WILKINSON & SHEERIN
Good Housekeeping: STRESS ULCER and VTE prophylaxis
Andy Wilinson and Eamonn Sheerin are registrars currently working in ICU in Sydney. They are relatively new to ICU and have been looking into why we do some of what we do on our daily ward rounds.
This podcasts focuses on ways of remembering the important things that can be forgotten, and in particular stress ulcer prophylaxis and venous thromboembolism (VTE) prophylaxis.
Click READ MORE for the podcast, and links…
Listen to the talk here:
For more on FAST HUG IN BED Please look here
The alternative (more hardcore) version is DANISH BUG FEST
D e-escalte – especially anti-biotics, review other meds that may no longer be needed
A nalgesia – Is that why they’re hypertensive & tachycardic?
N asogastric Tube – need one? Need to remove one?
I ndwelling Catheter – Pull it out ASAP
S edation – What’s the RASS? Can you cut back?
H ead of bed 30 degrees – Not amazing evidence but we do it.
B owel care – Many patients need aperiants. Look for, prevent and investigate diarrhoea.
U lcer prophylaxis – listen to the podcast!
G lycaemic control – here’s a podcast & review
F eeding and Fluids – are you feeding? what are you giving? should you be giving less fluid?
E nvironment – think delirium avoidance. Prevention is better than cure! What would you want in ICU?
S kin – pressure areas can get infected; rashes may be significant.
T hromboembolism prophylaxis – listen to the podcast!
Notes to go with the stress ulcer prophylaxis section:
Notes to go with the VTE prophylaxis section:
- In the absence of appropriate prophylaxis, the incidence of DVT in hospital patients where objective diagnostic screening tests have been used to detect asymptomatic events has ranged from 10 to 80 percent in various medical and surgical groups.
- The PROTECT trial
- In a 2002 meta-analysis of four available trials, it was concluded that the efficacy of fondaparinux was superior to that of enoxaparin
- Cochrane meta-analysis has concluded that the use of IPC alone was effective in the prevention of DVT in surgical patients (relative risk reduction 54 percent; 95% CI 42 to 63)