Critical Care and Shock

Years ago, I remember vividly reading an article by the
late Dr. Roger Bone, where he described his emotions and
experience with his illness. I was quite captivated by
such description that I though, eventually I would write a
similar piece. However, to my surprise, over the past weeks
I have encountered an unprecedented feeling towards the
practice of medicine that involved caring for one of my best
friends.

Traditionally, cardiopulmonary resuscitation (CPR) has been the main tool for treating victims of cardiac arrest. This therapeutic modality has been known for millennia, and despite its widespread use for the last five decades, it has had only few modifications. The popular belief that CPR is an effective approach for patients with cardiopulmonary arrest has been supported by television medical drama series that always show CPR as a medical icon.

Hypertension remains the “silent killer”. Over 72 million Americans suffer from this condition and it is estimated that as many as 1 billion people worldwide may have it [1]. Critical care clinicians are likely to encounter patients with this malady. Indeed, one percent of patients with essential hypertension (HTN) will develop at some point in their life a hypertensive crisis [2].

In the year 2008, knowledge and technology develop continually in every field of our lives, and, with no exception, in critical care medicine as well. This continuous growth is implicit in our daily activities. We could not imagine our lives today without it. Nowadays, as health care professionals, we surely do not want a fever to last for one week before we can make a diagnosis of typhoid fever for our patients. We can use some simple tests instead and institute prompt therapy.