Critical care clinics
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A health care facility must develop a comprehensive disaster plan that has a provision for critical care services. Mass critical care requires surge capacity: augmentation of critical care services during a disaster. ⋯ Having an adequate supply chain and a cache of critical care supplies is essential. Virtual critical care or tele-critical care can augment critical care capacity by assisting with patient monitoring, specialized consultation, and in pandemics reduces staff exposure.
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Radiation accidents are rare, but can produce large numbers of casualties with predictable patterns of injury. Casualties may suffer from a wide range of radiation exposures. ⋯ Treatment of acute radiation syndrome is supportive: including fluids, antibiotics, blood products, colony-stimulating factors, and stem cell or bone marrow transplantation. Care of radiation-injured patients with conventional trauma or burns needs to be modified to account for adverse effects of radiation on wound healing and susceptibility to infections.
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Natural disasters are extreme events generally caused by abrupt climate change and other environmental factors. Intensive care units (ICUs) need to be prepared, because in the event of a natural disaster, the number of patients that require service stresses an already occupied facility. ⋯ Efforts have been made to prepare the health care system to be ready for a disaster. A natural disaster can disrupt the daily routine of a hospital and ICU personal need to be equipped with the necessary tools to be able to respond appropriately.
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Critical care clinics · Oct 2019
ReviewSpecial Populations: Disaster Care Considerations in Chronically Ill, Pregnant, and Morbidly Obese Patients.
Special populations, which include the morbidly obese and patients with chronic, complex medical conditions that require long-term health care services and infrastructure, are at increased risk for morbidity and mortality when these services are disrupted during a disaster. Past experiences have identified significant challenges in restoring necessary care services to these patients following major environmental events. This article describes the impact of disasters on special populations, provides a framework for future disaster preparation and planning, and identifies areas in need of further research. Gravid patients, who are often overlooked in disaster planning and preparation, are also discussed.
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Critical care clinics · Oct 2019
ReviewIntensive Care Unit Preparedness During Pandemics and Other Biological Threats.
In the twenty-first century, severe acute respiratory syndrome (SARS), 2009 A(H1N1) influenza, and Ebola have all placed strains on critical care systems. In addition to the increased patient needs common to many disasters, epidemics may further degrade ICU capability when staff members fall ill, including in the course of direct patient care. In a large-scale pandemic, shortages of equipment and medications can further limit an ICU's ability to provide the normal standard of care. Hospital preparedness for epidemics must include strategies to maintain staff safety, secure adequate supplies, and have plans for triage and prioritization of care when necessary.