No abstract

Summary A telephone survey was carried out to determine how many United Kingdom intensive care units were using therapeutic hypothermia as part of their management of unconscious patients admitted after cardiac arrest. All 247 intensive care units listed in the 2008 Directory of Critical Care Services were contacted to determine how many units were using hypothermia as part of their post‐cardiac arrest management and how it was implemented. We obtained information from 243 (98.4%) of the intensive care units. At the time of the study, 208 (85.6%) were using hypothermia as part of post‐cardiac arrest management. There has been a steady increase annually in the number of units performing therapeutic cooling from 2003 to date, with the majority of units starting in 2007 or 2008. The International Liaison Committee on Resuscitation guidelines, which recommend the use of therapeutic hypothermia for comatose patients following successful resuscitation from cardiac arrest, have taken at least 4–5 years to achieve widespread implementation in the United Kingdom.

Among OHCA patients who met recognised inclusion criteria, therapeutic hypothermia was implemented successfully by the ED staff. The temperature should be measured continuously from the same site in both the ED and the ICU. This will provide consistent and continuous temperature monitoring between the ED and the ICU and will enable prompt intervention to prevent temperature increases.

No abstract

This chapter describes the role of corticosteroids in pain management. The overview section discusses both the classes of steroids and the British Pain Society’s recommendations of their use in neuraxial pain interventions. This chapter further discusses comparative potencies, along with the mode of action, effects, and side effects of triamcinolone, methylprednisolone, betamethasone, dexamethasone, and hydrocortisone. Finally, this chapter also includes a ‘steroid passport’, specially useful in chronic pain patients who can keep a log of all steroid injections that they can receive.