The press, medical information, ethics and money


Jeremy Groves reflects on some of the wider issues arising from the tragic case of Charlie Gard.

I have already written about something the adult critical care community can take away from the tragic case of Charlie Gard; however, I think there are several other issues that we can mull over.  Charlie and his parents’ plight captured the public’s attention and everyone had a view, as I discussed before, informed or otherwise.  To me it was striking how much of the discussion, and presentation of clinical information, took place in the press.

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Life support for critical care staff


Dr Linda Jayne Mottram, Intensive Care Consultant at Belfast HSC Hospital discusses the crucial importance of maintaining clinicians mental wellbeing in the current medical culture.

Basic life support algorithms start with the premise that clinicians check for danger before approaching the patient.  The rationale being that if you are injured by something in the environment, you will be of little practical use to a patient in extremis.   The same logic applies to scene safety in prehospital medicine. No one questions your commitment to the patient by protecting yourself first, because it makes common sense to do so.  You have to be free from injury in order to provide any meaningful assistance.

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Rehabilitation after critical illness in adults

Gill Sharpe

Gillian Sharpe, Lead Critical Care Physiotherapist, Chesterfield Royal Hospital, welcomes the update on NICE Quality Standard CG83 and the increased focus on rehabilitation of the critically ill it will bring.

Historically, mortality rates have been the main indicator of success following critical illness. Healthcare professionals working with the critically ill however, have long recognized that many of those who survive are left with significant physical and non-physical morbidity and often face a lengthy convalescence.

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A lesson from little Charlie


Dr Jeremy Groves reflects on one implication that the case of Charlie Gard has in adult critical care.

The Charlie Gard case has been the dominant medical story over the last few months.  One cannot but have extreme sympathy for Charlie’s parents who fought valiantly to give their son a chance in life. It was a personal tragedy, played out on social media and in the press, where the pope, presidents, politicians and pundits all had a view and expressed it, informed or otherwise.

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Fasting our patients in the critical care unit. How can we get it right?


Ella Segaran, Advanced dietitian for Critical Care, Imperial College Healthcare NHS Trust and Chair of the NAHP committee of the ICS, considers barriers to achieving nutritional targets in critical care and proposes some solutions.

On average critically ill patients only receive 50-60% of their nutritional target. As a critical care dietitian this causes me considerable frustration. I perform a detailed nutritional assessment, develop a feeding plan only to find the system is working against me. Underfeeding is associated with more infections and longer ICU and hospital stay. We know if we get it right and achieve more than 80% of the target we decrease mortality and ventilator days.

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Using a Winston Churchill Memorial Trust Travelling Fellowship for critical care research – Applications open for 2018


by Joanne McPeake

In 2011, I was a Staff Nurse in critical care in Glasgow, and a Lecturer Practitioner at the University of Glasgow. I first heard about the Travelling Fellowships through a list of openings advertised by the university. I felt that this could be a fantastic opportunity for me so I decided to apply. I was elated when I found out my application had been successful. I discovered after the interview that about 1,000 people had applied, so I definitely didn’t expect to be chosen!

For my Fellowship, I went to the USA for four weeks. The broad aims of my project were to look at how to improve outcomes for patients recovering from a period of critical illness. I visited several Intensive Care Units (ICUs), exploring the use of various techniques to improve short and long-term outcomes for patients.

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In Search of the Intensive Care “Pessimist”


Peter Brindley Circle

By Peter Brindley

In spring I wrote in this venerable blog about travelling to India and hoping to see the elusive tiger 1.  In summer I subsequently came to Britain expecting to see nothing but ICU pessimists. I saw lots of Indian tigers; I met very few true British pessimists. Despite a UK summer that could be remembered for bombs, knives, fires and anger, your lovely country has endured, despite being injured.  Like much of the world, you have a political and healthcare system seemingly tailor-made to produce burnout and despondency. However, while many of you are “down”, you are definitely, and defiantly, not “out”. Continue reading “In Search of the Intensive Care “Pessimist””

The ARCP, – “if only i knew what i was supposed to do” – a tirade, and a request to my fellow trainees…


by Jamie Strachan

The Annual Review of Competency Progression (ARCP) season has just passed for many trainees in Intensive Care Medicine in the UK, and we are at the start of a new academic year.  Those that sail through with an outcome 1 (ready to progress to the next year) breathe a sigh of relief, but those with any other outcome, for example an outcome 5,  need to provide more evidence and may feel despondent – “I didn’t know I had to have that paperwork in that place”…

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The Medical Training Initiative – a personal perspective.

The Medical Training Initiative enables overseas graduates to come to the UK for experience in intensive care. In small and large units with posts and training capacity the scheme can be mutually beneficial. Dr David Odaba, currently working at the Cumberland Infirmary in Carlisle, gives us his view on the application process and the benefit of the experience he gained. – Jeremy Groves

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What is the Medical Training Initiative?


by Jon Sturman,

Clinical Director of Critical Care, North Cumbria.

MTI stands for Medical Training Initiative and is one way of allowing overseas doctors access to training in the UK. Applicants should have at least 3 years’ postgraduate clinical training and possess a postgraduate medical qualification – see MTI sections in the RCOA and RCP websites for more information on this. Application is facilitated by the Colleges to help with GMC registration and hospital trusts’ sponsorship on a tier 5 (2 year) visa.

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