Winter Pressures

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Dr Gary Masterson, President of the Society, reflects on the current winter pressures facing those working and being treated in intensive care and high dependency units.

I’ve just completed a week covering my ITU and I suspect that many of you have or are currently experiencing the same sort of chaos I have just endured. There’s no doubt that this winter is intensely busy for us and the NHS in general. Many hospitals are log jammed with sick patients from the front door (ED), through the wards, including critical care, to our discharge lounges. This makes it difficult for all the nurses, AHPs, consultants and trainees working on our units.

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State of the Art 2017 Day 1 Round Up.

We’ve had an incredibly energetic first day at State of the Art. People were buzzing as they entered the gates bright and early and the energy has yet to die down as I write this in the midst of the drinks reception sponsored by GE.

Our social media group were fantastic. They were on hand all day to moderate the various sessions, live-stream interviews with speakers and periscope stream from the conference floor.

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#FiftyScansInFiftyDays – My journey through FICE Accreditation

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 Dr Nitin Arora (@aroradrn), Consultant Intensivist at Heart of England NHS Trust, discusses his journey in attempting to complete #fiftyscansinfifty days and offers advice to those undertaking the FICE accreditation.

Over the last few years, FICE has become the de-facto standard bedside focused echo accreditation for UK intensive care. Having tried and failed to complete my FEEL logbook as a registrar in 2012, I decided I’d try again as a consultant. After 2 years, a business case and having trialled various machines, our 2 new machines finally arrived in April 2017, and I immediately set about finding a FICE course.

Day 1 (FICE Course)

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

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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

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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”

 

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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””

Hospital Politics

Reporters: M Beed, G Suntharalingam, P Brindley

As results came in, it became clear that asking hospital staff for their opinion had backfired. Ms May, from the orthopaedic wing of the party, has been accused of fighting a lacklustre campaign, and there are calls for her to resign as Chief Surgeon. Ms May has taken responsibility and has sought support from eight little-known staff Anaesthetists Continue reading “Hospital Politics”

The Manchester Attack – A personal view

The amazing responses of the of the NHS to the recent atrocities & fire in Manchester and London is a testament to the dedication of the critical care teams as well as other medical staff in those hospitals involved.  An overriding desire to help when adversity struck was the hallmark of their attitude.  The last five years in the NHS has been punctuated with feelings of doom at times – not enough money, not enough staff, too much poorly considered change etc, etc. It’s all too easy to forget why we entered our professions in the first place.  This blog by Dr Andrew Bently, Clinical Director of the University of South Manchester adult critical care unit might help jog our memories.

Gary Masterson, ICS President Continue reading “The Manchester Attack – A personal view”

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”