Major burns have previously been considered a contraindication to solid organ donation. We present two cases of successful organ donation and transplantation, after Maastricht category III cardiac death in adult patients with non-survivable burns injury. The implications of the outcome of these cases are that major burns should not be considered a contraindication to organ donation, and that cardiac death provides opportunity for patients with non-survivable burns to contribute to the pool of potential organ donors.

Intermediate-care or high-dependency units can provide a level of care that lies between the intensive care unit (ICU) and general ward, but the patients who are most likely to benefit from such level of care remains uncertain. This nested case-control study assessed the incidence and risk factors of high-dependency patients requiring ICU admission and whether these admissions were associated with a worse outcome when compared to other emergency ICU admissions. Seventy-seven consecutive high-dependency patients requiring ICU admission (cases) were compared with 77 patients who did not require ICU admission (controls) and also 928 emergency ICU admissions from other areas. The incidence of high-dependency patients requiring ICU admission was 6.7% (95% confidence interval 5.3 to 8.2). High-dependency admissions from the ward (odds ratio 4.46, 95% confidence interval 1.55 to 12.78) or emergency department (odds ratio 4.48, 95% confidence interval 1.54 to 13.0) and a need for concurrent non-invasive ventilation, inotrope infusion and acute kidney injury (odds ratio 14.90, 95% confidence interval 3.79 to 58.3) was associated with a higher risk of ICU admission. Hospital mortality of the high-dependency patients requiring ICU admission was not significantly different from other emergency ICU admissions (odds ratio 1.08, 95% confidence interval 0.55 to 2.11). In summary, high-dependency patients requiring ICU admission were uncommon unless they had multi-organ failure and their hospital mortality was not significantly different from other emergency ICU admissions.

Influenza is a common seasonal viral infection that affects large numbers of people. In early 2009, many people were admitted to hospitals in Mexico with severe respiratory failure following an influenza-like illness, subtyped as H1N1. An increased mortality rate was observed. By June 2009, H1N1 was upgraded to pandemic status. In June-July, Australian ICUs were experiencing increased activity due to the influenza pandemic. While hospitals implemented plans for the pandemic, the particularly heavy demand to provide critical care facilities to accommodate an influx of people with severe respiratory failure became evident and placed a great burden on provision of these services. This paper describes the initial experience (June to mid September) of the pandemic from the nursing perspective in a single Australian ICU. Patients were noted to be younger with a higher proportion of women, two of whom were pregnant. Two patients had APACHE III comorbidity. Of the 31 patients admitted during this period, three patients died in ICU and one patient died in hospital. Aerosol precautions were initiated for all patients. The requirement for single room accommodation placed enormous demands for bed management in ICU. Specific infection control procedures were developed to deal with this new pandemic influenza.

There is one feature of the medical experience presented in the tables of the report which must be emphasized from the outset; that is, the figures are derived entirely from the experience of hospitals and other medical units and hence relate to admissions to these units and not to all sickness' occurring in the Army. Excluded therefore are those who are treated at unit medical officer level, together with those who are attended at home or on sick leave. The result is that in terms of rates of sickness and of non-effectiveness there is a possible under-statement, so that to be strictly accurate the tables shouldbe headed" Rates of Sickness, etc. determined at medical units."The first group of tables -presented gives a summary of the admission rates by Commands· (for both British Army males and females) and the comparison of these rates yearly over the past five-year period. As the experience of British Army males forms the greatest part of the medical sickness story, the comments below will relate to the male experience only, unless specific reference is made to females.The difference between Commands preserves the pattern observed in the past, with BAOR showing the most favourable rate (179.7 per thousand strength) and FARELF the highest (337.4 per thousand). Referring to the annual comparisons, the rates for the individual Commands all show a continuous improvement over this period, although not all are lower than the corresponding 1964 figures. It is perhaps noteworthy that the one theatre not showing the same general improvement is the UK, for which the rates have been virtually consistent for the past four years. The next batch of tables presents the incidence of medical non-effectives, also by Commands, and an annual comparison over the five-year period. The same " between Command" differences as were observed in considering admission rates are seen here; in fact the differences are accentuated. Thus the average medical non-effective rate for the UK is 12.4 per thousand, whilst for BAOR the corresponding figure is 5.5 This reflects the fact that the duration of stay in hospitals in the UK is considerably longer than that in BAOR. Working froin the admission rates and the non-effective rates, a figure of 16.5 days' stay is obtained for the UK compared with 11.5 for BAOR. Even the figure for FARELF, in terms of by copyright.