September 2018 Journal Club

Hi Everyone Welcome to September’s Journal club, this month we’re going to be looking at that old chestnut Albumin….. Have a read of the paper here https://www.nejm.org/doi/full/10.1056/NEJMoa1305727 Cheers Rob “Hi All Interesting that the post hoc analysis of patients with septic shock at time of enrolment, did find a statistically significant difference in 90 day … More September 2018 Journal Club

Secretion management & PARAMEDIC2

This month’s questions: Excessive respiratory secretions are a common reason for prolonged ventilator weaning and failed extubation. (1) What treatments or interventions are most effective in controlling/reducing excessive respiratory secretions? (2) When it is safe to consider extubation / decannulation in a patient with excessive respiratory secretions i.e. are there any useful measurements / scoring … More Secretion management & PARAMEDIC2

Next Sira Debate

Before we discuss this month’s questions and papers I would ask everyone to consider what components of critical care create an outstanding ICU? The context is that Portsmouth ICU http://www.portsmouthicu.com/ (Queen Alexandra Hospital) has recently been awarded Outstanding in all CQC domains, which I believe is unprecedented. One of the cornerstones of this model is the impressive standardisation through SOPs and guidelines of … More Next Sira Debate

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