Critical care clinics
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Critical care clinics · Oct 2019
ReviewChemical Agents in Disaster: Care and Management in the Intensive Care Unit.
Chemical agents of warfare are divided into lung agents, blood agents, vesicants, and nerve agents. Intensivists must familiarize themselves with the clinical presentation and management principles in the event of a chemical attack. ⋯ Patients may make complete recovery with aggressive supportive care, even if they appear to have a poor prognosis. Hospitals must have an emergency response disaster plan in place to deal with all potential causes of disasters, including illnesses resulting from chemical agents.
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Children are affected by all types of disasters disproportionately compared with adults. Despite this, planning and readiness to care for children in disasters is suboptimal locally, nationally, and internationally. ⋯ Some are pediatric focused or have pediatrics well integrated into the greater coalition. This article discusses key points of pediatric disaster planning, specific vulnerabilities, and the care of children in general and in specific disaster situations.
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Telehealth in intensive care units (TeleICU) is the provision of critical care using audio-visual communication and health information systems across varying clinical and geographically dispersed settings. The optimal structure of a TeleICU team is one that leverages expert clinical knowledge to address the needs of critical care patients, regardless of hospital location or availability of an onsite intensivist. Information related to the optimal TeleICU team structure is lacking. This article examines the optimal TeleICU team composition, which is one that incorporates the use of an interdisciplinary approach, leverages technology, and is cognizant of varying geographic locations.
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Critical care clinics · Jul 2019
ReviewEvolution of the Intensive Care Unit Telemedicine Value Proposition.
Advances in clinical information sciences, telecommunication technologies, electronic health records, early warning systems, automated acuity assessment, and clinician communication support systems have allowed current-generation intensive care (ICU) telemedicine systems to address the inefficiencies of the failed advice-upon-request ICU telemedicine model. Value is related to the ability of health care systems to leverage ICU telemedicine resources to provide care. Local financial benefits of ICU telemedicine program implementation depend on changing behavior to better focus on activities that reduce the duration of critical illness and length of stay.