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It is a common sight in the intensive care unit. Family members at the bedside, sometimes 24/7. Holding vigil and attentively monitoring each moment of the day for their critically ill/injured loved one. After all, who knows the needs and subtle hints of change of the patient better then close loved ones?

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To recap from our first post in this series, the definition of Post Intensive Care Syndrome (PICS) is new or worsening health problems after a stay in the ICU. These health problems can affect the body, mind, and/or emotions and often present after the patient has been discharged from the hospital. These problems may last anywhere from a few weeks, to months, and in some cases even years. People with PICS often experience a wide array of symptoms.

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This document is aimed at respiratory and general medical physicians. It summarises published data regarding the risks of Venous thromboembolism (VTE) in patients with COVID-19, and discusses clinical issues regarding prevention, diagnosis and management of VTE.

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This guideline was formulated following consultation with stakeholders from the medical and nursing professions, patient groups and healthcare management. Basic diagnostic procedures in adults using a flexible bronchoscope are included in the guideline.  
Topics covered in the guideline:
Monitoring of a patient during the procedure.
Specific precautions, contraindications and complications.
Sedation, premedication and topical anaesthesia.
FB in specific patient groups.
Role of bronchoscopy in infections.
FB in the ICU.
Cleaning and disinfection of equipment.
Staffing and staff safety.
Diagnostic accuracy and specific procedures.
Patient satisfaction and patient care.  
Topics not covered in the guideline
Training in bronchoscopy (The BTS is producing separate guidance on training).
Advanced diagnostic and therapeutic FB.3 Rigid bronchoscopy.
FB used for intubation, percutaneous tracheostomy placements and intraoperative complications.
Paediatric FB.
FB performed under general anaesthetic.

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Cam ICU Pocket Cards help the medical practitioner to do "delirium assessment" and " Sedation Assessment".

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This is the pocket card version of RASS scale and new CAM-ICU Flowsheet.

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For COVID-19 patients who’ve been treated in the intensive care unit (ICU) and survived the virus, the road to full recovery isn’t straightforward. While the long-term effects of the virus are still unclear, there’s also a lot more to learn about what life after COVID-19 will look like for those who are experiencing the worst of it.

Researchers at the University of British Columbia are examining the type of long-term support that’s needed for patients who’ve been sent to the ICU.

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ICU capacity is a current and future health system challenge in Canada, as stays there are resource-intensive and costly. The aging population and concerns around the potential increase in severity of illness among hospital patients could place additional demands on Canadian ICUs in the coming decades. Care in Canadian ICUs provides information on operating patterns, patient flows, trends in admissions, patient populations and processes of care for those treated in the ICU. This report and its companion products can help inform evidence-based system improvement efforts by providing a baseline of comparable measures.

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Specialists in intensive care medicine have long focused on the prevention of short-term mortality. As intensive care unit (ICU) mortality continues to improve, interest in outcome measures has expanded to include the morbidity and mortality of survivors. Over the last 10 years it has been increasingly recognised that critical illness is a medical condition itself, irrespective of the underlying cause for ICU admission, and patients experience physical, psychological, and cognitive dysfunction after hospital discharge (Figure 1). However, because relatively few patients ultimately require critical care, many GPs may have little contact with these patients. It may therefore be difficult to provide the additional support required by ICU survivors. This short paper highlights some of the physical and psychological difficulties that patients face after discharge from ICUs, and will hopefully help GPs to plan long-term management of their patients in the community.

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The majority of women remain healthy during pregnancy and childbirth. The UK has one of the lowest maternal mortality rates in the world.1 Nevertheless, there has been an increase in the number of women who become unwell around the time of childbirth, due to factors including increasing maternal age, increasing rates and levels of obesity and other comorbidities. Women who become acutely unwell during pregnancy, labour or the postnatal period should have immediate access to critical care, of the same standard as other sick patients, delivered by teams skilled in providing critical care to the acutely deteriorating obstetric patient. With this aim, in 2011, a multidisciplinary group from several royal colleges, including obstetricians, anaesthetists, intensivists, midwives and critical care nurses, published a document: 'Providing equity of critical and maternity care for the critically-ill pregnant or recently pregnant woman'.

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Introduced what the caregivers' ABCDE stands for, and explained them in detail.

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Patients with COVID-19 are staying longer than the average three to four days in the intensive care unit (ICU), says Megan Hosey, a rehabilitation psychologist at Johns Hopkins Hospital’s medical ICU. This puts them at greater risk for developing post-intensive care syndrome (PICS). While more patients than ever are surviving after treatment in the ICU, research over the last two decades shows that survival can come with the cluster of physical, psychological and cognitive symptoms associated with PICS — hindering patients’ quality of life for weeks or years to come. Although the exact prevalence of PICS is unknown, “it happens in more patients than we probably realize,” says Hosey, and it is occurring in some patients with COVID-19.