Crit Care Resusc
-
To establish the success rate, time taken and expertise required to place a feeding catheter into the small intestine using a device that permits real-time localisation of the catheter through detection of an electromagnetic field. ⋯ An electromagnetically guided device enabled reliable and rapid bedside placement of small intestinal feeding catheters. Proficiency with the technique was quickly developed and successfully disseminated to a range of clinicians.
-
Comparative Study
Induced hypothermia after out-of-hospital cardiac arrest: one hospital's experience.
Induced mild hypothermia has been shown to reduce in-hospital mortality and to improve neurological outcome in patients who remain comatose after out-ofhospital cardiac arrest (OHCA). We conducted a retrospective audit to assess whether induced hypothermia had been successfully incorporated into routine care at our hospital, and whether this improved patient outcomes. ⋯ We found that induced hypothermia can be incorporated into routine care of patients admitted to an ICU after OHCA. For patients with an initial rhythm of VF or uVT, this seems to have significantly improved hospital survival and neurological outcome. We also found that rapid infusion of cold intravenous fluids was effective for inducing hypothermia.
-
The Fellowship Examination for Intensive Care Medicine in Australian and New Zealand, first held in 1979, has undergone four distinct periods of development and change: * 1979-1996. Initiation and establishment of the exam as a relevant and comprehensive assessment process for a new specialty. * 1997-2001. (*) Revision to increase breadth of coverage and reliability for a growing number of candidates, and to ensure that each candidate received the same exam. (*) Expansion to incorporate assessment of CanMEDS skills, including communication, procedures and professional qualities. (*) Lengthening to increase the number of exposures, to ensure reliability. (*) Quarantining of candidates to allow the provision of a similar exam for each candidate. * 2002-2006. Increasing emphasis on examiner training and standard setting, increasing feedback to candidates to improve the educational experience and guide exam preparation, and blueprinting of questions to maintain validity. * 2007 onwards. ⋯ The exam has been regarded as a "tough but fair" assessment in its 30 years of existence, and the committee overseeing its development has aimed to continually review the process to maintain those qualities, as well as reliability, validity and feasibility. The increasing number of candidates has allowed usable statistics to be accumulated but has tested the feasibility of running such a labour-intensive exam. To date, there have been 800 presentations to the exam, with 498 successful candidates.