Critical Care
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Communicate Collaboratively Before End-of-Life Care Conversations Disintegrate
Once communication breaks down, it is difficult to rebuild. Clinicians, ethicists, and palliative care all should be talking to each other to be sure the family hears a common message.
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Families Are Confused, Skeptical About ‘Inappropriate’ Treatment
Many, if not most, ethics consults involve conflicts over withdrawal of life-sustaining treatment at the end of a patient’s life. Yet families are likely to be quite confused by commonly used terms such as “futile” and “potentially inappropriate.”
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Report Links ED Boarding to Worse Clinical Outcomes
Some hospitals have found a novel solution in the form of resuscitative care units, which are ICUs based in EDs. Patients who need time-sensitive respiratory, metabolic, neurologic, or hemodynamic critical care can receive it in the ED. This prevents these patients from waiting so long for a bed to finally open in the appropriate specialty ICU.
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Improved ICU Physician Staffing Leads to Better Safety Grade
When Doylestown Hospital in Pennsylvania received a C on the Spring 2016 Leapfrog Hospital Safety Grade, leaders launched a campaign to improve patient safety. A central tactic was adapting its staffing model to meet Leapfrog’s ICU Physician Staffing criteria.
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Targeting 100% or 70% of Enteral Calorie Requirements During Critical Illness Results in Equivalent Outcomes at Six Months
This was a multicenter, blinded, parallel-group, randomized trial of mechanically ventilated critically ill patients. Achieving 100% calorie requirements did not change outcomes at six months when compared to a more modest goal of 70% of predicted calorie requirements.
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Evaluation and Treatment of Severe Community-Acquired Pneumonia in the ICU
Community-acquired pneumonia is a common cause for hospital admission. This article serves to summarize new updates in the definition, prognosis, and treatment, specifically of bacterial, severe community-acquired pneumonia.
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HHS Releases Latest Iteration of Antibiotic Resistance Action Plan
New edition builds on similar plan that preceded it, success hinges on proper resource allocation.
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Do Not Intubate Orders Becoming More Common
Rates increased over time, from about one in 10 patients 20 years ago to about one in three patients in the past five years. The exact reasons for this increase remain unclear.
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Treatment Withdrawal Policies Could Harm Families
Chaplain: "Your patient is not just the person in the bed. It’s the whole family."
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Conflicts Over Decision-Making Frequent in ICUs
Consider psychological, biological, spiritual, and social factors, and the role they play in understanding illness and healthcare delivery. Using this model, clinical ethicists can encourage dialogue between healthcare professionals caring for seriously ill patients.