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New Requirements Are Discouraging Physicians from Writing DNR Orders

Ethicists should help develop related protocols. For practitioners, code status conversations should be treated with the seriousness of surgery. That means involving the right people and taking the time to ensure medical understanding and prognosis, as well as patient values and goals, before talking about a care plan. When possible, practitioners should bring up DNR at the end of a meaningful conversation.

Medical, Law Enforcement Teams Share Expertise, Support During Dangerous Situations

One way to accelerate care to victims of mass casualty events is to direct physicians who are accustomed to working with law enforcement to respond to the scene so they can provide high-level care to victims immediately. That is part of the emerging specialty called tactical medicine.

Healthcare Leaders Identify Steps to Maximize Response to Mass Shooting Events

As mass shooting events continue, healthcare leaders are focused on how the medical response is effective and expeditious. Frontline providers who have experienced such events have first-hand knowledge about where the weak links are and can offer unique insight on how organizations can work within their regions to be better prepared.

Mortality, Days Alive Outside Institutions Among Older Patients After Tracheostomy

Medicare beneficiaries who underwent tracheostomy and gastrostomy tube placement often remained institutionalized beyond three months, with three-, six-, and 12-month mortality greater than 40%, 50%, and 60%, respectively.

A Collaborative Three-Step Physician and Nurse Support Strategy for Families of Patients Dying in the ICU

When physicians and nurses offer collaborative and repeated support to families of patients dying in the intensive care unit, it may decrease prolonged grief, depression, and anxiety symptoms.

Frailty Is Associated with Longer Duration of Mechanical Ventilation and Higher Mortality

In this retrospective, population-based cohort study, patients with frailty spent more time on mechanical ventilation, had longer intensive care unit and hospital stays, and had higher mortality than patients without frailty.

Mortality and Days Alive Outside Institutions in Older Patients After Tracheostomy with or Without Gastrostomy Tube

Medicare beneficiaries who underwent tracheostomy and gastrostomy tube placement often remained institutionalized beyond three months, with three-, six-, and 12-month mortality greater than 40%, 50%, and 60%, respectively.

Occult Hypoxemia Is More Common in Black Patients than in White Patients About to Undergo ECMO for Respiratory Failure

In this retrospective analysis of de-identified Extracorporeal Life Support Organization registry data, the prevalence of occult hypoxemia was higher in Black patients than in white patients. Hispanic and Asian patients had a similar prevalence of occult hypoxemia compared to white patients.

Surviving Sepsis: The New Guidelines

Subsequent revisions of Surviving Sepsis guidelines highlighted the need for early, appropriate antibiotics along with a new focus on initial resuscitation, stressing the importance of dynamic measurements instead of static variables to predict fluid responsiveness. The most recent 2021 revisions continue to stress the importance of these ideals, but they also place an increased emphasis on the hour-1 bundle and improving the care of sepsis patients after they are discharged from the intensive care unit.

COVID-19 Associated with Significant Increase in Hospital-Acquired Bloodstream Infections

The time period of the COVID-19 pandemic was associated with increases in hospital-onset bloodstream infections, mainly in patients with COVID-19.