Rules for a routine electroencephalogram recording

Electroencephalography (EEG) is the primary method for functional assessment of the brain bioelectrical activity. It is the most effective for epilepsy diagnosing, and also used for localization of the epileptogenic zone in presurgical evaluation for pharmaco-resistant epilepsy and in critical care medicine. In practice, the most common type is a 'routine' EEG, the informative value of which depends largely on the accuracy of its performance. The paper briefly outlines the rules for performing a routine EEG and lists the most common mistakes that can affect its interpretation.

Assessment of physician training and prediction of workforce needs in paediatric cardiac intensive care in the United States

Objective: To assess the training and the future workforce needs of paediatric cardiac critical care faculty. Design: REDCap surveys were sent May−August 2019 to medical directors and faculty at the 120 US centres participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database. Faculty and directors were asked about personal training pathway and planned employment changes. Directors were additionally asked for current faculty numbers, expected job openings, presence of training programmes, and numbers of trainees. Predictive modelling of the workforce was performed using respondents’ data. Patient volume was projected from US Census data and compared to projected provider availability. Measurements and main results: Sixty-six per cent (79/120) of directors and 62% (294/477) of contacted faculty responded. Most respondents had training that incorporated critical care medicine with the majority completing training beyond categorical fellowship. Younger respondents and those in dedicated cardiac ICUs were more significantly likely to have advanced training or dual fellowships in cardiology and critical care medicine. An estimated 49–63 faculty enter the workforce annually from various training pathways. Based on modelling, these faculty will likely fill current and projected open positions over the next 5 years. Conclusions: Paediatric cardiac critical care training has evolved, such that the majority of faculty now have dual fellowship or advanced training. The projected number of incoming faculty will likely fill open positions within the next 5 years. Institutions with existing or anticipated training programmes should be cognisant of these data and prepare graduates for an increasingly competitive market.

Psychological Considerations in the Intersection of Infectious Disease with Critical Care Medicine

This chapter discusses the intersection between infectious disease and critical care and how it has impacted the delivery of critical care medicine as well as the ability to provide rehabilitation and psychological intervention. It also considers the psychological implications for critical care staff, relationships at work and team dynamics, and the requirements for staff support. Specific issues encountered during worldwide pandemics are also reviewed, along with implications for future practice. The family of coronavirus illnesses are highlighted, including Middle East respiratory syndrome, severe acute respiratory syndrome, and coronavirus, which causes coronavirus disease (COVID-19). Similarities and differences between practices in the United Kingdom and United States are also discussed.