This study provides clinicians with valuable guidance on a technique by which insulin therapy may be intitiated and intensified using a safe, timely, and rational therapeutic approach.
Utilization of continuous EEG monitoring in mechanically ventilated patients in the ICU was associated with a reduction in hospital mortality without sigificantly affecting hospital costs or length of stay.
Nurse practitioners (NP) have been involved in the care of critically ill patients since the late 1980s. Today, multiple universities and colleges offer NP preparation with specialization in a variety of areas.
Implementation of an evidence-based extubation-readiness bundle was associated with a decrease in mechanical ventilation days and pneumonia in brain-injured patients.
Recently The Joint Commission created a new standard, which calls for the identification of ED patients who are suicidal. This is based, in part, on the fact that a significant proportion of patients who die by suicide are seen in the ED in the months prior to their suicide. However, many of these patients are seen for non-mental health reasons.
There are several relatively new adjuvant treatments for patients with massive hemorrhage. Of these, TXA is most widely recommended. It is inexpensive and has been shown to reduce mortality when given within three hours of injury.
A new test, viscoelastic hemostatic assay, identifies the patient's stage of coagulability and fibrinogen status. The result of the test is a curve, which can help determine the need for fibrinogen, clotting factors, and platelets.
Massive transfusion is an independent predictor of increased mortality, increased infection rate, SIRS, andmulti-organ failure.
Complications of massive transfusion include acid/base derangement, electrolyte abnormalities (particularly hyperkalemia with rapid infusion), immune system changes, acute lung injury, and fluid overload.
