Zachary Mulkey MDa
Correspondence to Zachary Mulkey MD. Email: zachary.mulkey @ttuhsc.edu
SWRCCC 2013;2(4):43.
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• The ECRI Institute is a nonprofit organization that focuses on improving patient safety and healthcare quality and the roles of medical technology in patient care. They recently judged “alarm fatigue” to be the number one technology hazard for 2013. Read an overview here.
• One way to address the critical care physician shortage: a one year fellowship for hospitalists that have at least three years of clinical experience. This is somewhat similar to how existing nephrologists and infectious disease subspecialists can complete a one year fellowship. The proposal is a joint recommendation from the Society of Hospital Medicine and the Society of Critical Care Medicine.
• Acute delirium is always a challenge to manage in any hospitalized patient and can be more difficult in the ICU setting. A recent small randomized, controlled trial showed no help from haloperidol in delirium in critical care patients. From The Lancet Respiratory Medicine and commentary.
• Evidence is still scarce on the health effects, both benefits and toxicity, but the theoretical advantage of electronic cigarettes over traditional tobacco cigarettes is obvious. A recent study asks if e-cigarettes help smokers quit.
• The evidence of benefit for low-tidal-volume ventilation for patients undergoing abdominal surgery has so far depended on the outcomes measured. A study in the BJA last year was unable to demonstrate a mortality benefit or any significant improvement in pulmonary function. A new larger study in the NEJM now has shown a reduction in post-operative pulmonary complications (primary outcome) as well as a significant reduction in length of hospital stay.