1. Venous thromboembolism in the critically ill:
a. Patients should routinely undergo ultrasound scanning to detect asymptomatic deep venous thrombosis.
b. Raised D-dimer is useful in the diagnosis of deep venous thrombosis.
c. An IVC filter should be placed prophylactically in trauma patients.
d. A paper reviewed in this issue of the Monitor indicates that a prophylactic placement of an IVC filter in trauma patients is associated with development of deep venous thrombosis.
2. Acute kidney injury (AKI):
a. Is not an independent predictor of mortality in patients with multi-organ failure.
b. Occurs in less than 5% of critically ill patients.
c. In patients with hepatorenal syndrome the urine sodium concentration is typically <20 mmol/l.
d. A study reviewed in this issue of the Monitor suggests that nephrologist follow up of patients with AKI requiring dialysis reduces mortality.
a. Early enteral nutrition within the first 24 hours of ICU admission reduces mortality.
b. Patients who cannot be fed enterally within the first 3 days of ICU admission should be fed parenterally.
c. Addition of glutamine to parenteral feed does not improve income.
d. A study reviewed in this issue of the Monitor confirms the importance of monitoring gastric residual volume reduces the risk of ventilator-associated pneumonia in patients receiving enteral feed.
4. Infection control:
a. Hand hygiene should be performed both after touching the patient and after using a bedside clinical information system.
b. Washing hands that are not visibly soiled with antiseptic and water is more effective than using alcohol hand rub.
c. Airborne precautions should be used for patients with untreated smear negative pulmonary tuberculosis.
d. A paper reviewed in this issue of the Monitor demonstrates that universal use of gloves and gown reduces nosocomial transmission of bacteria.