Analysis of Difficult Tracheal Intubation Based on Video Records Using a Macintosh Type Video Intubating Laryngoscope in Adult

To assess the incidence of the difficult intubation and evaluate its clinical characteristics, we analyzed 964 cases of video records of tracheal intubation by Macintosh type video laryngoscope (MVL; X-Lite video^[○!R]: Rusch, Germany). The views during the laryngoscopy were recorded on a video system, and the number of intubation attempts and total attempt times were measured afterwards. The video laryngoscope grade (V-grade) was determined based on the Cormack & Lehane grade (C-grade), and its correlation with the Mallampati classes (MP), the number of intubation attempts, and total attempt time were analyzed. V-grade 3 was defined as a difficult intubation, and morphological measurement of the head and neck regions was performed postoperatively. Of the 964 patients, 522, 416, and 26 patients were classified into V-grade 1, 2 and 3, respectively, and the number and time of attempts significantly increased with the grade (p<0.05). The V-grades were significantly correlated with the MP classes and the number and time of attempts (p<0.0001). At least 1 of the 3 morphological measurement items was abnormal in the 26 patients with difficult intubation in visual assistance and recognition. The use of MVL might facilitate difficult intubation. Its video records were useful for analysis. The postoperative morphological feature was consistent with previous reports where MVL was not used

Critical Care Medicine: Bangladesh Perspective

Bangladesh became an independent and sovereign country in 1971 following a nine-month blood shedding liberation war. Bangladesh has a population of about 152.25 million, making it one of the most populous countries in the world. Intensive care is an emerging but less emphasized concept in Bangladesh. The first intensive care unit (ICU) in Bangladesh was established in the National Institute of Cardiovascular Diseases (NICVD) in 1980. Since then many ICUs have been established. In Bangladesh there is no governing body like Bangladesh Medical and Dental Council (BMDC) that can set the standard of such units. There are no reliable statistics regarding the number of both governmental and private ICUs, bed capacities, no. of patients getting admitted per month, services offered, equipment, qualification of health professionals, cost/benefits and mortality rates of these ICUs

Critical Care Medicine: Bangladesh Perspective

Bangladesh became an independent and sovereign country in 1971 following a nine-month blood shedding liberation war. Bangladesh has a population of about 152.25 million, making it one of the most populous countries in the world. Intensive care is an emerging but less emphasized concept in Bangladesh. The first intensive care unit (ICU) in Bangladesh was established in the National Institute of Cardiovascular Diseases (NICVD) in 1980. Since then many ICUs have been established. In Bangladesh there is no governing body like Bangladesh Medical and Dental Council (BMDC) that can set the standard of such units. There are no reliable statistics regarding the number of both governmental and private ICUs, bed capacities, no. of patients getting admitted per month, services offered, equipment, qualification of health professionals, cost/benefits and mortality rates of these ICUs

Teaching paediatric critical care medicine to paediatric residents

Critical care training during paediatric residency provides an ideal opportunity to learn and refine the skills needed in the early recognition and prompt treatment of the acutely ill paediatric patients. Paediatric critical care medicine is a relatively young sub-specialty in Pakistan. The aim of this study is to describe our experience of teaching paediatric residents in paediatric critical care medicine during paediatric intensive care unit rotation. Our paediatric critical care teaching curriculum for residents is based on the spectrum of our common critical care problems along with basic principal of critical care. The clinical rotation in our paediatric intensive care unit is very dynamic, thrilling, enjoyable and provides a lot of learning opportunities. During the rotation, the residents were exposed to all major critical care illnesses in infants and children. We use four traditional models of learning in our Paediatric Intensive Care Unit (PICU): bedside rounds, direct patient care, didactic learning and self-study. Our curriculum enhances the resident\u27s educational and clinical experience of paediatric intensive care medicine

Citation classics in critical care medicine

Objective: The number of citations an article receives after its publication reflects its impact on the scientific community. Our purpose was to identify and examine the characteristics of the most frequently cited articles in the field of critical care medicine. Design: The 74 top-cited articles in critical care journals were identified by a computer search using the database of the Science Citation Index Expanded (SCI-EXPANDED, 1945 to present) and the Web of SCIENCE. The 45 top-cited critical care articles in all other biomedical journals were identified using the database SciSearch (1974 to present) with the key word "Critical Care”. Results: The most cited articles received 3402 and 2860 citations, respectively. The citation classics in critical care journals were published between 1968 and 1999 in six high-impact journals, led by Critical Care Medicine (37 articles), followed by the Journal of Trauma (21), and American Journal of Respiratory and Critical Care Medicine (9). Seventy articles were original publications, two were reviews or guidelines, and two were editorials. The top 45 classic articles in non-critical care journals were published in 13 different journals, led by the New England Journal of Medicine (11 articles), followed by JAMA and Lancet (6 articles each). The United States of America contributed most of the classic articles. Pathophysiology of the lung, sepsis and scoring systems were the primary focus of classic publications. Conclusions: Our analysis gives a historical perspective on the scientific progress of critical care medicine and allows for recognition of important advances in this specialt

Implementing the SCCM Family-Centered Care Guidelines in Critical Care Nursing Practice

Family-centered care is an important component of holistic nursing practice, particularly in critical care, where the impact on families of admitted patients can be physiologically and psychologically burdensome. Family-centered care guidelines, developed by an international group of nursing, medical, and academic experts for the American College of Critical Care Medicine/Society of Critical Care Medicine, explore the evidence base in 5 key areas of family-centered care. Evidence in each of the guideline areas is outlined and recommendations are made about how critical care nurses can use this information in family-centered care practice.</jats:p