October 2018 Journal Club

Hi Everyone Have a look at this month’s paper here https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fjournals.lww.com%2Fshockjournal%2Ffulltext%2F2013%2F12000%2FRadial_to_Femoral_Arterial_Blood_Pressure.13.aspx%23R11-13&data=02%7C01%7C%7C7229646d25464736f0f008d638eb2985%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636758979987318298&sdata=N5oE9oVKkCGZIMh8cG%2Ba0l2oEqCISF1q5ChccLYBfPc%3D&reserved=0 It’s food for thought….. Cheers Rob “Hi everyone Hope you all enjoyed the paper! I appreciate that this isn’t a very “academic” topic but it’s something that has always interested me, namely how reliable / robust are the numbers that we aspire to normalise? … More October 2018 Journal Club

QOTM – BP management in sepsis

This month’s questions: 1. In patients on escalating doses of vasopressors (and/or inotropes) should we routinely be inserting a femoral arterial line to correlate with radial arterial pressures, and if so and they differ which pressure do we target? Is anyone doing this already 2. Is there ever any benefit in using inotropes as part of the management of septic shock? Do they do more harm … More QOTM – BP management in sepsis

Next Sira debate

This is a bit of a bumper month but it seemed sensible to cohort these similar topics than split them over the next two months. This month’s questions: 1. In patients on escalating doses of vasopressors (and/or inotropes) should we routinely be inserting a femoral arterial line to correlate with radial arterial pressures, and if so and they differ which pressure … More Next Sira debate

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