Critical Care General
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Antibacterial Therapy in the Critically Ill
Appropriate antibiotic therapy in the critically ill requires consideration of important patient-specific factors, such as antibiotic therapy in the preceding 30 days; culture and sensitivity data, if available, within the prior six months; and local resistance patterns.
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Family Members of Critically Ill Patients with SARS-CoV-2 Pneumonia Have a High Burden of Symptoms of PTSD
This multicenter cohort study found a high incidence of post-traumatic stress disorder symptoms among family members of COVID-19 patients at three months after the index intensive care unit admission.
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Family Members of Critically Ill Patients with SARS-CoV-2 Pneumonia Have a High Burden of Symptoms of PTSD
This multicenter cohort study revealed a high incidence of PTSD symptoms among family members of COVID-19 patients at three months after the ICU admission.
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Limitation of Tidal Volume Is Cardioprotective Among Mechanically Ventilated Patients Undergoing Cardiac Surgery
In this experimental study, rising tidal volume increased right ventricular afterload.
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Appropriate Oxygenation Targets in the Treatment of Hypoxemic Respiratory Failure
The care of critically ill patients in the ICU remains challenging. Recent studies support current protocols for the delivery of oxygen to patients who require supplemental oxygen due to respiratory failure of varying etiologies. Broad oxygenation targets of SpO2 between 88% to 97% continue to be supported by recent trials.
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New Requirements Are Discouraging Physicians from Writing DNR Orders
Ethicists should help develop related protocols. For practitioners, code status conversations should be treated with the seriousness of surgery. That means involving the right people and taking the time to ensure medical understanding and prognosis, as well as patient values and goals, before talking about a care plan. When possible, practitioners should bring up DNR at the end of a meaningful conversation.
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Court-Appointed Guardians for Unrepresented Patients
Ethicists are seeing a range of issues arise during consults involving unrepresented patients, including conflicts over how aggressive treatment should be, whether to treat at all, how to discharge, and how to follow up with compliance with treatment. Creating a template for actions to take related to unrepresented persons who present to the hospital is a proactive first step.
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Updated Recommendations on Pediatric End-of-Life Care
A report includes a review of essential elements of care for patients and families. The authors covered discussions on goals of care, how to establish end-of-life care goals, advance care planning, and palliative and hospice involvement.
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Healthcare Leaders Identify Steps to Maximize Response to Mass Shooting Events
As mass shooting events continue, healthcare leaders are focused on how the medical response is effective and expeditious. Frontline providers who have experienced such events have first-hand knowledge about where the weak links are and can offer unique insight on how organizations can work within their regions to be better prepared.
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Medical, Law Enforcement Teams Share Expertise, Support During Dangerous Situations
One way to accelerate care to victims of mass casualty events is to direct physicians who are accustomed to working with law enforcement to respond to the scene so they can provide high-level care to victims immediately. That is part of the emerging specialty called tactical medicine.