Journal of critical care
-
Journal of critical care · Dec 2015
Interobserver agreement in the evaluation of B-lines using bedside ultrasound.
We evaluated agreement among trained emergency physicians assessing the degree of B-line presence on bedside ultrasound in patients presenting to the emergency department (ED) with acute undifferentiated dyspnea. We also determined which thoracic zones offered the highest level of interobserver reliability for sonographic B-line assessment. ⋯ Interrater agreement was best in the anterior/superior thoracic zones followed by the lateral/superior zones for both expert/expert and expert/novice pairs. Agreement in the lateral/inferior lung zones was overall inferior. Intrarater agreement was highest at extreme high or low numbers of B-lines.
-
Journal of critical care · Dec 2015
Intensive care unit capacity strain and adherence to prophylaxis guidelines.
The purpose of the study is to examine the relationship between different measures of capacity strain and adherence to prophylaxis guidelines in the intensive care unit (ICU). ⋯ Rising capacity strain in the ICU reduces the odds that patients will receive appropriate VTEP but not SUP. The variability among different types of ICUs in the extent to which strain degraded VTEP use suggests opportunities for systems improvement.
-
Journal of critical care · Dec 2015
Observational StudyA quality improvement project to decrease emergency department and medical intensive care unit transfer times.
To reduce transfer time of critically ill patients from the emergency department (ED) to the medical intensive care unit (MICU). ⋯ A team made up of frontline health care professionals using a structured quality improvement process and implementing multifaceted, multistage interventions, reduced transfer delays, and length of stay. Added benefits included engagement among members of the 2 microsystems and a more cohesive approach to patient care.
-
Journal of critical care · Dec 2015
Key stakeholders' perspectives on a Web-based advance care planning tool for advanced lung disease.
There is a paucity of scalable advance care planning strategies that achieve the diverse goals of patients, families, and clinicians. We convened key stakeholders to gain their perspectives on developing a Web-based advance care planning tool for lung disease. ⋯ There is strong stakeholder support for the development of a Web-based advance care planning tool for lung disease.
-
Journal of critical care · Dec 2015
Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy.
Creatinine kinase isoenzyme-MB (CK-MB) is a biomarker for detecting myocardial injury. The aim of this study was to evaluate the association between admission CK-MB levels and in-hospital and long-term clinical outcomes in pulmonary embolism (PE) patients treated with thrombolytic tissue-plasminogen activator. ⋯ Creatinine kinase isoenzyme-MB is a simple, widely available, and useful biomarker for predicting adverse in-hospital clinical outcomes in PE.