Intensive care medicine
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Intensive care medicine · Oct 2001
Changes in the profile of paediatric intensive care associated with centralisation.
To compare intensive care admissions from a defined population of children in 1991 and 1999, during a period of organisational change and centralisation of paediatric intensive care. ⋯ Centralisation by expansion of the lead centre was associated with a large increase in the numbers of children receiving intensive care consistent with an unmet need for paediatric intensive care in 1991, which may still exist. Centralisation of paediatric intensive care may have contributed to the fall in child mortality over this time period.
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Intensive care medicine · Oct 2001
Case ReportsMassive pulmonary embolism with large floating thrombus in the truncus of the pulmonary artery.
A conservative strategy with anticoagulation led to spontaneous dissolution of a large floating thrombus (7.0x0.5 cm) in the truncus of the pulmonary artery in a 51-year-old woman with massive pulmonary embolism (pulmonary emboli in both lungs down to the level of the segmental arteries). Interventional therapy such as thrombolysis or pulmonary thrombectomy was not considered to be appropriate for this patient because of the risk of disrupture and embolization of parts of this large central thrombus. We believe that in certain cases with massive pulmonary embolism and large floating central thrombi a conservative strategy with anticoagulation may be appropriate. Such cases may be observed more often in the future using the technique of spiral computed tomographic angiography.
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To quantify the incidence and specify the types of medication administration errors from a list of error-prone medications and to determine if patient harm resulted from these errors. ⋯ This multicenter evaluation found fewer medication administration errors than the published literature, possibly due to the varying observational techniques and pharmacist involvement. Lorazepam and wrong infusion rates are associated with errors that occurred frequently, resulted in the greatest potential for harm and were common oversights in the system. These errors should be considered potential areas for betterment in the medication use process to improve patient safety.