How important is the main daily ward round we do each day in the Intensive Care Unit? Is the ward round in your ICU focused and concise? Do you adequately communicate the plans you generate on the ward round to the whole ICU team?
John Myburgh AO (@JAMyburgh), an experienced Australian intensivist, who began his life and career in South Africa, is Professor of Intensive Care Medicine at St George Clinical School, University of New South Wales and Director of Critical Care at the George Institute, Sydney. He has an international research profile and is a Foundation Member and Past-Chairman of the ANZICS Clinical Trials Group.
In this episode, John gives a very insightful commentary on how much attention he puts on the clinical ward round as our key tool in intensive care practice. We might do more than one ward round a day but John says the main daily ward round is where it should all happen. Where we try and think about how the patient, with their individual characteristics of life and disease, is actually progressing through their critical illness. Whether they are on an upward trajectory to improvement, whether they are on a downward trajectory that may lead to death, or whether they are stuck on the flat “curve” which we often don’t have our eyes open to.
John also tells us to be careful of using too many “toys” (machines) and focusing too much on the test results. And he warns us that we are at point in the development of intensive care medicine where we save the lives of more people, but forget to realise that many of these have a greater disease burden from their chronic critical illness than they did when they were admitted to the ICU.
- SMACC 2019 – Is less best in critical care?
- SMACC 2019 – The Great Fluid Debate
- Mastering Intensive Care 009 with John Myburgh
My genuine hope with the Mastering Intensive Care podcast is to inspire and empower you to bring your best self to the ICU by listening to the perspectives of such thought-provoking guests as Wes Ely. I passionately believe we can all get better, both as carers and as people, so we can do our absolute best for those patients whose lives are truly in our hands.
Feel free to leave a comment on the Facebook “mastering intensive care” page, on the LITFL episode page, on Twitter using #masteringintensivecare, or by sending me an email at andrewATmasteringintensivecare.com.
Further reading and listening
- Full podcast collection on LITFL and Libsyn
- More conversation on Twitter (@andrewdavies66) and Facebook
Mastering Intensive Care
with Andrew Davies