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iPad hands on review: Fits in your white coat and is fast enough for Medical point of care use [Healthcare Perspective]

April 13th, 2010 Dr. Birdi No comments

iPad hands on review: Fits in your white coat and is fast enough for Medical point of care use [Healthcare Perspective]

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Categories: ICU 2.0, Resources Tags:

Poll: End of Life decisons

January 24th, 2010 Dr. Birdi No comments
Categories: Resources Tags:

End of Life Decisions – UPDATED!

January 24th, 2010 Dr. Birdi No comments

It really starts with you. As taboo as the topic may be, its a must for every individual to think about this and most importantly discuss it with the ones you love most. This is the most effective way to ensure that your wishes are truly upheld.

Here’s a great tool available online – The One Slide Project

theoneslide

Here is a link to the US Living Will Registry where you can find out more specific information. The link takes you directly to the state specific forms.

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Updated Minutes now iPhone friendly!

July 20th, 2009 Dr. Birdi No comments

I apologize for the long delay between posts but I have been working on getting some updates into the website. As you can see, our theme is entirely different and starting today – We are iPhone friendly! :) now you can visit anytime and have the same ease of use that you do from the computer at home or work. Enjoy!

Categories: ICU 2.0, Website Logistics Tags:

How do you assess quality of care in the Intensive Care Unit?

May 21st, 2009 Dr. Birdi No comments

Several measures of ICU performance have been proposed in the past 30 years. It is intuitive, and correct, to assume that ICU mortality may be a useful marker of quality. However, crude mortality rates does not take into consideration the singular aspects of each specific patient population that is treated in a certain geographic region, hospital or ICU. Therefore approaches looking for standardized mortality ratios that are adjusted for disease severity, comorbidities and other clinical aspects are often sought. Severity of illness is usually evaluated by scoring systems that integrates clinical, physiologic and demographic variables. Scoring systems are interesting tools to describe ICU populations and explain their different outcomes. The most frequently used are the APACHE II, SAPS II and MPM. However, newer scores as APACHE IV and SAPS III have been recently introduced in clinical practice. More than only using scoring systems, one should search for a high rate of adherence to clinically effective interventions. Adherence to interventions as deep venous thrombosis prophylaxis, reduction of ICU-acquired infections, adequate sedation regimens and decreasing and reporting serious adverse events are essential and have been accepted as benchmarking of quality.

The complex task of collecting and analyzing data on performance measures are made easier when clinical information systems are available. Although several clinical information systems focus on important aspects as computerized physician order entry systems and individual patient tracking information, few have attempted to gather clinical information generating full reports that provide a panorama of the ICU performance and detailed data on several domains as mortality, length of stay, severity of illness, clinical scores, nosocomial infections, adverse events and adherence to good clinical practice. Through implementing quality initiatives, increasing the quality of care and patient safety are major and feasible goals. Such systems are available for clinical use and may facilitate the process of care on a daily basis and provide data for an in-depth analysis of ICU performance.

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FDA to convene May 28th to discuss Sedasys Sedation System

May 19th, 2009 Dr. Birdi No comments

FDA’s anesthesiology and respiratory therapy devices advisory committee will meet May 28 in Gaithersburg, Md., to discuss Johnson & Johnson/Ethicon Endo-Surgery’s pre-market approval application for its Sedasys computer-assisted personalized sedation system, indicated for minimal to moderate sedation in adult patients undergoing colonoscopy and esophagogastroduodenoscopy procedures.

This is certainly going to spark some fireworks on both sides of the court. Can this really replace anesthesiologist presence in the GI suite? Lets see what the FDA has to say. In my opinion, we should certainly not jump to quick legislation and really put patient safety at the forefront! Just because it can be done DOESN’T mean it should be done.

Here is information about this controversial and potentially game changing technolology from JnJ.

Ethicon Endo-Surgery announced that the results from its pivotal trial demonstrated physician/nurse teams using the SEDASYS™ System reduced the risk of over sedation with propofol in patients undergoing screening and diagnostic procedures for colorectal cancer (colonoscopy), and disorders of the upper gastrointestinal tract (EGD). The study [...] included 1,000 subjects who underwent sedation for colonoscopy and EGD at eight sites and compared the SEDASYS™ System to the current standard of care for sedation (midazolam plus fentanyl or meperidine). Results were included in Ethicon Endo-Surgery’s PreMarket Application (PMA) for approval of the SEDASYS™ System, which is currently in review with the U.S. Food and Drug Administration.
Read more…

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