handover is not a unilateral transfer of information and that when poorly conducted it can degrade quality of care [1]. A key feature of handover required by clinicians is the big picture, which shapes the viewpoint of the receiving party [1]. Frequently this is obscured in critically ill patients by a surfeit of physiological variables or results, and this ‘noise’ denigrates the handover proce...

Investigators continue to debate whether gender plays any role in patient outcome following injury/critical illness. We submit that age and hormonal milieu at the time of injury, rather than gender, are the critical factors influencing patient outcome under those conditions.

The re-emergence of infection due to multidrug-resistant Gram-negative bacteria in critically ill patients presents particular challenges to clinicians, given the lack of a pipeline of new antibiotics active against these resistant strains. Infected patients have a worse outcome than non-infected patients, although the additional contribution of antimicrobial resistance is less easy to define. ...

Modern travel and military operations have led to a significant increase in the need to provide medical care in extreme climates. Presently, there are few data on what happens to the doctor, their drugs and equipment when exposed to these extremes. A review was undertaken to find out the effects of 'extreme heat or cold' on anaesthesia and critical care; in addition, subject matter experts were...

Albumin is a frequently prescribed drug in hospitalized patients, and its effect on clinical outcomes has been scrutinized in recent years. Data from meta-analyses has suggested harm related to albumin therapy in critically ill patients, and new observational data are consistent with these results. However, appropriately powered randomized, controlled trials have shown albumin to be safe in bro...

Nurses play a vital role in A&E, monitoring patients' physiological responses to stress and disease, and identifying any deterioration in their condition so that appropriate treatment can be instigated. This article describes the monitoring techniques used in A&E to assess critically ill patients.

Page 1 of 3 (page number not for citation purposes) The Critical Care Canada Forum was held in Toronto, Canada from 11 to 13 November 2008. This internationally recognized conference focuses on topics relevant to the care of critically ill patients, wherever these patients are located. The conference was attended by 1,146 healthcare professionals and featured 191 presentations covering many div...

For decades, the standard technique for tracheostomy was the open, surgical technique. However, during the past 20 years, the use of percutaneous dilatational tracheostomy has been increased and shown to be a feasible and safe procedure in critically ill patients. The purpose of this report is to review the percutaneous dilatational tracheostomy technique, describe the role of bronchoscopy as g...

Care of the critically ill patient is becoming increasingly complex. Protocols, which standardize care of patients with similar diseases, represent a potential solution to managing multiple simultaneous problems in critically ill patients. In this article, we examine the advantages and disadvantages to care protocolization, and posit that careful and thoughtful implementation of protocols is li...