The Hong Kong Society of Critical Care Medicine Position Statements

The HKSCCM Position Statement: Guidelines on Certification of Death Following the Irreversible Cessation of Brainstem Function (2015)

Endorsed in July 2015
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INTRODUCTION

The irreversible cessation of brainstem function (“brainstem death”) is established by the documentation of irreversible coma and irreversible loss of brain stem reflex responses and respiratory center function or by the demonstration of the cessation of intracranial blood flow. Despite philosophical arguments, the concept that brainstem death is equivalent to death is accepted legally and within the medical community in Hong Kong. Once brainstem death has occurred, artificial life support is inappropriate and should be withdrawn. It is good medical practice to recognize when brainstem death has occurred and to act accordingly, sparing relatives from further emotional trauma of futility.

The HKSCCM Position Statement: Massive Transfusion Protocol in Trauma

Position Statement of the Hong Kong Society of Critical Care Medicine
Massive Transfusion Protocol in Trauma
Author:
Dr Chau Chin Man, Associate Consultant, Intensive Care Unit, North District Hospital, Hong Kong
On behalf of the Hong Kong Society of Critical Care Medicine
This Position Statement was endorsed by the HKSCCM Council in the 20th Council Meeting on 22nd July 2012

Early identification of the patient at risk for massive transfusion
Formula driven transfusion practice due to evolving data from military penetrating trauma, suggests improved outcomes for patients transfused in excess of 10 U of packed red cells in retrospective cohort studies.
Plasma transfusion in patients without massive transfusion was associated with a trend toward increased mortality and was also associated with an increased rate of lung injury. Additionally, transfusion of plasma to patients who do not require it raises issues of resource utilization.1

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The HKSCCM Position Statement: The Use of Hypothermia After Cardiac Arrest

Position Statement of the Hong Kong Society of Critical Care Medicine
The Use of Hypothermia After Cardiac Arrest
Author:
Dr LEUNG Kit Hung, Anne (Consultant, Queen Elizabeth Hospital, Hong Kong)
On behalf of the Hong Kong Society of Critical Care Medicine
 
This Position Statement was endorsed by the HKSCCM Council in the 20th Council Meeting on 19th July 2011

Recommendations on the use of therapeutic hypothermia (32-34 oC) after cardiac arrest
1. Cardiac arrest patients who present with ventricular fibrillation or nonperfusiong ventricular tachycardia, are resuscitated to hemodynamic stability, but remain unresponsive should receive therapeutic hypothermia (32oC to 34oC for 12-24 hours)
2. Therapeutic hypothermia (32oC to 34oC for 12-24 hours) should be considered for rhythms other than VF ie cardiac arrest patients who present with asystole or pulseless electrical activity; felt to be of cardiac origin and are resuscitated to hemodynamic stability, but remain unresponsive.
3. Therapeutic hypothermia should be initiated as soon as possible

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The HKSCCM Position Statement: The Role of Molecular Adsorbent Recirculating System (MARS) in the Intensive Care Unit

Position Statement of the Hong Kong Society of Critical Care Medicine
The Role of Molecular Adsorbent Recirculating System (MARS) in the Intensive Care Unit
Authors:
1. Dr Alexander CHIU (MBChB, MRCP(UK),FHKCP,FHKAM(Med),FRCP(Edin), Specialist in Critical Care Medicine. Cluster Director, Quality and Safety, Hong Kong West Cluster, Hospital Authority, Hong Kong SAR), & 
2. Professor Sheung Tat FAN (MS, MD, PhD, DSc, State Key Laboratory for Liver Research, The University of Hong Kong and Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China)
On behalf of the Hong Kong Society of Critical Care Medicine
 
This Position Statement was endorsed by the HKSCCM Council in the 20th Council Meeting on 24th May 2011

Fig. A patient on MARS in Queen Mary Hospital, Hong Kong

Introduction

Intensive Care Units are constantly consulted by peers, health authorities and even the public about application of liver support technology in patients with hepatic failure. This article serves to provide the readership the official stance and evaluative opinion of HKSCCM on the use of Molecular Adsorbent Recirculating System (MARS), one of the most commonly applied extracorporeal liver support technology as of the latest evidence available.

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2000 Jan 22 - HKSCCM Position Statement: Withholding or withdrawal of life support in the Intensive Care Unit

 Date: 22 Jan 2000 by Dr Florence Yap (Chairlady) on behalf of the Hong Kong Society of Critical Care Medicine
This was a statement issued in 2000 to the Hong Kong Medical Council in response to an article in the South China Morning Post regarding withholding or withdrawal of life support in the Intensive Care Unit. For your reference. 

To: The Hong Kong Medical Council

Re. Withholding or withdrawal of life support in the Intensive Care Unit
As a group of concerned medical practitioners, we welcome the attention the Medical Council paid to the important issue of the dying process of patients in Hong Kong. However, we would like to express some concern regarding the press release (South China Morning Post, 14 January 2000) from the Medical Ethics Committee regarding the ‘sanctioning of passive euthanasia’. We would like to respectfully bring to the Council’s attention our opinion regarding four important points made in the article.

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The HKSCCM Position Statement: Prevention of Venous Thromboembolism in Intensive Care Units in Hong Kong

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Position Statement of the Hong Kong Society of Critical Care Medicine
Prevention of Venous Thromboembolism in Intensive Care Units in Hong Kong 
Dr Thomas ST LI, Prince of Wales Hospital, on behalf of the Working Group for the Prevention of Venous Thromboembolism in ICU in Hong Kong and the HKSCCM
This Position Statement was endorsed by the HKSCCM Council in the 15th Council Meeting on 20th July 2010

Prevention of venous thromboembolism (VTE) in critically ill patients has been advocated by various international guidelines (1,2). The American College of Chest Physicians guideline in 2008 suggests that all patients should be assessed for risk of VTE on admission to ICU. Most patients should receive thromboprophylaxis. For patients who are at high risk for bleeding, mechanical prophylaxis with graduated compression stocking and/ or intermittent pneumatic compression should be used until bleeding risk decreases. For patients with moderate risk for VTE (eg. medically ill patients or postoperative patients), low dose unfractionated heparin or low molecular weight heparin is recommended. For patients with high risk for VTE (following major trauma or orthopaedic surgery), low molecular weight heparin is recommended.

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The HKSCCM Position Statement: Protocol of Hyperbaric Oxygen Therapy for Critically Ill Patients in Hong Kong


Position Statement of the Hong Kong Society of Critical Care Medicine
Protocol of Hyperbaric Oxygen Therapy for Critically Ill Patients in Hong Kong
Dr YAN Wing Wa, Chairman of the Hong Kong Society of Critical Care Medicine (HKSCCM), on behalf of the HKSCCM
This Position Statement was endorsed by the HKSCCM Council in the 14th Council Meeting on 18th May 2010


Figure. The Recompression Treatment Centre at Ngong Shuen Chau, Hong Kong. For more photos, click here
Introduction

Hyperbaric oxygen (HBO) therapy is the breathing of 100% oxygen inside a treatment chamber at a pressure higher than one atmosphere absolute (1 ATA).

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The HKSCCM Position Statement: Catheter Associated Blood Stream Infection

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Position Statement of the Hong Kong Society of Critical Care Medicine

CATHETER ASSOCIATED BLOOD STREAM INFECTION
Dr CHAN Wai Ming, on behalf of the HKSCCM 
This position statement was endorsed by the HKSCCM Council in Feb 2010

Definitions
1. Central line: A vascular infusion device terminates at or close to the heart or in one of the great vessels.

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