Latest news with #intensivecare
Daily Mail
4 hours ago
- General
- Daily Mail
Consultant missed 'high-risk indicators' girl, 13, was suffering from sepsis and should have sent her to intensive care, tribunal rules
A 13-year-old girl died from sepsis after a senior doctor missed 'high-risk' signs of the condition and didn't send her to intensive care, a tribunal has ruled. Martha Mills was an inpatient on the Rays of Sunshine Ward at King's College Hospital in London after she suffered a serious injury to her pancreas when she slipped while riding a bike on a family holiday in Wales in July 2021. Weeks later she experienced a fever, increased heart rate and had a catheter inserted into her vein, which is said to have been a likely source of the deadly infection, the Medical Practitioners Tribunal Service (MPTS) hearing was told. More spikes in her temperature followed, before consultant hepatologist Professor Richard Thompson saw Martha on his morning ward round on August 29 at the hospital. The on-call consultant left the hospital at 3pm, but was phoned at home two hours later by a trainee doctor, who gave an update on Martha's condition. Martha collapsed on August 30 and was moved to intensive care, before she was transferred to London's Great Ormond Street Hospital, where she died in the early hours of August 31. At a 2022 inquest into her death a coroner ruled Martha would most likely have survived if doctors had identified the warning signs and transferred her to intensive care earlier. Medical records showed she had deteriorated over the course of the afternoon, and into the early evening, with a drop in her blood pressure, the appearance of a new rash and increases in heart rate, respiratory rate and body temperature. Tribunal chairman Robin Ince noted that by 5pm there were 'several high-risk indicators' as set out in the Nice guidelines relating to sepsis. He said: 'These changes collectively indicated a sudden and significant deterioration for no clearly identified was evident that by around 5pm the clinical condition of Martha justified escalation to PICU (paediatric intensive care unit) and this opportunity was not taken.' The duty registrar called Prof Thompson again at 8.30pm because of ongoing concerns over Martha's fever, but she was kept on the ward despite the continued presence of moderate to high-risk signs and the absence of meaningful clinical improvement, said the tribunal. Mr Ince said: 'The tribunal notes that Professor Thompson expressed a preference to prearrange any PICU involvement, rather than having PICU clinicians arrive unexpectedly and cause distress to Martha's parents. 'While the tribunal understands the desire to manage the family anxiety sensitively, this did not, in its view, justify withholding or delaying a clinically indicated escalation of care.' He added: 'The tribunal therefore concluded that the GMC (General Medical Council) has proved its case that Professor Thompson failed to take more aggressive intervention from 12 noon onwards in that he did not escalate Martha to the PICU team for a direct clinical review.' The tribunal also ruled that Prof Thompson should have conducted a direct in-person review and assessment of Martha, including the developing rash, from 5pm, which would have been 'beneficial'. Mr Ince said: 'He would no doubt have discovered that no observations had been taken in respect of Martha from 2pm to at least 4.45pm. 'The tribunal notes that one of the advantages of escalating a patient to PICU would have been an increased level of monitoring. 'Although no explanation has been given to the tribunal for the failure to monitor Martha between 2pm and 4.45pm, this absence of monitoring on the ward would no doubt have been a significant factor in justifying such an escalation.' The tribunal cleared Prof Thompson of the GMC's allegations that he gave 'outdated, misleading' information on Martha's condition to a consultant colleague in the intensive care unit, and that he failed to mention her rash. Martha's mother, Merope Mills, an editor at The Guardian, said she and her husband, Paul Laity, raised concerns about Martha's deteriorating health a number of times but these were not acted on. The couple later successfully campaigned for Martha's Rule to give patients, families and carers the chance to easily request a second opinion from a senior doctor in the same hospital in the event of a suspected deterioration or serious concern. The MPTS hearing in Manchester continues as the tribunal considers whether Prof Thompson's fitness to practice is impaired.
