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Welcome to Critical Care Nursing in Resource Limited Environments

This blog / website has been created to become a resource for critical care nurses who work in resource limited environments. Initially, there will be an emphasis on critical care nursing within Sub-Saharan Africa and Indian subcontinent. It is understood that both areas have centres of excellence and advanced health technologies. However, this website is aimed at emerging centres of critical care that work in constrained conditions and yet provide Level I critical care.

High Acuity care. Post-anaesthesia care. Recovery. High Dependency Care. Intensive Care. Critical Care.

This website is dedicated to critical care nursing and how a registered nurse can consolidate and expand their ability and role within a safe, suitable and sustainable service.

Ultimately the website will incorporate the provision of critical care in remote locations; as occurs in conflict and catastrophe. These reflect the authors particular interests and professional experience.

In time, the site will be developed to combine the ethos and knowledge bases of  tropical nursing and critical care nursing in all resource-limited environments.

The website is a spin-off from a current PhD study regarding critical care nursing in resource limited environments (2017-2021). The content expresses the personal and professional opinions of various Editors and does not represent the view from any healthcare institution or University.

Glasgow Coma Score

A review of the GCS by David Muir and Adrama Faida will be presented on Thursday 14/12/17. at 16.00 hr (GMT). Review you’re own practice and join the discussion.

Early Enteral Feeding

Early enteral feeding is not dependent on presence of bowel sounds but should be delayed in patients with >500 millilitres gastric residual volume in 6 hour period.

South African Triage Scale (SATS)

Patients become critically ill before they appear on ICU. Ideally, a pre-hospital life support is available within a local ambulance service. In reality, many deteriorating patients simply arrive at a clinic or hospital and join a queue of people waiting to be seen by a doctor or a nurse.

The SATS system is an effective and evidence-based method of sorting and prioritising adults and children according to the severity of their illness. It provides a way of screening the severity of illness of adults and children as they arrive at a clinic or hospital.

The above website contains a large collection of clinical guidelines and learning resources.

The manual is currently under review and a revised version is scheduled for late 2017.

The SATS system has been designed and tested in resource limited environments and the literature and audio-visual guides are full of practical content.

The Silent Child

The silent emergency – the critically ill child. What are the oxygen requirements?

Information about neonatal resuscitation in resource limited environments

Neonatal resuscitation in low resource settings

Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths


Essential Obstetric Care in resource poor settings

Essential Obstetric Care in resource poor settings

Caring for the Critically Ill in the Tropics

This book is published by Macmillan and it is available in the Africa catalogue. It can be difficult to locate as it is currently out-of-print but a reprint is scheduled for July 2011. There is a chapter that discusses the nursing care of critically ill patients in the Tropics, aka, critical care nursing in resource limited environments.

About Me

I am a Registered Nurse (UK)  with a particular interest in critical care nursing in resource limited environments.

In the mid-eighties the technology within Intensive Care Units in UK was limited. The equipment and technology was in use tended to be robust, unsophisticated and often reusable. In contrast, the current technology utilised within UK critical care units is highly sophisticated and utilise single-use items.

I would like to reevaluate and renew some of the techniques and technology that have previously been used by critical care nurses, that may be applicable to resource limited environments. Equally, i would like to highlight innovative practices that are undertaken by critical care nurses within resource limited environments.

I have had a long career as a critical care nurse, lecturer practice educator, global health lecturer and combat military technician. I intend to utilise all these influences to establish resources and clinical practice for registered nurses that work in a critical care setting within a resource-limited environment.

I am also under taking doctoral research into the educational needs of registered nurses who work in critical care units in resource limited environments.

David Muir