Critical Care SmartBrief

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December 14, 2012

Right Care. Right Now.

Critical Care Update

ICU patients with delirium have higher mortality risk, study says
ICU patients with delirium were three times more likely to die as those without the condition and six times more likely to have at least one complication, Chinese researchers reported in the journal General Hospital Psychiatry. The study found ICU stays for patients with delirium were seven days longer, and Dr. Alexandru Serghi of the University of Hawaii commented, "The more severe the delirium, the worse the outcome." Health Behavior News Service (12/6)

Study compares treatment methods for ICU patients with TBI
Treating ICU patients with severe traumatic brain injury using guidelines-based management that relies on monitoring intracranial pressure is not better than delivering care based on imaging and clinical exams, University of Washington research showed. The study in the New England Journal of Medicine did not find significant variation in outcomes or lengths of ICU stay between the two methods. PhysiciansBriefing.com (12/12)

Intervention lowers incidence of serious safety events
A model that included three daily inpatient huddles significantly reduced the occurrence of unrecognized situation awareness failures events transfers, according to a study in the journal Pediatrics. Researchers from Cincinnati Children's Hospital Medical Center analyzed serious safety events and transfers from floor units to the ICU, finding days between inpatient SSEs over the study period also rose following the implementation of the model. PhysiciansBriefing.com/HealthDay News (12/12)

Medicine in the News

Study: More cancer patients decline CPR after seeing video
About 20% of terminal cancer patients who watched a short video on CPR said they wanted the aggressive treatment at the end of life, compared with 48% who were just told about what happens during the procedure, Massachusetts General Hospital researchers reported in the Journal of Clinical Oncology. Dr. Susan Gaeta at the University of Texas MD Anderson Cancer Center commented that videos are good but need to be part of a wider discussion about patients' goals and values. Reuters (12/12)

More hospitals require physical, cognitive exams among older doctors
Some 42% of physicians in the U.S. are older than 55, according to data from the American Medical Association, while 21% are older than 65. With the number of older doctors increasing, some hospitals have adopted policies prompting senior physicians to undergo periodic cognitive and physical assessments in exchange for renewed privileges. The Washington Post/Kaiser Health News (12/10)

Trends and Technology

Study: Telestroke networks save money, lead to better outcomes
Telestroke networks lead to more patients being discharged to home, and upfront development costs are offset by more patients getting clot-busting drugs and less stroke-related disability, according to researchers from Mayo Clinic in Phoenix. The trauma network study model estimated the hub hospital would spend about $405,000 a year, and the spoke hospital could save about $109,000, according to the study in Circulation: Cardiovascular Quality and Outcomes. MedWire News (U.K.) (12/11)

SmartQuote

The best preparation for tomorrow is to do today's work superbly well."

--William Osler,
Canadian physician

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