BreakingNews.ie
a day ago
- General
- BreakingNews.ie
CHI audit finds paediatric critical care units 'under strain'
An audit of the country's two paediatric critical care units, at Crumlin and Temple Street, has found that while they deliver high-quality care, the system is under strain. The number of children admitted to adult intensive care units doubled to 148 cases in 2023. Advertisement The National Office of Clinical Audit found high bed occupancy rates, that were above 95 per cent, and says more investment is needed. The Minister for Health Jennifer Carroll MacNeill has said that one of her major concerns is how waiting lists are managed which was why she had called for an overall audit of how waiting lists are managed 'across the board in CHI'. Speaking on RTÉ radio's Morning Ireland, Ms Carroll MacNeill said that as Minister she needed to ensure that the public system was working in the most productive way 'during the public hours that consultants are paid to do public work in a public hospital. 'What's not acceptable and what the concern is here is that those procedures are not happening quickly enough or in a sufficiently efficient way and that they're becoming such long waiters that NTPF intervention is required. Advertisement 'So my underlying issue is, how are those lists being managed? So what I've done is, Bernard Gloster and I have decided to have an overall audit of how are these waiting lists managed generally across the board in CHI in every discipline to ensure that that's not being replicated.' Ms Carroll MacNeill urged concerned parents to 'just sit with me and sit with the NTPF for a number of days, for a week or 10 days to allow the NTPF to do their work". 'This is something where the NTPF absolutely need assurance that this is being done correctly but what they also need is to make sure that there is no mismanagement of lists such that a child is waiting so long that they are required to be on the NTPF list where there could have been an earlier surgical intervention. 'And that is the bigger issue here. That is the bigger issue and that is what raises such particular concerns around the issues in this report but it also raises the broader patient safety concerns and what we need to do is make sure that that is happening in the most productive way in the public system in every discipline.' Advertisement The Minister said that in addition to the audit there would be a change to a centralised referral mechanism which would mean that if a child was referred to a consultant surgeon, they would not be referred to an individual surgeon, but into a central referral mechanism. 'Which means that the hospital can assess who has the shortest list, who has capacity to do this, rather than being sort of assigned to or stuck with an individual, who then has the capacity to do things at whatever pace, and some of them are doing very efficiently, and others less so.' 'We need to make sure and the NTPF need to make sure, and I need to make sure, Bernard Gloucester needs to and the CHI need to make sure that there are no perverse practices or no perverse incentives from the way in which waiting lists are managed. 'So I would ask parents to just sit with me just for a week or 10 days to allow the NTPF to get these assurances and to do their work. The NTPF have already assured that existing surgery scheduled will not be impacted but our concern is we need to make sure that this isn't happening anywhere else in the system.' Advertisement Ms Carroll MacNeill acknowledged that the NTPF had only recently discovered that there had not been a referral to the National Patient Safety Office. 'Let's not underestimate the impact of that, nor was there a referral to the department or a notification to any of us. So that's not a satisfactory way of managing that, and I expect that to be very, very different. There is no CHI without the state. The state is the funder of all of these services, and people who work in CHI, both at executive level, but let me be very clear, consultants in CH , and everybody who is in CHI is a public servant, and it is important that they understand that.'
The Sun
3 days ago
- General
- The Sun
Woman, 24, left battling fatal ‘muscle death' condition triggered by her first ever spin class
A WOMAN landed in intensive care with a fatal condition triggered by pushing herself too much during her first spin class. The 24-year-old had rhabdomyolysis, which is when overworked muscles die, break down and leak toxins into the blood. 1 These toxins can damage the kidneys and cause them to stop working, which can be life-threatening if not treated quickly. Spinning is a high-intensity indoor cycling workout that targets the large muscles in the thighs and glutes. It's hugely popular for its fast calorie burn and endurance boost, but the intense effort can sometimes push beginners too far, medics describing the case in Cureus warned. They said that young women, especially those with high BMIs have "adequate" energy and "muscle bulk" - like the woman in the case report - to do spinning. "This endurance and some over-enthusiasm can lead them to spin for prolonged durations at varying intensities," they wrote. "Combined with dehydration, lack of fitness and the muscle mass of the quadriceps make them more prone to rhabdomyolysis after their first spinning session," they added. Just two days after the class, the unnamed woman was unable to walk upstairs as her thighs throbbed. But her pain was unusually severe, and when her pee turned from clear to brown, she knew something was seriously wrong. She went to hospital where tests showed her creatine kinase levels, a marker of muscle damage, were more than 50 times the normal limit. Tests and scans revealed that muscle cells in her thighs had ruptured, releasing harmful substances like myoglobin into her bloodstream putting severe strain on her kidneys. Bizarre medical case reports Doctors immediately started her on IV fluids to flush the toxins from her system and closely monitored her kidney function to prevent failure. After five days of intensive treatment, her muscle enzyme levels finally dropped, and her kidney function began to improve. She was eventually discharged and made a full recovery - but doctors warn that pushing too hard in a first spin class can trigger this rare, life-threatening condition. "We recommend gradual, low-intensity training or periodic training with adequate hydration and replenishing the fluid loss for all young women engaging in indoor cycling for weight reduction in the early phases of their fitness program," they wrote. "Awareness regarding warm-ups and cool-downs should be given to all beginners involved in indoor spinning," they added. What is rhabdomyolysis? Rhabdomyolysis, called rhabdo for short, happens when muscles are pushed too hard and start to die and break down, releasing toxins into the bloodstream. These toxins can seriously damage your kidneys and even cause kidney failure if untreated. Common causes: Intense exercise (like spin classes or heavy lifting) Muscle injury or trauma Certain medications or infections Symptoms: Severe muscle pain and weakness Swelling and stiffness Dark or brown urine (a key warning sign) Fatigue and fever Why it's dangerous: The toxins released can overload the kidneys, which filter your blood, leading to kidney damage or failure. Treatment: Early hospital care with IV fluids helps flush toxins and protect kidney function. Most people recover fully with prompt treatment. If you experience severe muscle pain after exercise and notice dark urine, get medical help fast.
