At present, medical knowledge is experiencing an exponential growth. This results in serious difficulties to healthcare professionals in keeping up to date. At the same time, medical education is mostly taught using traditional learning methodologies, not always the most efficient. Recently however, there has been a significant increase in the use of computer games for both teaching and trainin...

reason that there is a dearth in the British literature of reports of their use in peritonitis. The purpose of this paper is to draw attention to the benefits and dangers of steroid therapy in peritonitis. A plea is made that hydrocortisone should be given as a short course early in the management of critically ill patients with peritonitis. In this text critically ill is used in the sense "lik...

BACKGROUND The optimal approach to managing hyperglycemia in noncritically ill hospital patients is unclear. OBJECTIVE To investigate the effects of targeted quality improvement interventions on insulin prescribing and glycemic control. DESIGN A cohort study comparing an intervention group (IG) to a concurrent control group (CCG) and an historic control group (HCG). SETTING University of ...

Delirium occurs frequently in critically ill patients and has been associated with both short-term and long-term consequences. Efforts to decrease delirium prevalence have been directed at identifying and modifying its risk factors. One potentially modifiable risk factor is sleep deprivation. Critically ill patients are known to experience poor sleep quality with severe sleep fragmentation and ...

INTRODUCTION This study was conducted to provide Intensive Care Units and Emergency Departments with a set of practical procedures (check-lists) for managing critically-ill adult patients in order to avoid complications during intra-hospital transport (IHT). METHODS Digital research was carried out via the MEDLINE, EMBASE, CINAHL and HEALTHSTAR databases using the following key words: transfe...

In Brief Hyperglycemia in the hospital setting affects 38-46% of noncritically ill hospitalized patients. Evidence from observational studies indicates that inpatient hyperglycemia, in patients with and without diabetes, is associated with increased risks of complications and mortality. Substantial evidence indicates that correction of hyperglycemia through insulin administration reduces hospit...

Critically ill people are unable to eat. What's the best way to feed them? Nutrition authorities have long recommended providing generous amounts of protein and calories to critically ill patients, either intravenously or through feeding tubes, in order to counteract the catabolic state associated with this condition. In practice, however, patients in modern intensive care units are substantial...

ICU patients are identified as targets for quality of care and patient safety improvement strategies. Critically ill patients are at high risk for complications due to the complex and invasive nature of critical care. Several reports in the literature describe initiatives aiming to zero the healthcare-associated infection rate. We discuss the results of a study assessing a systematic team appro...

OBJECTIVES Controversy exists about the value of greater nutritional intake in critically ill patients, possibly due to varied patient nutritional risk. The objective of this study was to investigate whether clinical outcomes vary by protein or energy intake in patients with risk evaluated by the NUTrition Risk in the Critically Ill score. DESIGN Prospective observational cohort. SETTING A ...