essential interventions in critical care

... conducting trials and for clinicians attempting to critically appraise their results These difficulties include determining a representative study population, defining the intervention and deploying ... Critical Care Vol 12 No Delaney et al improve the management of all patients in the intensive care unit (ICU) [7] Complex interventions are defined as interventions or therapies ... guidance to clinicians regarding the timing of these interventions Comparison group Placebo The control group could receive ‘usual care as determined by individual clinicians, a defined protocol...

Ngày tải lên: 13/08/2014, 08:21

... Outcomerea Database Investigators: Reliability of diagnostic coding in intensive care patients Crit Care 2008, 12:R95 Martin GS: Epidemiology studies in critical care Crit Care 2006, 10:136-137 ... Critical Care Vol 12 No Martin many healthcare databases, their use has expanded from the original intent to permit novel research investigations for important areas in healthcare For ... to the OutcomeRea database, to local coding practices or training, to national effects specific to France, or to influences of critical care or critical care medical conditions Regardless, the...

Ngày tải lên: 13/08/2014, 11:22

... error interception Intensivist participation in ICU care Adequate staffing Pharmacist participation in ICU care Incorporation of quality assurance into academic education ICU, intensive care unit ... errors involving continuously infused medications in a surgical intensive care unit Crit Care Med 2004, 32:428-432 80 Stambouly JJ, McLaughlin LL, Mandel FS, Boxer RA: Complications of care in a ... Impact of a clinical pharmacist in a multidisciplinary intensive care unit Crit Care Med 1994, 22:10441048 66 Baldinger SL, Chow MS, Gannon RH, Kelly ET 3rd: Cost savings from having a clinical pharmacist...

Ngày tải lên: 25/10/2012, 10:35

... becoming important in critical care Infectious Diseases in Critical Care Medicine (third edition) remains the only book exclusively dedicated to infectious diseases in critical care Importantly, Infectious ... 19 Infections in Cirrhosis in Critical Care Laurel C Preheim 20 Severe Infections in Asplenic Patients in Critical Care Mohammed S Ahmed and Nancy Khardori 21 Infections in Burns in Critical Care ... in the critical care unit Infectious diseases maintain their preeminence in the critical care unit setting because of their frequency and importance in the critical unit patient population Since...

Ngày tải lên: 06/03/2014, 06:20

... Following the development of the Statement on Competence, a working group met in 2009 to develop guidelines for training in critical care ultrasonography Representatives from major critical care ... Training Standards serve as useful guides both for the intensivist who seeks training and for faculty intensivists who will be training their colleagues in this important skill Competing interests ... cardiologist who is trained in echocardiography It includes training in transesophageal echocardiography (TEE) Competence in advanced level CCE is not a key element of competence in critical care ultrasonography...

Ngày tải lên: 21/06/2014, 00:20

... (O), and Italy and Spain none TRAINING IN INTENSIVE CARE MEDICINE IN THE UK An increasing number of appointments in ICM are now available to trainees in general internal medicine at senior house ... rehabilitation.9 TRAINING IN INTENSIVE CARE MEDICINE Improved training of medical and nursing staff and organisational changes have undoubtedly played their part in improving the outcome of critical illness ... the growing numbers of respiratory physicians who pursue a subspecialty interest in this clinical arena T EVOLUTION OF INTENSIVE CARE MEDICINE AS A SPECIALTY In Europe intensive care medicine (ICM)...

Ngày tải lên: 29/06/2014, 11:20

... albumin-to-creatinine ratio, ASA = aspirin, ACE/ARB = angiotensin-modifying agent guidelines for glucose, LDL, and BP; and the prescriptions rates for insulin, beta blockers, angiotensin-modifying ... improvement interventions include some degree of feedback, making this the ‘usual care comparator) [23] In particular, the Ministry of Health and Long-Term Care in Ontario (MOHLTC) is providing feedback ... of would indicate testing of urinary microalbumin and serum LDL within a year, measuring BP and glycosylated haemoglobin within six months, and having active prescriptions for a statin and an...

Ngày tải lên: 10/08/2014, 10:23

... monitoring) The CWG continues to be involved in this phase to assist researchers in interpreting feedback from the evaluation process Training Training of selected staff members at participating ... organizations is essential in implementing and sustaining the intervention The training should begin soon after package dissemination and should review the manuals and include role playing to showcase ... incorporation into job duties, securing funding, and training new personnel), re-customizing intervention delivery as circumstances change, and preparing the refined package, training, and TA program...

Ngày tải lên: 11/08/2014, 05:22

... monitoring) The CWG continues to be involved in this phase to assist researchers in interpreting feedback from the evaluation process Training Training of selected staff members at participating ... organizations is essential in implementing and sustaining the intervention The training should begin soon after package dissemination and should review the manuals and include role playing to showcase ... incorporation into job duties, securing funding, and training new personnel), re-customizing intervention delivery as circumstances change, and preparing the refined package, training, and TA program...

Ngày tải lên: 11/08/2014, 16:20

... critical- care calculations, such as calculated creatinine clearance and intravenous infusion rates Additional software for medical reference data was introduced during the study period, including ... advantages and increasing use of handheld computers in medicine, we evaluated the benefits and drawbacks associated with introducing this technology in an academic ICU Harris-Benedict equation Intravenous ... used This appeared to relate more to inadequate training than to faults in the databases In many cases, the PDA users were unaware that certain information was in their PDAs This was because data...

