Category: Intensive Care

Anaesthesia is one of the largest and most wide-ranging medical specialties, and it is used in some form in around two-thirds of all hospital patients. It is generally a very safe procedure, and the risk of adverse events is low. Furthermore, many of the complications that do occur are minor and temporary in nature. However, a small proportion result in permanent harm or […]

A hospital-acquired infection (HAI) is any infection that is not clinically manifest or incubating at the time of admission. Conventionally, infections that become evident within 48 hours of admission are deemed to be community-acquired, while those that appear later, unless there is clear evidence of their existence at admission, are classified as hospital-acquired. HAIs are common, affecting around 6.5% of patients, with a higher prevalence in […]

The four key elements of the Enhanced Recovery After Surgery multimodal approach are comprehensive preoperative evaluation of the patient, optimum anaesthesia and minimally invasive surgery with the aim of reducing patient response to surgical stress, adequate postoperative management of symptoms such as pain to allow early mobilisation, and prompt reintroduction of an adequate diet.

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 […]