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British Journal of Anaesthesia, 2003, Vol. 90, No. 5 699-702
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Correspondence

Outreach critical care—cash for no questions?

E. Williams1, C. P. Subbe1, L. Gemmell1, R. J. M. Morgan2, G. R. Park3, M. McElligot3, C. Torres3 and B. H. Cuthbertson4

1 Wrexham, UK 2 Blackpool, UK 3 Cambridge, UK 4 Aberdeen, UK

The first 150 words of the full text of this article appear below.

Editor—We read with interest the Editorial by Cuthbertson, ‘Outreach critical care—cash for no questions?’,1 but we were startled by some of its omissions and conclusions. The call to break down the walls of the ICU has nothing to do with touchy-feely new age medicine, but is a very real cry for help from nurses and clinicians in general medicine and surgery for skills and knowledge in dealing with an increasingly sick population. For this reason outreach has to be, by definition, multidisciplinary.

Critical Care Outreach operates around three principles: (i) early detection of patients at risk of catastrophic deterioration; (ii) early treatment; and (iii) fault analysis. The means to achieve these are essentially educational.

(i) Contrary to Cuthbertson’s statement, the Modified Early Warning Score (MEWS) has been validated with data on sensitivity and specificity of the total score and its elements being in the public domain.2 Considering that MEWS is . . . [Full Text of this Article]


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