Improving Decision Making in Intensive Care

Many decisions are made during a day’s work in critical care. Should this octogenarian with pneumonia and cancer be admitted to the ICU or left on the ward with palliative care? And if admitted to the ICU, will she benefit from being ventilated or should she only be treated with antibiotics and inotropes? How long should we continue administrating antibiotics in a patient with peritonitis due to anastomotic leakage after low anterior resection? Will antibiotics do the job or does he have to go back to the operating theatre? Should we give more fluids in a patient with shock, should we start vasoconstrictors or vasodilators or should we accept this low blood pressure? Continue treatment with a curative intent or accept the inevitable? Act on a laboratory result or stop ‘just treating the numbers’?

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