It’s that time again, time to recap what is new in the LITFL Critical Care Compendium (as you probably know, the quick way to get there is to click on the CCC at the very top of every LITFL page). Updated pages have a revision date noted under the page heading. Once again I’d like to express my thanks to everyone who continues to send me comments and suggestions about what to correct, improve or add to the CCC. This resource can only keep on getting better because of this.
Remember, if you see something wrong or out-of-date, leave a comment on the post or send me an email…. Don’t let me (or anyone else!) be wrong on the internet!
Let’s crack on with the updates:
- Thanks to a bit of prompting from Sarah Yong, the VISEP study and last year’s post hoc analysis of NICE-SUGAR have been added to the glucose control literature summaries. Furthermore, the summaries of many of the classic studies have been revised.
- A new section of dysglycaemia and a new summary of how the evidence for glucose control in ICU has evolved have been added.
- What’s new here? A section describing the classification of severity categories, that’s what.
- A whole new CCC page (at last) on this fascinating addition to the RSI pharmacological armamentarium — let’s face it, gamma-cyclodextrans are cool!
- A new section on potential confounding factors has been added.
- I just can’t stop tweaking this page on one of the most studied interventions in intensive care. Still, we don’t use it in Australasia. Its worth making sure you know why.
- Early mobilisation, preventing deconditioning and rehabilitation are becoming more important in ICU, and so does the role of physiotherapy as a result. This is a brief overview with links to some useful references.
- This has come up in the last two FCICM exams — surely a hat-trick is out of the question…?
- This one is always controversial, I have added in the Chua systematic review. You need to know the pros and cons and exactly what you would/ will do.
- This a commonly delayed diagnosis with very poor outcomes if not treated – the triad of fever, headache and altered mental state is only present a third of the time. Think about it, get the imaging and do the LP!
That’s enough for now I’m sure…
Vive la FOAM!
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.