The history and future of intensive care units
Editor – I very much enjoyed the fascinating review on the history and future of intensive care units (ICUs) (Clin Med August 2014 pp 376–9) but wanted to highlight two points. Firstly, the author's comment that cooling patients to 33°C is now common. A recently published targeted temperature management trial showed no benefit from cooling to 33°C versus maintaining controlled normothermia at 36°C.1 Indeed, the International Liaison Committee on Resuscitation put out an update statement acknowledging local ICUs may choose to aim for controlled normothermia as opposed to hypothermia.2 This is our local practice. Secondly, the authors state the formation of a stand-alone intensive care medicine (ICM) certificate of completion of training (CCT) should make training more accessible to physicians. However, the current Faculty of ICM (FICM) guidelines only accept dual CCT with a limited number of specialties namely; respiratory, renal and acute medicine (as well as anaesthesia and emergency medicine).3 Therefore, although the new system opens ICM registrar training to those from the core-medical training, it has shut the door on dual qualifying with varied specialities. Specifically, one cannot currently qualify in cardiology and ICM, which was stated as a possibility in the article. Furthermore, there is currently no linking of the curricular or portfolios for the dual CCTs between the FICM and Royal College of Physicians. This means undertaking this training route is associated with an enormous administrative burden merely to prove competency.
Footnotes
Please submit letters for the editor's consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine{at}rcplondon.ac.uk
- © 2014 Royal College of Physicians
References
- 1.↵
- 2.↵
- Jacobs I,
- Nadkarni V
- 3.↵
- The Faculty of Intensive Care Medicine
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