Bereavement Care in UK ICUs: Time for a Change

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by Jeremy Groves, Consultant Anaesthetist in Intensive Care

I’ve just been looking at the last Annual Report for the North Trent Critical Care Network and, if you look at the Network Units as a whole, the mortality rate is about 16%.  This equates to over a thousand deaths.  Now a death is not just a statistic.  To the relatives left behind, and to carers, there can be significant trauma.  This is true even for those with significant co-morbidity where death is always in the shadows.  It makes bereavement care a real and important issue. Continue reading “Bereavement Care in UK ICUs: Time for a Change”

Informed Consent

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by Hugh Montgomery

You’re diving a deep wreck far from the European mainland with no access to a decompression chamber and before mobile telephones; what do you do if someone gets ‘the bends’ and is paralyzed? One option: ‘Put them over the side, and report a drowning accident.’  No-one (or so a bunch of young bloods thought) would want to live paralysed. Wind forward two years, and a spinal bend happens. The victim isn’t going over the side, and no-one is actually going to put him there. Continue reading “Informed Consent”

Are We Innovators?

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by Craig Brown

I was speaking to a colleague recently who reflected that it appears we have been through the age of research, then came the age of standards and now we appear to be moving into “the age of innovation” in the NHS.

It was an interesting comment and perhaps picks up the zeitgeist where we have seen the development of “Quality Improvement” initiatives, sometimes on a local scale and sometimes on a regional or national level. The growth and expansion of Academic Health Science Networks (AHSNs) supports this regional transformation through platforms for education, supporting system wide projects and attempting to link innovators with the appropriate clinicians. Continue reading “Are We Innovators?”

Learning from Patient Safety Incidents

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by Jeremy Groves, Consultant, Critical Care and Anaesthesia

I was helping out this morning with a bronchoscopy on a patient with a significant sputum load. My colleague Tim, who was supervising one of our trainees, Naomi, who was steering the scope, couldn’t see the wall mounted monitor.  I commented that the patient’s ventilation was being compromised by the presence of the scope. Tim wanted to see what was going on and asked me to turn the monitor towards him.  This I did and, with rather a large crash, a yelp from Naomi and a gasp of surprise from the rest of us, the monitor fell off the wall. Continue reading “Learning from Patient Safety Incidents”

Resuscitation to Recovery: A National Framework to improve care of people with out-of-hospital cardiac arrest (OHCA) in England

In 2013, the Cardiovascular Disease Outcomes Strategy (CVDOS), published by the Department of Health, highlighted that many lives could be saved if CPR and early defibrillation were instituted promptly, more often, and the whole pathway of care from successful resuscitation to subsequent rehabilitation were improved.

Recently, an OHCA steering group was convened Continue reading “Resuscitation to Recovery: A National Framework to improve care of people with out-of-hospital cardiac arrest (OHCA) in England”

No Smoke Without Fire: The Badness of Burnout

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by Linda-Jayne Mottram, Consultant in Anaesthesia and Intensive Care

Burnout: exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration.

 

Who is at risk from burnout?

You may have heard the expression – ‘the flame that burns twice as bright burns half as long’, or similarly the colloquialism ‘to experience burnout you had to be fired up in the first place’. It suggests that only the highest achievers in medicine and nursing get burned out. I’ve started to think that this is an oversimplification. Continue reading “No Smoke Without Fire: The Badness of Burnout”

[Long Read] The TGN1412 drug trial: A personal view

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by Ganesh Suntharalingam, Honorary Secretary, Intensive Care Society

On the morning of Monday 13 March 2006, six out of eight healthy male volunteers on a clinical trial received a first dose of a drug never before given to humans, in an independent commercially-run clinical trials unit within the grounds of Northwick Park Hospital.

This was planned and expected to be completely routine. However, all six men had a life-threatening reaction requiring an emergency response by the NHS, which not only had a lasting impact on them but also brought about changes in how higher-risk clinical trials are run and regulated in the UK, EU, and beyond.

Saving the lives of those volunteers Continue reading “[Long Read] The TGN1412 drug trial: A personal view”