Critical care medicine
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Critical care medicine · Feb 1979
Staff attitudes towards the care of the critically ill in the medical intensive care unit.
In an attempt to study the basis for conflict and tension surrounding decision making in ICU settings, a questionnaire was used to examine staff attitudes in a newly opened medical ICU in four major areas: (1) ethical issues; (2) decision-making process; (3) communications; and (4) emotional reactions of staff. All of the 36 house officers and 32 of 34 nurses (all RNs) completed the questionnaire. Results showed there was no monolithic nursing as opposed to physician position on any issue. ⋯ There was remarkable agreement between physician and nurse groups on ethical issues. However, nurses were less satisfied with the decision-making process and communication in the medical ICU and were more aware than physicians of their own and other's emotional reactions. The results suggested four ways to reduce tension in the medical ICU: (1) frankly recognize the inevitability of conflict and tension in a system where physicians have ultimate authority; (2) avoid perpetuating stereotypes; (3) maximize the continuity of physician care; and (4) maximize communication between and within professional groups.
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Critical care medicine · Jan 1979
Multiple determination of cardiac output using a two-bottle technique.
A technique is described to perform multiple determinations of cardiac output; two 150 ml bottles of 5% dextrose in water, stored in identical conditions, are immersed in an ice slush, contained in a styrofoam cooler. Comparison of cardiac output determinations obtained with this technique and with multiple syringes indicates very close duplication of results. The technique is very inexpensive and allows one to follow patients for up to four hours with as many as 30 consecutive determinations of cardiac output.
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Critical care medicine · Jan 1979
Comparative StudyComparison of assisted and controlled mechanical ventilation in anesthetized swine.
We compared assisted mechanical ventilation with controlled mechanical ventilation with and without PEEP in 10 anesthetized swine. Catheters were placed to measure airway, intrapleural, and blood pressure; PaO2 and PaCO2; arterial pH; total minute ventilation; and mixed exhaled oxygen and carbon dioxide tensions. We calculated the ratio of physiological dead space to tidal volume, alveolar minute ventilation, CO2 production, VO2, and RQ. We found no clinically or statistically significant difference between assisted and controlled ventilation.