Early mobilization in the critical care unit: A review of adult and pediatric literature.

Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Alternative airway management devices in emergency medicine: pros and cons

Supraglottic airway devices (laryngeal mask, laryngeal tube) are still used in the algorithm of the expected and unexpected difficult airway. Data on prehospital and outpatient airway management are heterogeneous and sometimes contradictory. This paper critically discusses the use of the laryngeal tube in preclinical emergency medicine and shows clear advantages and disadvantages of its use. Pro: it is argued that the laryngeal tube is a valuable alternative to endotracheal intubation in prehospital management of the difficult respiratory tract in the hands of the experienced user and it should not be abandoned at present. Contra: there is evidence from several studies showing a high complication rate when using the laryngeal tube. With this in mind, the use of the laryngeal tube in resuscitation outside a strict indication should currently be viewed critically