Ivan Joubert
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View article: Distribution and demographics of critical care subspecialists for adult patients in South Africa
Distribution and demographics of critical care subspecialists for adult patients in South Africa Open
Background. Critical care has been a recognised subspecialty in the Health Professions Council of South Africa (HPCSA) since 1992, with a formal examination to obtain the Certificate of Critical Care established in 1999 with the Colleges o…
View article: Mixed methods rapid evaluation of sedation practices in the intensive care units of a public sector tertiary academic hospital in South Africa
Mixed methods rapid evaluation of sedation practices in the intensive care units of a public sector tertiary academic hospital in South Africa Open
Background Sedation is routinely administered to mechanically ventilated ICU patients. Evidence-based practices such as the Richmond Agitation and Sedation Scale (RASS), Spontaneous Awakening Trials (SAT), and Spontaneous Breathing Trials …
View article: Exploring the influence of communication and team dynamics relating to infection care on intensive care unit patient discussions: Insights from sociograms and team reflexivity
Exploring the influence of communication and team dynamics relating to infection care on intensive care unit patient discussions: Insights from sociograms and team reflexivity Open
Mapping and quantifying interactions shows the distribution of power and influences in patient discussions. Sociograms and reflexive practices aid self-assessment of interactions to improve team dynamics. Structured communication strategie…
View article: Co-design of a nurse handover tool to optimise infection control and antimicrobial stewardship in a low resource setting intensive care unit: A nurse led collaboration
Co-design of a nurse handover tool to optimise infection control and antimicrobial stewardship in a low resource setting intensive care unit: A nurse led collaboration Open
Background The quality of intensive care unit (ICU) nursing handover impacts patient safety, including infection prevention and control (IPC) and antimicrobial stewardship (AMS) practices. We report a co-designed quality improvement study …
View article: SARS-CoV-2 Viral Replication Persists in the Human Lung for Several Weeks after Symptom Onset
SARS-CoV-2 Viral Replication Persists in the Human Lung for Several Weeks after Symptom Onset Open
Rationale: In the upper respiratory tract, replicating (culturable) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is recoverable for ∼4-8 days after symptom onset, but there is a paucity of data about the frequency and durat…
View article: Groote Schuur Hospital neurosurgical intensive care unit: A 2-year review of admission characteristics
Groote Schuur Hospital neurosurgical intensive care unit: A 2-year review of admission characteristics Open
Background. At Groote Schuur Hospital (GSH), the neurosurgical intensive care unit (NsICU) is a 6-bed unit headed by a specialist neurosurgeon with extensive experience in neurocritical care, working in close collaboration with intensivist…
View article: Core competencies in critical care for general medical practitioners in South Africa: A Delphi study
Core competencies in critical care for general medical practitioners in South Africa: A Delphi study Open
Background. Despite a high burden of disease that requires critical care services, there are a limited number of intensivists in South Africa (SA). Medical practitioners at district and regional public sector hospitals frequently manage cr…
View article: Intensive Care Unit Sluice Room Sinks as Reservoirs and Sources of Potential Transmission of Carbapenem-Resistant Bacteria in a South African Tertiary Care Hospital
Intensive Care Unit Sluice Room Sinks as Reservoirs and Sources of Potential Transmission of Carbapenem-Resistant Bacteria in a South African Tertiary Care Hospital Open
There is a higher density of CRB in the u-bend of ICU sluice room sinks which can act as a potential source of transmission. The data inform targeted CRB transmission-interruption strategies in resource-poor settings.
View article: SARS-CoV-2 viral replication persists in the human lung for several weeks after symptom onset
SARS-CoV-2 viral replication persists in the human lung for several weeks after symptom onset Open
Rationale In the upper respiratory tract replicating (culturable) SARS-CoV-2 is recoverable for ∼ 4 to 8 days after symptom onset, however, there is paucity of data about the frequency or duration of replicating virus in the lower respirat…
View article: The Feasibility of Early Chemical Thromboprophylaxis in Traumatic Brain Injury Patients Admitted to a Trauma ICU
The Feasibility of Early Chemical Thromboprophylaxis in Traumatic Brain Injury Patients Admitted to a Trauma ICU Open
Object: Traumatic Brain Injury (TBI) increases the risk of coagulopathy and thromboembolism, and its presence is a poor prognostic factor.There is no clear evidence to support recommendations regarding the preferred drug, dose or the timin…
View article: Effect of the Covid-19 Lockdown Regulations on the Severe Trauma Burden in an Urban Trauma Centre in Johannesburg, South Africa
Effect of the Covid-19 Lockdown Regulations on the Severe Trauma Burden in an Urban Trauma Centre in Johannesburg, South Africa Open
Background: During the Covid-19 pandemic, the South African government introduced stringent lockdown restrictions.Social restrictions affected patient presentation to hospitals with non-Covid related illnesses. Objectives:The aim of this r…
View article: The impact of enteral feeding and therapeutic monitoring of rifampicin with dose escalation in critically ill patients with tuberculosis
The impact of enteral feeding and therapeutic monitoring of rifampicin with dose escalation in critically ill patients with tuberculosis Open
We found low rifampicin concentrations in all patients receiving continuous enteral feeding. TDM-guided dose escalation provided an effective strategy to achieve target drug exposure in these critically ill patients with TB.
View article: The optimal management of the patient with COVID‐19 pneumonia: HFNC, NIV/CPAP or mechanical ventilation?
