Crit Care Resusc
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In the past 5 years, there has been a significant rise in the number of trained and fully qualified specialists in intensive care medicine. Recent concerns about saturation of specialist employment opportunities and the prospect of new Fellows unable to find appropriate employment after completion of training has brought intensive care workforce issues to the forefront. The board members of the College of Intensive Care Medicine (CICM) and Australia and New Zealand Intensive Care Society (ANZICS) held the Intensive Care Workforce Summit with presidents of other medical colleges, government officials and legal experts. ⋯ Recent changes to the selection process for new trainees have had a dramatic impact on the number of new trainees in 2014 but the enduring effect of this is yet to be determined. The group discussed potential growth areas for employment of intensive care consultants, including changes in employment patterns and also the impact of reduced numbers of trainees on unit staffing. CICM and ANZICS have agreed to continue to monitor and discuss the situation on a regular basis.
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Large multicentre studies of continuous renal replacement therapy (CRRT) in critically ill patients may influence its bedside prescription and practical application. Despite this, many aspects of CRRT may not be informed by evidence but remain a product of clinician preference. Little was known about current CRRT practice in Australia and New Zealand and it is not known if the evidence from recent studies has been integrated into practice. ⋯ Our results provide insight into existing clinical management of CRRT. There is considerable variation in the prescription of CRRT in Australian and New Zealand ICUs.
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The provision of health care has significant direct environmental effects such as energy and water use and waste production, and indirect effects, including manufacturing and transport of drugs and equipment. Recycling of hospital waste is one strategy to reduce waste disposed of as landfill, preserve resources, reduce greenhouse gas emissions, and potentially remain fiscally responsible. We began an intensive care unit recycling program, because a significant proportion of ICU waste was known to be recyclable. ⋯ In our 11-bed ICU, we recycled 14% of the total waste produced over 7-days, which was nearly half of the potentially recyclable waste. There was no infectious contamination of recyclables and minimal contamination with other waste streams, except for the PVC plastic. The estimated annual cost of the recycling program was $1000, reflecting the greater cost of disposal of some recyclables (paper and cardboard v most plastic types).
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