ICU and You

This week

The young adult

Eighteen to thirty. The most physiological reserve you will ever treat, and the narrowest margin once it is spent — they hold their numbers long after the loss is serious, and then go all at once. Almost everything that brings them in is something that happened rather than something that grew. And pregnancy sits squarely in this band, which an adult unit forgets.

• Podcast60

  Just imagine the bump isn’t there

  Katie Cranfield on FICM Learning. Half of the women who die in the UK are not dying of anything obstetric — they are dying of what we deal with every day. Fetal fixation, the creatinine that does not flag, and why a tertiary unit admitting thirty a year cannot be fluent in them.

  Open
• Journal club101

  Nineteen, in a children’s unit

  Young adults with severe sepsis died more often in paediatric units than adult ones — 13.5% against 8.2%. The odds ratio rests on twenty-two deaths, there is no adjustment for how sick anyone was on arrival, and the authors say plainly that the thing they adjusted for is the thing they could not measure.

  Open
• Mind map36

  The young adult

  Four stations: the reserve that hides deterioration, what actually brings them in, the pregnant patient, and what outlasts the admission. Several lines contradict what is normally taught — the Australian causes of maternal death are not the classic quartet, and there is no four-minute rule.

  Open