Other bulletins in this series include:

Breast Surgery

Wednesday, 27 February 2008

Choices, choices

At the moment this site includes a newsfeed from Emergency Care Specialist Library but this is just one of many possibilities. If you prefer you could have the Health Management or Palliative Care newsfeeds. Which ones would you prefer? Use the comments facility to vote for your selection.

The full list of specialist libraries can be viewed at: http://www.library.nhs.uk/SpecialistLibraries/

Tuesday, 26 February 2008

Survival from in-hospital cardiac arrest during nights and weekends

20/02/08 - Link to abstract here.

JAMA 2008;299(7):785-792
Access: Full-text online access to this article requires subscription to the journal.

Publication Date: 20 Feb 2008
Publication Type: Observational Study
Publisher: Journal of the American Medical Association, American Medical Association

Terminal sedation and the "imminence condition".

J Med Ethics. 2008 Feb;34(2):69-72.
Cellarius V.

Temmy Latner Centre for Palliative Care, Mt Sinai Hospital, Box 13, 60 Murray St, Toronto, Ontario, Canada. victor.cellarius@utoronto.ca

"Terminal sedation" refers to the use of sedation as palliation in dying patients with a terminal diagnosis. Although terminal sedation has received widespread legal and ethical justification, the practice remains ethically contentious, particularly as some hold that it foreseeably hastens death. It has been proposed that empirical studies show that terminal sedation does not hasten death, or that even if it may hasten death it does not do so in a foreseeable way. Nonetheless, it is clear that providing terminal sedation in combination with the withholding or withdrawing of life-prolonging treatments such as fluid and nutrition can foreseeably hasten death significantly-what is here called early terminal sedation (ETS). There are ethical justifications for the use of sedation in palliative care and thus it would seem that ETS is an ethically and legally acceptable practice. However, what emerges from the literature is the repeated assertion that terminal sedation must be restricted to use in imminently dying patients--the "imminence condition"--and that therefore ETS is unacceptable.

This restriction has taken on greater significance with the trend of palliative care to include the care of patients who are not imminently dying. This paper proposes to show that although there is widespread intuitive support for the imminence condition, it does not follow from the justifications for sedation as palliation, and that explicit arguments for the imminence condition are needed.

PMID: 18234940 [PubMed - in process]

Welcome to the Critical Care Bulletin

This is an experiment to publish articles of relevance to our ITU staff. If all goes well, they should be able to sign up to receive regular updates which will take the place of the bulky paper documents previously circulated.

Monday, 25 February 2008


From the Eur J Clin Microbiol Infect Dis. 2008 Feb 13 - PubMed

Humphreys H.

Care bundles

Click the link below to visit the full article.