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You have just taken sign-out when a nurse comes up to you and says that there is a 64-year-old man in the critical bay who took an overdose of his medications. The patient has a history of hypertension, atrial fibrillation, and depression. The patient is lethargic but arousable, and reports he took about 40 tablets of immediate-release metoprolol three hours ago in an attempt to "end it all." The nurses are starting IV lines, checking vitals, and putting the patient on the monitor. You wonder, "Is it too late for gastric decontamination? If he is symptomatic, which therapy will I try first, and what are my options?"
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In this issue: Tiotropium for uncontrolled asthma, sibutramine pulled from market, incidence and mortality data from WHI, FDA Actions.
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Following a chart review that indicated few (24%) medical ICU (MICU) patients received consultation for physical therapy (PT) or occupational therapy (OT) a percentage almost 50% lower than at two other academic medical centers in the same city as well as a higher prevalence of deep sedation, the authors elected to initiate a QI project designed to reduce the use of deep sedation and improve patients' functional ability.
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Desai and colleagues carried out a comprehensive review of published studies on long-term complications among survivors of critical illness in an attempt to find common characteristics and themes that might be used in developing strategies for preventing or mitigating them.
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Acetaminophen (known as paracetamol outside the United States) is the most commonly used analgesic in the world, usually considered to be safe and benign.
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Quality assessments can be a good strategy for finding compliance problems that otherwise would fly under the radar. These not-for-cause audits require some staffing resources, but if handled efficiently they uncover problematic trends and bad habits before an issue becomes serious.
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One of the chief problems with adverse event reports is these often cast a net so wide that many disease symptoms are swept up with the reports. This particularly is an issue with oncology clinical trials.
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Academic researchers spend a large chunk of their time on paperwork. Regulatory and institutional burdens could seem overwhelming.