A short cut review was carried out to establish whether the use of preprocedural checklists prior to intubation of critically ill patients outside a theatre environment can reduce the incidence of adverse events. Four directly relevant papers were found using the reported search strategy and presented the best evidence to answer the
Therapeutic hypothermia is used to reduce mortality and morbidity following cardiac arrest. It is increasingly being used to cover a variety of indications including primary out-of-hospital ventricular fibrillation (VF) and non-VF cardiac arrests, in-hospital cardiac arrests and cardiac arrests of secondary cause. We have studied indications, techniques, efficiency, outcomes and complications of post-cardiac arrest cooling processes used in routine clinical practice in intensive care units in the north west of England. Survival at hospital discharge post-VF arrest was 53% in this multicentre cohort and all survivors at discharge had good or fair neurological recovery. This study confirms that our cooling and rewarming practices are effective and similar to those described in current literature, and meet standards set by the International Liaison Committee for Resuscitation (ILCOR).
We describe efforts made at Blackpool Victoria Hospital to implement the well-established international Surviving Sepsis guidelines. These included posters, pocket guides and stickers inserted in patient notes. All doctors and nurses in acute areas received specific information and education. Sepsis teams comprising both doctors and nurses were formed to encourage implementation and to audit and disseminate data. Data collection occurred from February to November 2009. Cases were considered prospectively at the time of initial assessment and 198 patients were identified; 169 (85%) had blood cultures taken; 146 (74%) had lactate levels measured; and 145 (74%) received antibiotics within the target time. We believe these results demonstrate relatively effective implementation of guidelines in the challenging environment of a district general hospital. Our results could be replicated easily and provide a good way of reducing patient mortality at minimal financial cost.
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