Telegraph
7 days ago
- General
- Telegraph
Parental intuition can predict child's serious illness before doctor's tests
Parents can sense when their child is becoming seriously ill before their vital signs show it, according to new research. Experts found that in about one in five cases where a child's health worsened while in hospital, parents raised concerns before doctors became aware. Parental intuition was a better indicator of a child needing intensive care than vital readings including heart rate and abnormal breathing, the study found. It comes after the NHS introduced Martha's Rule last year giving patients, including parents, the right to ask for a second opinion. The protocol is named after Martha Mills, who died aged 13 in 2021 from sepsis. Martha's parents, Merope Mills and Paul Laity, raised concerns about their daughter's deteriorating health to doctors on a number of occasions after she was admitted to hospital with a pancreatic injury caused by falling off her bike. A coroner ruled she would most likely have survived if doctors had identified the warning signs of her rapidly worsening condition and transferred her to intensive care earlier. Data from 190,000 hospital admissions For the new study, experts from Monash University in Melbourne, Australia, analysed data from almost 190,000 emergency hospital visits. Parents or caregivers were routinely asked: 'Are you worried your child is getting worse?' In almost five per cent of cases, parents said they were concerned their child was deteriorating. The research team found that this concern was 'significantly' linked to the child being admitted to an intensive care unit (ICU). Children were found to be four times more likely to need ICU admission if parents had raised concerns, compared with children of parents who were not concerned. Researchers also found that parental concern was associated with a higher likelihood that the child would need mechanical ventilation or to be given help to breathe. Parents could prompt earlier treatment The study, published in the journal Lancet Child and Adolescent Health, also found that 'caregiver concern was more strongly associated with ICU admission than any abnormal vital sign', including abnormal heart rate, abnormal breathing or blood pressure. There were 1,900 cases where parental concern was documented along with the timing of abnormal vital signs. The research team noted that in almost one in five cases parents raised concerns about deterioration before vital signs indicated that the child was deteriorating. They added that this could mean that taking parents' views into account could lead to earlier treatment. 'Parents are the experts' Overall, they found that the children of caregivers who voiced concerns were 'more unwell, they were more likely to be admitted to an inpatient ward, and stayed in hospital almost three times as long'. Dr Erin Mills, a lead author from Monash University, said: 'We know that parents are the experts in their children, but stories of parents not being heard, followed by devastating outcomes, are all too common. We wanted to change that.' She said: 'We wanted to test whether parent input could help us identify deterioration earlier – and it can. 'If a parent said they were worried, their child was around four times more likely to require intensive care. That's a signal we can't afford to ignore 'Parents are not visitors – they are part of the care team. We want every hospital to recognise that and give parents permission, and power, to speak up.' In March the House of Commons Health and Social Care Committee was told that thousands of patients or their loved ones have sought a second opinion about their NHS care under Martha's Rule. More than 100 patients have been taken to intensive care 'or equivalent' as a result.
Yahoo
27-05-2025
- Yahoo
Four FRU officers remain in ICU after Teluk Intan crash, condition improving, says police chief
KUALA LUMPUR, May 22 — Four members of the Federal Reserve Unit (FRU) remain in intensive care following a recent road accident, with three being treated at Teluk Intan Hospital and one at Raja Permaisuri Bainun Hospital (HRPB) in Ipoh. The officers currently receiving treatment in the Intensive Care Unit (ICU) at Teluk Intan Hospital are Corporal Haslizal Mohd Ali, 44; Sergeant Mazlan Mat, 50; and Corporal Mohd Izwan Ishak, 39. Corporal Syed Isfan Syed Mohammad, 32, is being treated at the ICU in HRPB, Ipoh. Hilir Perak District Police Chief Assistant Commissioner Bakri Zainal Abidin told Harian Metro that the most recent officer discharged from Teluk Intan Hospital was Sergeant Mohd Parih Ali, 44, at 6.30pm on Tuesday. 'As of this morning (Wednesday), three officers remain in the ICU at Teluk Intan Hospital, and one at HRPB. I pray for their full recovery. Doctors have reported positive developments. 'They are now conscious, stable, and breathing with oxygen support. This was described as a positive sign. Most of their injuries were caused by the impact of the accident. 'Full recovery may take time, but the Hilir Perak District Police Headquarters remains committed to ensuring the welfare of the victims' families. 'This is why we have been conducting regular hospital visits to meet with the families, identify their needs, and provide welfare support,' he reportedly said after attending a special assembly at the Hilir Perak District Police Headquarters, where he presented 75 certificates of appreciation to those involved in managing the incident. The first officer to be discharged was Corporal Nizam Tarmizi, 38, on the day of the incident, followed by Lance Corporal Muhammad Aniq Taufiq Rozi, 26, on May 14; Corporal Mohd Harrisul Ikhsan Mohd Mahabudin, 39, on May 16; and Corporal Mohammad Zulnaidi Muhammad Zulkifli, 34, on May 17. Bakri added that senior police leadership have also made visits to the victims and their families to offer moral support.