The optimal management of the patient with COVID‐19 pneumonia: HFNC, NIV/CPAP or mechanical ventilation? Open
The recent pandemic has seen unprecedented demand for respiratory support of patients with COVID‐19 pneumonia, stretching services and clinicians. Yet despite the global numbers of patients treated, guidance is not clear on the correct cho…
View article: A retrospective descriptive analysis of non-physician-performed prehospital endotracheal intubation practices and performance in South Africa
A retrospective descriptive analysis of non-physician-performed prehospital endotracheal intubation practices and performance in South Africa Open
Introduction Prehospital advanced airway management, including endotracheal intubation (ETI), is one of the most commonly performed advanced life support skills. In South Africa, prehospital ETI is performed by non-physician prehospital pr…
View article: A Retrospective Descriptive Analysis of Non-physician-performed Prehospital Endotracheal Intubation Practices and Performance in South Africa
A Retrospective Descriptive Analysis of Non-physician-performed Prehospital Endotracheal Intubation Practices and Performance in South Africa Open
Introduction: Prehospital advanced airway management (PHAAM), including endotracheal intubation (ETI), is one of the most commonly performed advanced life support skills. In South Africa, prehospital ETI is performed by non-physician preho…
View article: Outcomes of patients with COVID-19 acute respiratory distress syndrome requiring invasive mechanical ventilation admitted to an intensive care unit in South Africa
Outcomes of patients with COVID-19 acute respiratory distress syndrome requiring invasive mechanical ventilation admitted to an intensive care unit in South Africa Open
Background. Up to 32% of patients with COVID-19 pneumonia may require intensive care unit (ICU) admission or mechanical ventilation. Data from low- and middle-income countries on COVID-19 acute respiratory distress syndrome (ARDS) are limi…
View article: The organisational response of a hospital critical care service to the COVID-19 pandemic: The Groote Schuur Hospital experience
The organisational response of a hospital critical care service to the COVID-19 pandemic: The Groote Schuur Hospital experience Open
We describe the organisational requirements to successfully expand critical care facilities and strategies to reduce the need for invasive mechanical ventilation in COVID-19 pneumonia. We also present the intensive care outcomes of these p…
View article: Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa.
Outcomes of patients with COVID-19 Acute Respiratory Distress Syndrome requiring Invasive Mechanical Ventilation admitted to an Intensive Care Unit in South Africa. Open
Background Up to 32% of patients with COVID-19 pneumonia may require ICU admission or mechanical ventilation(1, 2). Data from low- and middle-income countries for COVID-19 ARDS are limited. Groote Schuur Hospital in Cape Town, South Africa…
View article: South African Guidelines on the Determination of Death
South African Guidelines on the Determination of Death Open
Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation. The following document compiled by the Critical Care Society of Southern …
View article: South African guidelines on the determination of death
South African guidelines on the determination of death Open
Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation. This document compiled by the Critical Care Society of Southern Africa ou…
View article: South African guidelines on the determination of death
South African guidelines on the determination of death Open
Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation. This document compiled by the Critical Care Society of Southern Africa ou…
View article: Critical care triage during the COVID-19 pandemic in South Africa: A constitutional imperative!
Critical care triage during the COVID-19 pandemic in South Africa: A constitutional imperative! Open
Triage and rationing of scarce intensive care unit (ICU) resources are an unavoidable necessity. In routine circumstances, ICU triage is premised on the best interests of an individual patient; however, when increased demand exceeds capaci…
View article: The mechanics of setting up a COVID-19 response: Experiences of the COVID-19 epidemic from Groote Schuur Hospital, Cape Town, South Africa
The mechanics of setting up a COVID-19 response: Experiences of the COVID-19 epidemic from Groote Schuur Hospital, Cape Town, South Africa Open
The SARS-CoV-2 pandemic has challenged the provision of healthcare in ways that are unprecedented in our lifetime. Planning for the sheer numbers expected during the surge has required public hospitals to de-escalate all non-essential clin…
View article: Clinical management of COVID-19: Experiences of the COVID-19 epidemic from Groote Schuur Hospital, Cape Town, South Africa
Clinical management of COVID-19: Experiences of the COVID-19 epidemic from Groote Schuur Hospital, Cape Town, South Africa Open
The SARS-CoV-2 pandemic has presented clinicians with an enormous challenge in managing a respiratory virus that is not only capable of causing severe pneumonia and acute respiratory distress syndrome, but also multisystem disease. The ext…
View article: Variation in timing of decisions to withdraw lifesustaining treatment in adult ICU patients from three centres in different geographies: Do clinical factors explain the difference?
Variation in timing of decisions to withdraw lifesustaining treatment in adult ICU patients from three centres in different geographies: Do clinical factors explain the difference? Open
This study has identified variation in the timing of decisions to withdraw life-sustaining treatment in adult ICUs in three centres in three different healthcare systems. Although differences in clinical decision-making likely explain some…
View article: The role of laboratory testing in hospitalised and critically ill COVID-19-positive patients
The role of laboratory testing in hospitalised and critically ill COVID-19-positive patients Open
The COVID-19 pandemic has placed healthcare resources around the world under immense pressure. South Africa, given the condition of its
\nhealthcare system, is particularly vulnerable. There has been much discussion around rational healthc…
View article: The Critical Care Society of Southern Africa guidelines on the allocation of scarce critical care resources during the COVID-19 public health emergency in South Africa.
The Critical Care Society of Southern Africa guidelines on the allocation of scarce critical care resources during the COVID-19 public health emergency in South Africa. Open
Letter by Gopalan et al. on article by Singh and Moodley (Singh JA, Moodley K. Critical care triaging in the shadow of COVID-19: Ethics considerations. S Afr Med J 2020;110(5):355-359. https://doi.org/10.7196/SAMJ.2020.v110i5.14778); and r…