Crit Care Resusc
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Multicenter Study
Terror Australis 2004: preparedness of Australian hospitals for disasters and incidents involving chemical, biological and radiological agents.
To assess the level of preparedness of Australian hospitals, as perceived by senior emergency department physicians, for chemical, biological and radiological (CBR) incidents, as well as the resources and training available to their departments. ⋯ This survey raises significant questions about the level of preparedness of Australian EDs for dealing with patients from both conventional and CBR incidents. Hospitals need to review their plans and functionality openly and objectively to ensure that their perceived preparedness is consistent with reality. In addition, they urgently require guidance as to reasonable expectations of their capacity. To that end, we recommend further development of national standards in hospital disaster planning and preparedness.
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Comparative Study
Missed opportunities? An observational study of vital sign measurements.
To determine the frequency of monitoring of patient vital signs in two wards of a tertiary hospital. ⋯ Blood pressure, heart rate and temperature were the most diligently recorded vital signs, but documentation of respiratory rate was poor. Failure to perform vital sign measurements may underpin the failure to recognise patients in general wards whose condition is deteriorating.
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Comparative Study
Hypothermia on arrival in the intensive care unit after surgery.
Minimising perioperative hypothermia is a priority for anaesthetists. However, there are few studies of postoperative hypothermia in intensive care units. We tested the hypotheses that many patients arrive in the ICU with hypothermia and that patients are warmer after cardiac surgery than after non-cardiac surgery. ⋯ Hypothermia is common among postoperative patients admitted to our ICU. We suggest that ICU staff should routinely expect to actively warm postoperative patients, particularly after non-cardiac surgery, and should have sufficient resources to do so.
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It is often assumed that critical care outcomes in the elderly are uniformly poorer than those in younger populations. We examined the pattern of admissions to our intensive care unit in Dublin, Ireland, between 2002 and 2005 to determine the admission characteristics and mortality in those aged 80 years and older. ⋯ The nature of the admission and severity of illness, but not age, are determinants of ICU survival. Evidence-based criteria are needed to assess the appropriateness of ICU admission in the very elderly. Clear criteria would help to prevent initiation of futile therapies and also to ensure that the very elderly are not denied potentially beneficial ICU care. We need to study triage patterns and outcome data further to ensure that the very elderly have the same opportunities to access appropriate intensive care treatment as the rest of the population.
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To review the indications for admission, demographics, clinically relevant aspects of medical care and outcomes of critically ill obstetric patients admitted to a tertiary hospital intensive care unit. ⋯ This audit is a reminder that continued vigilance is required to ensure maternal safety. It also emphasises the need to integrate free-standing maternity units with hospital intensive care services.