Too Tall for Guatemala

I was clearly out of place. I came to the highlands of Guatemala during my fourth year of medical school to study Spanish, work in a rural clinic, and experience a different way of life. For a month, I lived with a Guatemalan family, ate plantains with every meal, and generally tried to immerse myself in the rich Mayan culture surrounding me. Almost a year later, my Spanish is fading fast. The handful of days I spent in volunteer clinic is a distant memory at this point. Why did I go there again? I was the epitome of an outsider. I came down with Montezuma’s revenge, just like all of my American classmates who traveled there with me. Despite its location in tropical Central America, Guatemala is an exceptionally mountainous country and despite all the warnings from the program’s director about the cool climate, I severely under packed. That left me living, eating, and sleeping in my one Patagonia fleece. As a tall American, I towered over the local people and fit very poorly in nearly all things Guatemalan. I rode buses with my knees under my chin and my head on the ceiling

Clinical information systems in the intensive care unit: primum non nocere

Information and communication technology has the potential to address many problems encountered in intensive care unit (ICU) care, namely managing large amounts of patient and research data and reducing medical errors. The paper by Morrison and colleagues in the previous issue of Critical Care describes the adverse impact of introducing an electronic patient record in the ICU on multi-disciplinary communication during ward rounds. The importance of evaluation and technology assessment in the implementation and use of new computing technology is highlighted

Mobile technology: students perceived benefits of apps for learning neuroanatomy

Technology enhanced learning is expanding rapidly, due to research showing the benefits for learners in terms of engagement, convenience, attainment and enjoyment. Mobile learning approaches are also gaining in popularity, particularly during practical classes and clinical settings. However, there are few systematic studies evaluating the impact of tablet devices on students’ learning in practical settings. The main aim of this three-year study was to gather rigorous evidence about students’ use of apps on a pre-configured tablet device in a neuroanatomy practical class, their perceptions of this and the impact of the intervention on learning outcomes, using data collected from three cohorts of students between 2011 and 2013. Results showed that students made extensive use of resources provided, and considered the devices to be beneficial for learning, and found them to be easy to use with minimal support and training. Students’ ownership of touch screen devices increased significantly during the trial period as did their use of devices for academic study. Analysis of examination scores showed a statistically significant increase in performance for neuroanatomy related questions after the introduction of tablet devices

Pro/con debate: Should synthetic colloids be used in patients with septic shock?

You have recently heard reports that synthetic colloids may be associated with renal failure and other morbidities in certain populations of critically ill patients. You have been asked by the hospital chief of staff whether there should be a suspension of the use of synthetic colloids until further information is available. You need to make a decision

Wireless technology in the ICU: boon or ban?

Wireless communication and data transmission are playing an increasing role in the critical care environment. Early anecdotal reports of electromagnetic interference (EMI) with intensive care unit (ICU) equipment resulted in many institutions banning these devices. An increasing literature database has more clearly defined the risks of EMI. Restrictions to the use of mobile devices are being lifted, and it has been suggested that the benefits of improved communication may outweigh the small risks. However, increased use of cellular phones and ever changing communication technologies require ongoing vigilance by healthcare device manufacturers, hospitals and device users, to prevent potentially hazardous events due to EMI