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?"
Acetaminophen (known as paracetamol outside the United States) is the most commonly used analgesic in the world, usually considered to be safe and benign.
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.
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.
In this issue: Tiotropium for uncontrolled asthma, sibutramine pulled from market, incidence and mortality data from WHI, FDA Actions.
