Category: Intensive Care

A Medicolegal Perspective on the Impact of the Mental Capacity Act on Critical Care Practice  The Mental Capacity Act (MCA) 2005 came into force across England and Wales in April 2007. The aim of the Act is to set out in law the procedures to be followed to establish whether an individual has mantal capacity. […]

As with any procedure, there is a risk of complications following upper GI surgery. Many factors influence the occurrence of these, including increased age, male gender, comorbidities, very high body mass index and the experience of the treating team. Dr Martin Stotz discusses the challenges and potential complications associated with upper gastrointestinal surgery.

An advance directive, or living will, is a statement of instructions regarding future treatment options, including the right to refuse treatment, in the case of incapacitating illness which renders the patient unable to make decisions.

Clinically assisted nutrition and hydration (CANH) refers to all forms of artificial nutritional support, and includes intravenous parenteral nutrition and intravenous hydration, nasogastric tube feeding and the interventional placement of dedicated feeding devices.

Catheters are used almost universally in the intensive care unit and are an essential tool in the care of critically ill patients. They allow the intravenous administration of both medication and fluid resuscitation, along with monitoring of haemodynamic parameters. However, they can also give rise to bloodstream infections, which can result in significant morbidity and mortality

Over half of all patients admitted to an intensive care unit (ICU) will develop delirium at some point during hospitalisation, and in patients who are mechanically ventilated, this proportion rises to around 75%.

While complications of airway management are surprisingly common, most are minor in nature. Major complications are rare, and although they have the potential to be life-threatening, they tend to result in morbidity rather than mortality

Airway management techniques were first developed in the field of anaesthesia, and advanced airway management is still an extremely important factor in the care of the critically ill patient. For this reason, intensive care medicine is still closely allied to anaesthesia in many countries. However, the intensive care unit (ICU) environment is not specifically designed […]

The majority of people express a wish to spend their last days at home but, in reality, over half will die in hospital (1), and many of these deaths will take place in the intensive care unit (ICU) (2-4). There are many elements to consider when providing end-of-life (EOL) care, but the overarching principle must always be […]

Patients treated in an intensive care unit (ICU) often have complicated and life-threatening conditions, which may require treatments that are often invasive and sometimes potentially dangerous. Not surprisingly, adverse events are frequent and may lead to a claim for medical negligence. As well as an increase in mortality, patients may be left with long-standing health […]

A hospital-acquired infection (HAI) is any infection that originates from a stay in a medical facility. HAIs occur frequently and represent the most common adverse event among hospitalised patients. The highest incidence is seen in the Intensive Care Unit (ICU): nearly 10% of patients who spend two or more days in an ICU will develop […]

Sepsis is a relatively common condition which has very high rates of both morbidity and mortality. In recent years, there has been a significant rise in sepsis-related hospital admissions, both in the UK and other countries. This is thought to be due to a combination of better reporting, an ageing population who are more vulnerable […]