Ngày tải lên: 12/08/2014, 18:21

... Gastrointestinal promotility drugs in the critical care setting: a systematic review of the evidence Crit Care Med 2002, 30:1429-1435 Tisherman SA, Marik PE, Ochoa J: Promoting enteral feeding ... Metoclopramide versus erythromycin and cisapride* 10 *Studies of agents that are available as prokinetics in contemporary practice In view of recent critical care trials, it is disappointing that neither the ... erythromycin were attenuated in healthy individuals when their blood glucose concentrations were increased from approximately to 15 mmol/l [18] Another study [19], published in June 2002 in Critical Care...

Ngày tải lên: 12/08/2014, 19:21

... conflicting results regarding albumin, and as such clinicians have been confused on the issue of the safety of albumin Finally, at least for critically ill patients, with the publication of the Saline ... in the albumin arm with significantly less fluid administration, in a ratio of 1:1.4 (albumin versus normal saline) over the first days However, various subgroup analyses did reveal interesting ... albumin in sepsis has been examined in various in vitro and animal models, but the physiologic basis of this effect in vivo is not known [2] The increased risk of mortality among trauma patients in...

Ngày tải lên: 12/08/2014, 20:20

... both in terms of the safety of research participants and in public trust in the research enterprise Challenges in oversight and monitoring The lack of effective oversight and monitoring in clinical ... investigators and clinical departments, and institutional pride in affording these issues the time, resources and intellectual commitment that they deserve The appropriate role for critical care ... challenges inherent in critical care research, it would be tempting to propose a separate and distinct approach to their monitoring and oversight We not see it that way Although perplexing challenges...

Ngày tải lên: 12/08/2014, 20:20

... in Medline/PubMed and CINAHL databases using combinations of the following keywords: Ethics, Clinician-Manager, Critical Care, Intensive Care Unit (ICU), Management, Leadership, Decision-making, ... have been captured in the initial search We also hand-searched the following journals: Bioethics (1997 to present), Critical Care, Critical Care Clinics, Critical Care Medicine (1985 to present), ... withdrawal of intensive care Chest 1990, 97:949-958 Nelson RM: Ethics in the intensive care unit: creating an ethical environment Crit Care Clinics 1997, 13:691-710 York NL: Implementing a family...

Ngày tải lên: 12/08/2014, 20:20

... (GDP) icine are published in journals other than those included in the 'critical care medicine' category Furthermore, a proportion of articles published in journals included in the 'critical care ... example, in order to search for articles published in 'intensive care medicine' originating from Europe, the following phrase was used (where 'AD' means 'address'): intensive care medicine [journal] ... take into account the fact that many articles regarding critical care med- R262 Critical Care Vol No Michalopoulos et al Table 'Total product' of articles published in 'critical care medicine':...

Ngày tải lên: 12/08/2014, 22:21

... numerous investigations in sepsis Goscinski and colleagues [21] investigated the ability of tobramycin and ceftazidime to alter the inflammatory response to endotoxin infusion Prior to endotoxin administration, ... N-acetylcysteine infusion in patients with severe sepsis Patients in the N-acetylcysteine group (n = 27) received an intravenous bolus followed by a continuous infusion for 411 Critical Care August ... response to infection in patients with septic shock Insulin and glycemia in sepsis Rusavy and colleagues [16] compared energy expenditure and glucose uptake in response to insulin in non-diabetic...

Ngày tải lên: 12/08/2014, 22:22

... acute hypoxia Although plasma renin activity and angiotensin II immunoreactivity increased during hypoxia, angiotensin-converting enzyme inhibition and type angiotensin II receptor blockade did not ... during and after liberation from mechanical ventilation using pressure support, CPAP, and T-piece (n = 20 each) During weaning, plasma insulin and glucose as well as urinary vanilmandelic acid increased ... with aerosolized colistin as an adjunct to intravenous antimicrobial therapy (including intravenous colistin in 6/8 patients) for Gram-negative nosocomial pneumonia (seven Acinetobacter baumannii,...

Ngày tải lên: 12/08/2014, 22:22

... work training in the areas of conflict resolution, learning styles and giving feedback will help the staff to work together to create and achieve an inspiring vision [12] Although the financial ... work Competing interests The author(s) declare that they have no competing interests References Laporta D, Burns J, Doig C: Bench to bedside review: Dealing with increased intensive care unit ... satisfaction: Examination of a team-building approach J Nurs Adm 2005, 35:110-120 13 Kelley M, Angus D, Chalfin D, Crandall E, Ingbar D, Johanson W, Medina J, Sessler C, Vender J: The critical care crisis:...

Ngày tải lên: 12/08/2014, 22:22

... online http://ccforum.com/content/9/6/594 Table Table Indications for independent lung ventilation in critical care Comparative sizing of single-lumen , Univent and double-lumen tubes [12] Independent ... degrees to the left and finally advanced into the left main stem bronchus until resistance is felt Keeping the double-lumen tube stylet in place after intubation increases positioning accuracy from ... tried in pre-operative assessment, their practicality in critical care medicine is questionable Chest X-rays are subsequently used to assess correct positioning post-intubation by identifying the...

Ngày tải lên: 12/08/2014, 23:20

... saved using the qMRSA test • A substantial decrease in MRSA infections was seen in the medical ICU after increasing compliance with onadmission screening and implementing a strategy that linked ... for controlling methicillin-resistant Staphylococcus aureus in intensive care units Intensive Care Med 2005, 31:1051-1057 Page of (page number not for citation purposes) Critical Care Vol 10 ... streaked onto ORSA plates (Oxacillin Resistance Screening Agar; Oxoid, Basingstoke, UK) and then suspended in ml colistin-salt broth (brain–heart infusion with 10 µg colistin/ml and 2.5% NaCl) as a backup...

Ngày tải lên: 12/08/2014, 23:21