Critical care clinics
-
Despite decades of studies and experiences, an evidence-based medicine consensus on the more appropriate treatment of trauma patients in the out-of-hospital setting has not yet been achieved. Different approaches exist and no one has been demonstrated clearly superior over the others for all circumstances and for all patients. A number of factors likely account for this finding.
-
Timely diagnosis of the different severities of septic inflammation is potentially lifesaving because therapies that have been shown to lower mortality should be initiated early. Sepsis and severe sepsis are accompanied by clinical and laboratory signs of systemic inflammation but patients with inflammation caused by noninfectious causes may present with similar signs and symptoms. ⋯ This article presents currently interesting sepsis biomarkers. Other novel markers and their potential role are discussed.
-
Critical care clinics · Jul 2006
The World Federation: enhancing global critical care practice and performance.
The World Federation of Societies of Intensive and Critical Care Medicine is an international organization composed of 42 members of national societies of intensive and critical care medicine representing approximately 38,000 physicians and allied health professionals. To appreciate the importance of international collaboration in various specialties, it is imperative to recognize not only the similarities within health systems, but also to recognize the international focus of disease.
-
Critical care clinics · Jul 2006
Consensus forum: worldwide guidelines on the critical care nursing workforce and education standards.
This article explores the key themes, evidence, and arguments that inform the current position statements. It is acknowledged that future research, evidence, and practice experience may create the need to review and change these guidelines. Reform and refinement of the guidelines are inevitable; however, the current guidelines represent the best attempt yet to reach international consensus on what are appropriate standards to guide critical care nursing education and workforce requirements.
-
Critical care clinics · Apr 2006
ReviewSedative and analgesic medications: risk factors for delirium and sleep disturbances in the critically ill.
Sedatives and analgesics are routinely used in critically ill patients, although they have the potential for side effects, such as delirium and sleep architecture disruption. Although it should be emphasized that these medications are extremely important in providing patient comfort, health care professionals must also strive to achieve the right balance of sedative and analgesic administration through greater focus on reducing unnecessary or overzealous use. Ongoing clinical trials should help us to understand whether altering the delivery strategy, via daily sedation interruption, or protocolized target-based sedation or changing sedation paradigms to target different central nervous system receptors can affect cognitive outcomes and sleep preservation in our critically ill patients.