Current opinion in critical care
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Curr Opin Crit Care · Aug 2009
ReviewData based integration of critical illness and injury patient care from EMS to emergency department to intensive care unit.
Describe the challenges and opportunities for an integrated emergency care data system for the delivery and care of critical illness and injury. ⋯ Given its time-sensitive nature, new data systems and analytic methods will be required to examine the impact of emergency care. The linkage of emergency care data systems to outcomes based systems could create an ideal environment to improve patient morbidity and mortality in critical illness and injury.
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Curr Opin Crit Care · Aug 2009
ReviewA systems approach to the early recognition and rapid administration of best practice therapy in sepsis and septic shock.
The early recognition and treatment of sepsis is paramount to reducing the mortality of this disease. However, unlike trauma, stroke or acute myocardial infarction, the initial signs of sepsis are subtle and easily missed by clinicians. Thus, hospital-based systems are needed to identify and triage patients who might be septic. This review focuses on the early diagnosis of sepsis and the implementation of a systems-based approach to help coordinate the identification and treatment of patients with this disease. ⋯ The institution of a rapid response system for the detection and treatment of septic shock requires a multidisciplinary approach. The infrastructure to create such a system must be facilitated by administrators and implemented by front-line healthcare providers. Continuous assessment of the outcome benefit of such a system by a quality assurance team is the final part of a truly integrated approach to sepsis treatment.
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This review will examine the current scenario of critical care medicine and describe trends for the future. ⋯ The future of ICU will rely on management and teamwork. The costs of critical care will be restrained through the use of better management, guidelines, and skepticism regarding new technologies and drugs. Policy makers will help society build better strategies for critical care services.
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To provide updated information on recent developments within individual components of multimodal interventions to improve postoperative outcome (fast-track methodology). ⋯ Procedure-specific standardization of perioperative care programs (the fast-track methodology) should be adopted more widely and adjusted to current scientific evidence.