > Have a look at this month’s paper (https://nam01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.nejm.org%2Fdoi%2Ffull%2F10.1056%2FNEJMoa1705835&data=02%7C01%7C%7C756911e9384a4f9803d708d5721dda41%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636540394902093537&sdata=3xTFesIwISny6%2FjtduQCC7FeU6SitxTs5piaaTpuZ1c%3D&reserved=0) > It follows on from the discussion at last weeks audit meeting…. > Cheers > Rob “Hi all I have to be honest I do love a good paper on steroids…… In all honesty I suspect this paper (which is a testament to the … More February 2018 Journal Club

Fluid resus in sepsis

This month’s question concerns fluid administration in patients with septic shock. Are the surviving sepsis guidelines suggestion of an initial “rapid bolus of 30ml/kg crystalloid” in those patients with hypotension and lactate>4mmol/L  more harmful than useful? A  – I always think the proposal to limit fluid resus is pragmatically difficult, but it may well be a … More Fluid resus in sepsis