Current opinion in critical care
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Trauma systems are introduced world wide with the goal to improve survival and outcome of the injured patient. This review is focused on the influence of trauma systems on the survival and outcome of injured patients. ⋯ Trauma systems indeed improve survival rates in injured patients. Inclusive trauma systems do better than exclusive trauma systems. More attention should be given to quality of outcome.
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The ageing population, changing societal expectations and medical workforce shortages have created an unprecedented demand for intensive care services. This review describes the challenges to supporting rural-based critical care and discusses potential solutions for ensuring not only that rural patients receive a comparable level of care to their metropolitan counterparts, but also that patient outcomes are equivalent. ⋯ A number of solutions for supporting critical care in rural communities exist. None of these strategies are stand-alone solutions, nor are they universally applicable. Individual healthcare regions need to implement different strategies depending on local requirements and resources. Ultimately, lobbying for productive changes to healthcare policy will ensure the long-term viability of rural critical care.
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Curr Opin Crit Care · Dec 2007
ReviewEducation and simulation techniques for improving reliability of care.
Multiple factors influence the dependability of intensive care provision. The management of a group of unstable, critically ill patients requires focused attention from the clinical team. Medical simulation is an important tool to improve safety and team work within the ICU. ⋯ This review summarises the evidence and opinion about how simulation tools can be optimally used. In addition, we propose an educational strategy to optimise the impact on clinical practice by embedding simulation training in a multidisciplinary teaching programme based upon a specifically developed curriculum focusing on the teaching of crisis resource management and patient safety.
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The early detection of acute kidney injury may allow for timely preventive or therapeutic measures. This review discusses the role of traditional and novel biomarkers in early acute kidney injury diagnosis. ⋯ The early detection of acute kidney injury is a clinical and research priority. Traditional measures may contribute to delayed acute kidney injury diagnosis. Recent biomarkers have promise for earlier detection and for research into novel interventions.